Community Care Physicians was accepted by the Centers for Medicare & Medicaid Services (CMS) to form an Accountable Care Organization (ACO) called Aurora Community Care ACO (legal entity name Community Care Contracting, LLC doing business as Aurora Community Care ACO). The purpose of this ACO is to enable participation in Medicare’s Accountable Care Organization – Realizing Equity, Access, and Community Health, more commonly referred to as ACO REACH. This is a program in partnership with CMS that focuses on enhancing patient care while lowering the total cost of care for the healthcare system. This is accomplished by compensating providers not for the quantity of procedures performed, but rather for the quality of care we provide, measured by our patients’ health outcomes.

This is an excellent opportunity to move the CMS system toward paying for value and rewarding keeping our patients healthy – which is our primary goal at Community Care Physicians.

So, how do we accomplish this? In ACO REACH, physicians and other health care providers join together to ensure coordination of care across clinicians (like specialists you see) and care settings, offer services to improve your care, and take responsibility for the quality of care you receive and the total costs of that care.

The members of Aurora Community Care ACO

As a program of CMS, all CCP primary care practices that care for adults are part of the ACO; that includes all CCP family medicine and internal medicine practices.

CCP has also partnered with a company called Honest Medical Group that is also part of this ACO.

CCP and Honest partnered to form Aurora Community Care ACO to ensure your care is better coordinated (using data provided by Medicare), to provide you with enhanced resources at no cost to you (possible through the creation of this ACO), and to lower the total cost of care of our patients (since we are incentivized based on quality of care provided rather than quantity of care provided).

Since this is a program through CMS, only patients with Original Medicare (or Medicare Part B) are affected by this program, though all patients across CCP benefit from the processes and care improvements made as part of this initiatives.

The formation of Aurora Community Care ACO doesn’t change CCP’s structure in the Capital Region of NY. We continue to be an independent multispecialty practice and our locations remain the same. The CCP healthcare providers/practices in this program continue to be LOCAL and partners in the ACO utilize LOCAL resources to enhance services for our patients.

What communications can I expect regarding the ACO program. How do I know what is legit and what is fraud/spam?
There are a few communications you can expect:

  • Voluntary alignment – this is a letter from Community Care Physicians, CMS and the ACO that asks you to confirm that you receive your medical services from Community Care Physicians. Once completed, it notifies CMS that you voluntarily selected us as your primary care provider group and that we are responsible for your care.
Voluntary Alignment Cover Letter for Internal Medicine, Family Medicine, and Med/Ped patients with Original Medicare.
  • Beneficiary notice – you will receive a beneficiary notice (view sample notice) from CMS in partnership with the ACO that makes you aware of Community Care Physicians participation in the ACO REACH and information that your benefits haven’t changed and that you still have freedom to choose your physicians.
  • Health Risk Assessments – CCP notified all patients with emails on file that you may be contacted regarding a Health Risk Assessment (HRA, also sometimes referred to as a 5D visit). This is a virtual visit performed over the phone by a contracted partner of CCP’s called Housecall Doctors. This partner functions as an extension of your care team at our office. The HRA visit is conducted by certified advanced practitioners and addresses your emotional, physical, spiritual, social, and mental health. These contracted practitioners don’t have access to your full medical record, but instead they document your call to provide valuable information to your CCP provider for your next visit at your CCP office. These 5D HRA visits are different than Medicare Wellness Visits.

You may also receive additional communications throughout the year from CCP in partnership with CMS and Aurora Community Care ACO.

It’s important to note that CCP provides patients with updates on what communications to expect via email using our secure patient communication platform. We encourage you to provide your CCP primary care office with your email address (if you have one) so that we can communicate with you when needed.

Please read the below frequently asked questions for additional information.

General ACO FAQs

What is an ACO?
  • An ACO is a group of health care providers who take responsibility for the total cost and quality of care for their patients, and in exchange they can receive a portion of the savings they achieve.
  • An ACO agrees to work together with Medicare to give patients the best possible care.
  • ACOs have agreements with Medicare to be financially accountable for the quality, cost and experience of care that traditional fee-for-service Medicare patients receive.
  • According to ACO program guidance and specifications, participating in an ACO may involve earned shared savings payments or incurred losses.
    • ACOs are rewarded when they lower costs while meeting quality performance standards.
    • ACOs are also responsible for any shared losses.
Why is CCP participating in the ACO?
  • Community Care Physicians is well prepared to participate in an ACO. Value-based practice transformation efforts have already been taking place within our primary care and specialty care, and the ACO initiatives align with our hallmarks of multidisciplinary, team-based and integrated care. For example, CCP was already enrolled in value-based payment models like CPCI and CPC+.
  • Participating in an ACO will allow CCP to prepare for the industrywide shift toward pay for value and to improve Medicare sustainability.
How does the ACO REACH benefit patients?
  • The ACO REACH program is designed to improve quality of care for a whole population of Medicare fee-for-service (Part B) patients.
  • The data Medicare shares with Aurora Community Care ACO is used to inform CCP about the health needs of our Medicare fee-for-service population as a whole.
  • Information obtained from Medicare about quality, cost of care and patient experience will be used to enhance Aurora Community Care ACO’s care delivery tools and processes and continue to guide improvement of our high-quality care at Community Care Physicians.
What is the ACO REACH?

