Aurora Health Care Accountable Care Organization

At Aurora Health Care, we’re committed to helping you live well. That’s why we work closely with Medicare to help ensure you not only receive high-quality care but that every dollar spent on that care is spent wisely.

What is an Accountable Care Organization (ACO)?

An Accountable Care Organization (ACO) is a group of doctors, hospitals and other health care clinicians who agree to work together with Medicare to make sure you get the support you need to get and stay healthy and the care you need when you’re sick. ACOs have agreements with Medicare to be financially accountable for the quality, cost of care and the experience you receive.

Does an ACO change my Medicare benefits?

Your doctor’s participation in an ACO doesn’t change your Medicare benefits. An ACO is not an HMO managed care or Medicare Advantage plan. You still have original Medicare (Medicare fee-for-service), and your Medicare services, rights and protections also haven’t changed. An ACO can’t tell you which doctors and clinicians to see or hospital to visit and can’t limit your Medicare benefits. Your doctor may make recommendations based on quality, but it’s always your choice when it comes to which doctors or hospitals you use.

What kind of providers are part of the Aurora ACO?

Aurora has a network of doctors, clinicians, hospitals, outpatient clinics, a homecare company, and skilled nursing facility partners. Our network includes doctors employed by Aurora and private doctors who have a close relationship with our hospitals and outpatient services.

How does the Aurora ACO help me?

Aurora has care managers, nurses and social workers to help you and your family with navigating and coordinating your health care needs. This is called care management or care coordination services.

• If eligible, we provide you and your family with individualized support for the transition home or to your next site of care through our Care Transitions Program.
  • Upon discharge, you will be provided with a Care Transition Nurse Navigator (Transitions Nurse) and/or a series of follow-up phone calls and videos from a service called Emmi to help you navigate your care after you leave the hospital. Both services are provided free of charge.
• You may be assigned a care manager to see you in your primary care doctor's office or speak with you on the phone.
• Contact Advocate Aurora Health Care Management in Wisconsin at 888-394-7650.

The value of having a primary care doctor

A primary care doctor (PCP) can help ensure you receive the right care, at the right time and the right place. A PCP can help you and your family by acting like a quarterback of all health care services. Your PCP can best manage your health care by providing regular and preventative care and can help keep your health on track. See below on how to find a PCP to best fit your needs.

Benefits of receiving care from an ACO

With an ACO, you’re at the center of care, and your satisfaction is an important goal. Over time, you may notice:

• Less paperwork: You may not have to fill out as many medical forms that ask for the same information.
• Enhanced communication: Everyone on your care team knows what’s going on with your health because they communicate with each other.
• Fewer tests: You don’t need to repeat medical tests because your results are shared among your health care team.
• More choice: You’re free to choose your own doctor, but staying within the Aurora network can help us provide you with coordinated, high-quality care at a lower cost.

In an ACO, how will my health care records be used?

A valuable part of an ACO is that Medicare shares important health information with participating doctors and clinicians, including dates and times you visited a doctor or clinician, your medical conditions, and a list of past and current prescriptions. This information helps your care team to understand what services you’ve received and allows for smooth transitions between doctors or in and out of the hospital. This is one of the most important benefits of being in an ACO.

What if I don’t want to share my health information?

The privacy and security of your medical information is protected by federal law. You'll continue to get the same rights enjoyed by all people with Medicare. However, if you don’t want Medicare to share your health care information, call 800-MEDICARE (800-633-4227). Tell the representative your doctor is part of an ACO and you don’t want Medicare to share your health care information. TTY users should call 877-486-2048.

Even if you decline sharing specific health care information, Medicare still uses your information for some purposes, such as assessing the performance of the doctors and clinicians participating in our ACO.

Who can answer my ACO questions?

• To report a potential compliance or privacy issue, contact the Compliance and Integrity hotline at 888-847-6331 (toll-free) or submit your concern online at www.advocateaurorahealth.ethicspoint.com. (Available 24 hours a day, 365 days a year and hosted by Navex, a third-party provider.)
  • Information you provide through the hotline is confidential and anonymous unless you choose to provide your contact information. Whether you choose anonymity or not, you can trust that your voice will be heard.
• To speak directly to Medicare, please call 800-MEDICARE. (TTY users should call 877-486-2048.)
• Please visit Medicare’s website for more information.

Aurora Accountable Care Organization information

See more organizational and financial information for Aurora Accountable Care Organization, LLC.

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