VillageMD Primary Providers ACO III

Your doctor’s participation in an ACO enhances your benefits at no extra charge to you. However, you are still responsible for any regular co-insurance costs not covered by Medicare. Below is a list of some of the benefits you will find as a member of our ACO.

• Helps your doctors know your health history and talk to one another about your care and coordinate your health care needs.
• May save you time and money by avoiding repeated tests and unneeded appointments.
• May make it easier to spot potential problems before they become more serious—like drug interactions that can happen if one doctor isn’t aware of what another has prescribed.
• Access to expanded benefits at no extra cost. Ask your health care provider if you qualify.
  • Home Health Homebound Waiver for patients with two or more chronic conditions.
  • Virtual Care Expansion Waiver
  • Three Day Skilled Nursing Facility Waiver
  • Nurse Practitioner/Physician Assistant Services Waiver
  • Concurrent Care for patients that elect Medicare Hospice
    • Allows patients with a known cancer or end stage renal disease (ESRD) diagnosis or patient entering a skilled nursing facility to enroll in hospice care while still allowing them to benefit from symptom management such as pain control, oncology treatments or dialysis.
  • Chronic Disease Management Reward
    • Allows aligned patients to receive a nominal gift card for participating in their care.
  • Cost-Sharing for Medicare Part B Services
    • Allows aligned patients to achieve a higher quality of life by reducing financial barriers to advance one or more of the following clinical goals: 1) Adherence to a treatment regimen 2) Adherence to a drug regiment 3) Adherence to a follow up care plan and management of a chronic disease or condition 4) Better manage of patients high cost and chronic conditions.

Important! An ACO won’t limit your choice of health care providers. It isn’t a Medicare Advantage Plan. If your doctor is part of an ACO, you still have the right to visit any doctor, hospital, or other provider that accepts Medicare at any time.

One of the most important benefits of an ACO is that your doctors and other providers can communicate and coordinate your care. To help with that, Medicare gives certain information about your care to your health care providers’ ACO. Sharing your data in this way helps make sure all the people involved in your care have access to your health information when and where they need it, to work together to get you the care you need. If you don’t want Medicare to share your health care information this way, call 1-800-MEDICARE (1-800-633-4227) and tell that to the representative. TTY users can call 1-877-486-2048. If you decide you don’t want Medicare to give your health care information to your doctors, Medicare will continue to use your information for some purposes, like evaluating financial performance and quality of care.

To learn more about ACO's, visit https://www.medicare.gov/ or call 1-800-MEDICARE. TTY users can call 1-877-486-2048.

ACOs are under an agreement with Centers for Medicare and Medicaid Services (CMS) to participate in the Realizing Equity, Access, and Community Health (ACO REACH) Model.

Your benefits will NOT change, and you can visit any doctor, other health care professional, or hospital.