Sharp HealthCare ACO
Sharp HealthCare ACO FAQs
What is an ACO?
An ACO (Accountable Care Organization) is a group of doctors, hospitals and other health care providers who work together to give you better service and care. If you received a letter in the mail notifying you of our ACO, it is because your Sharp-affiliated doctor has elected to participate in Sharp HealthCare's Next Generation Accountable Care Organization — a program from Medicare.
Building upon experience from the Pioneer ACO Model and the Medicare Shared Savings Program, the Next Generation ACO Model offers a new opportunity in accountable care — one that sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care and aims to attain the highest quality standards of care. Sharp HealthCare previously participated in the Pioneer ACO Model, but it withdrew from the program in 2014.
What will Sharp HealthCare Next Generation ACO provide for me?
The goal is to provide you with improved health and a better patient experience, particularly if you're ever hospitalized or if you're living with a chronic condition. We will reach out to you to ensure you receive important exams and immunizations, and that you're receiving the preventive care you need when you need it. When you have an emergency room visit or are hospitalized at a Sharp hospital, Sharp HealthCare Next Generation ACO coordinates your care during your stay and helps make arrangements for any necessary follow-up appointments and medical equipment. If you are hospitalized at a non-Sharp hospital, you or a loved one can call Sharp HealthCare ACO at 858-499-2666 for care coordination following your discharge.
Additionally, as part of Sharp HealthCare Next Generation ACO, you have access to Sharp Nurse Connection. After hours or on weekends, you can call Sharp Nurse Connection at 1-800-767-4277 to get medical advice from an experienced registered nurse who will assess and evaluate your health symptoms, make recommendations for care and send a message to your doctor about your call.
Are my Medicare benefits changing because of the new ACO?
No. Neither Medicare benefits nor the cost of coverage will change. You still have the right to choose to receive care from any doctor or hospital that accepts Medicare, at any time.
What will change when I need treatment?
If you need treatment, we will help coordinate your care among your doctors. We'll help ensure that your entire treatment team has access to the information they need to provide the best possible care for you. This will help eliminate the inconvenience, expense and risk of duplicated tests and procedures.
Can I still see my regular doctor?
Yes. You will continue to be able to see any doctor or health care provider who accepts Medicare.
How will I know if my doctor is participating in the ACO?
Most doctors in Sharp Rees-Stealy Medical Group and Sharp Community Medical Group, including Graybill Medical Group, are participating in Sharp HealthCare Next Generation ACO, along with all Sharp hospitals. ACO members living in North County may be admitted to other North County hospitals, as directed by their Sharp Community or Graybill Medical Group doctor.
What does this mean for my privacy as a patient?
To help your Sharp-affiliated doctors and hospitals, as well as other health care providers, give you better, more coordinated care, Medicare will start sharing your personal health information with doctors, hospitals and other health care providers who are working together in Sharp HealthCare Next Generation ACO. This information will include visits to the doctor or hospital, medical conditions and prescriptions.
Your privacy is very important to us, and you control the use of your personal information. Just like Medicare, we put safeguards in place to make sure all your health information is protected.
Why is Sharp HealthCare participating in the ACO?
Sharp-affiliated doctors, hospitals and other health care providers have many years of experience providing outstanding, coordinated care and value to our patients. Based on our experience, Sharp was selected to participate in this enhanced approach to care delivery for select Medicare beneficiaries.
This new approach means we'll remind you and your physician if you're due for any necessary preventive care, or you may get a phone call after any hospitalization discharge to help coordinate your post-discharge care planning, among other enhanced experiences. We look forward to partnering with the Centers for Medicare and Medicaid Services to promote changes to benefit patients in their care.
What if I don't want my personal health information shared?
I have more questions about this program. Whom can I contact?
If you have any questions about Sharp HealthCare Next Generation ACO, please call 858-499-2666. For any other general information on ACOs, please contact Medicare at 1-800-MEDICARE (1-800-633-4227) or send us an email.