The ACO REACH provides alternative ways for health care organizations to be paid for their services based on performance in quality, cost, and patient experience. An ACO is one type of shared savings program that allows health care providers to work together to provide high-quality, cost-effective, coordinated care to patients.

The ACO REACH (Realizing Equity, Access, and Community Health) Model focuses on promoting health equity and addressing healthcare disparities for underserved communities. The Model provides tools and resources to empower doctors and other health care providers to better coordinate and improve the quality of care they provide for patients in traditional Medicare. This approach affords patients greater individualized attention to their specific health care needs while preserving all services and flexibilities beneficiaries enjoy in traditional Medicare. The goal of the Model is to provide beneficiaries with access to enhanced benefits and to increase the availability of high quality, coordinated care, including for people in underserved populations. The Model takes all the important lessons learned thus far from the CMS Center for Medicare and Medicaid Innovation’s (Innovation Center) previous model tests and brings accountable care to Medicare beneficiaries who have previously lacked access to healthcare providers that participate in value-based initiatives in new and exciting ways.

Who pays for this service?

There are no costs passed on to you as part of an ACO REACH. In fact, as a Medicare Part B beneficiary you get access to enhanced services as part of this program.

Are my health care benefits changing?
  • Your Medicare benefits are not changing. Your health coverage, premiums and insurance arrangements are not affected.
  • Community Care Physicians’ participation in the Aurora Community Care ACO doesn’t limit your choice of health care providers. You still have the right to visit any doctor, hospital or other provider that accepts Medicare at any time, just like you do now.
Is the ACO a Medicare Advantage Plan or an HMO?

An ACO isn’t a Medicare Advantage Plan, a health maintenance organization (HMO) plan or an insurance plan of any kind. It is an agreement between Aurora Community Care ACO and Medicare to be financially accountable for the quality, cost, and experience of care you receive.

Will my future care be restricted due to cost restraints?

No. Reductions in costs of care will be achieved by not repeating tests unnecessarily, improving the coordination of your care, and improving preventive care and wellness. Community Care Physicians’ participation in the ACO will not keep you from receiving tests or procedures when you need them.

Community Care Physicians did not participate in an ACO previously. Why did CCP change positions about joining an ACO?
  • Community Care Physicians always puts the patient first.
  • The Medicare Shared Savings Program that oversees the Accountable Care Organization program has evolved over the years since it started in 2012.
  • The current ACO REACH Program is focused on patient-centered outcomes and lowering costs. It aligns better with CCP’s values and approach to patient-centered and coordinated care.

Voluntary Alignment FAQs

The Aurora Community Care ACO website states that it is based outside of New York State. If that’s the case, how is this group going to assist in coordinating my care?

Aurora Community Care ACO is made up of two organizations in different locations – Community Care Physicians located in the Capital Region, NY and Honest Medical Group headquartered in Nashville, TN, however services and coordination remain local to the Capital Region of NY, where the patients are located.

The formation of Aurora Community Care ACO doesn’t change CCP’s structure in the Capital Region of NY. We continue to be an independent multispecialty practice and our locations remain the same. The CCP healthcare providers/practices in this program continue to be LOCAL and partners in the ACO utilize LOCAL resources to enhance services for our patients.

Why should I complete the form? What happens if I don’t complete it?

This form, called a voluntary alignment form, confirms that you receive your medical services from Community Care Physicians. Once completed, it notifies CMS that you voluntarily selected Community Care Physicians (CCP) as your primary care provider group and that we are responsible for your care.

If you do choose to complete the form, it confirms that CCP is responsible for your care and provides you access to services you wouldn’t otherwise have access to, many free of cost.

Completing the form is very helpful and voluntary. Whether you complete the form or not, your CCP primary care provider will not change unless or until you decide otherwise. You will continue to be our patient and see Community Care Physicians for your care (or any provider of your choosing) whether you complete the form or not. If you choose not to complete the form, you just won’t have access to the services available to patients who align their care with Community Care Physicians/members of the ACO.

What’s in it for me? What enhanced benefits do I get as a patient in this model if I sign this form?

There are proposed Beneficiary enhancements patients with Medicare Part B (Original Medicare) would receive, including:
1. Care Management Home Visits
2. Post-Discharge Home Visits
3. Telehealth
4. Chronic Disease Management Reward

How do I access these services?

Once the enhanced services are confirmed by CMS, Aurora Community Care ACO, via Community Care Physicians, will communicate these details to patients and educate patients how to access these services if they qualify.

Is this another way for healthcare firms to tap into Medicare funding?

