• 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.

• 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.

• 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.

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.

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.

• 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.

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.

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 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.

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.

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.

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

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.

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 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.

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.

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.

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

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

• 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.

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

• 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.

• 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.

• 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 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.