ACOs like Aurora Community Care ACO have agreements with Medicare to be financially accountable for the quality, cost and experience of care that traditional fee-for-service Medicare patients receive. This payment model incentivizes providers at CCP for quality of care provided rather than quantity of care.

This is a payment model that occurs behind the scenes of your care.

If Medicare began this initiative, why am I not hearing about it from them?

If you have Medicare Part B, also known as Original Medicare, the communications you receive regarding the ACO REACH and its services will come from Aurora Community Care ACO in collaboration with CMS. You’ll see the CMS logo on all the materials as well as Community Care Physicians’ logo and the ACO’s name – Aurora Community Care ACO. These are official communications from the ACO and CMS.

We’re being warned about many Medicare scams right now, how can we ensure the calls/letters we get are not scams?

Any official communications will say Aurora Community Care ACO, will have the CCP logo and the CMS logo. All calls regarding your care will come from your care team at your CCP doctor’s office, with the exception of one – the Health Risk Assessments which are being conducted by CCP’s partner, Housecall Doctors. These are advanced practitioners contracted by CCP to conduct health risk assessments via telemedicine. These partners will identify themselves as calling on behalf of the practice.

My name is spelled incorrectly on the form or my initial is incorrect, what should I do?

If the information on the letter is incorrect, please contact us by phone at (518) 881-0773 to notify us of the specific error. The name on the form comes from CCP’s data, so we will need to correct the information and send you a blank form or updated form to complete.

I’ve moved location or doctors and am not with CCP anymore, what should I do?

You can disregard the letter and contact CCP by phone at (518) 881-0773 to confirm you no longer are a patient of CCP.

If you have power of attorney, can you sign the voluntary alignment form on behalf of the patient?

Yes, sign your name and “power of attorney” next to your signature.

Privacy FAQs

What information is Medicare sharing with Aurora Community Care ACO?
  • The data that Medicare shares with the ACO is information that is from Medicare claims data, which is your Medicare billing information. For instance, the data may show that you had an X-ray or lab test, but it will not show the results of those tests. It will show the test name, date, and location where the test was performed.
  • The claims data from Medicare includes data for all providers, hospitals, and clinics where you have been seen (inside and outside Community Care Physicians)
  • The Medicare data informs Aurora Community Care ACO that patients have seen other providers, but it provides limited information.
  • The data informs Aurora Community Care ACO about the health needs of our Medicare fee-for-service population.
Will Medicare be able to see my medical record?

Medicare cannot see the health records (also known as electronic medical records) for Community Care Physicians or Aurora Community Care ACO.

Will the data that Medicare shares with Aurora Community Care ACO be kept private?
  • Yes, your privacy is important to both Aurora Community Care ACO and Medicare, and extensive systems and processes are in place to ensure the shared data is handled in a confidential manner.
  • Medicare shares the data with Aurora Community Care ACO through a very secure transmission process.
  • Aurora Community Care ACO is committed to protecting patients’ privacy and maintaining confidentiality.
What if I don't want to share my health information with the ACO?
  • If you do not want Medicare to share your health care information with the Aurora Community Care ACO, you must call 800 MEDICARE (800-633-4227). Tell the representative:
    • Your provider is part of an ACO REACH and you don’t want Medicare to share your health care information.
    • Aurora Community Care ACO started January 1, 2023.
    • Aurora Community Care ACO’s identification number is D0303-612038534.
If I decline to share my Medicare data, will my providers at Community Care Physicians still be able to see my medical information?
  • Community Care Physicians providers will still see your medical information about care that you receive at our sites. This data is stored in our electronic health record (EHR), also known as a medical record.
  • Medicare does not have access to Community Care Physicians’ electronic health records.
  • If you decline to share your data, this means that the Aurora Community Care ACO will not receive the claims data from Medicare about your care.
  • If you receive care from non-Community Care Physicians providers, you may sign an authorization for release of information to share that information with Community Care Physicians. Thus, Community Care Physicians may receive some of your health information directly from those providers, at your request.
If I decline to share my health care information, am I out of the ACO?
  • If you decline to share your Medicare claims data with the Aurora Community Care ACO, you are still a Community Care Physicians patient and there will be no change to your provider or care based on your decision.
  • According to Medicare, “Even if you decline to share your health care information, Medicare will still use your information for some purposes, like assessing the financial and quality of care performance of the health care providers participating in ACOs. Also, Medicare may share some of your health care information with ACOs when measuring the quality of care given by health care providers participating in those ACOs.”
    • This means that Medicare will not share specific information about you as a patient but will continue to share information about how Aurora Community Care ACO is performing regarding financials and quality of care for Medicare fee-for-service beneficiaries.
  • Aurora Community Care ACO is an agreement between Medicare and Community Care Physicians. Thus, Community Care Physicians practices are the participants in the ACO and are held accountable for the quality and experience of care.

More Help

If you have questions about Community Care Physicians’ participation in the Aurora Community Care ACO, you may contact us online using the general inquiry contact us form linked below or by phone at (518) 881-0773.