Did you know two out of three people in the U.S. over age 65 have more than one health problem and see more than one doctor? Plus, 93% of Medicare costs are a result of treating these patients.
Seeing more than one doctor can cause a lot of serious problems. Tests may be repeated or duplicated. Patients may not get care on time, or may not get the right type of care at all. Even when doctors work hard, sometimes it's tough to manage it all.
For the first time, most single adults under 65 who earn less than $14,500 a year can sign up for Medicaid coverage. This includes those who are disabled. A family of four that makes less than $29,700 a year can also get Medicaid coverage. The federal government will give the states that choose to expand Medicaid coverage extra money to help them pay for this coverage.
How does it work?
Yes, you must also meet certain federal and state rules, such as proof that you're a U.S. citizen.
How do I sign up for Medicaid coverage?
It's voluntary for doctors and hospitals to participate in an ACO, but they can earn more. Plus, with this program, the government expects to save $960 million over three years.
Doctors only get rewarded if they meet certain criteria. The Centers for Medicare and Medicaid Services (CMS) developed these criteria, based on costs and quality. If an ACO meets these benchmarks, it can earn more. Criteria are based on patient safety, care coordination, experience, how they treat at-risk patients, elderly patients, and more
How it impacts you
If you visit a large hospital system, chances are, it's an ACO. If you're treated at an ACO, the new law may improve how doctors manage your care.
How will my experience at an ACO be different?
Instead of relying on you to call all of your doctors, your doctors will talk to one another. You might have less paperwork to fill out or fewer phone calls to make. Overall, your care experience at an ACO should feel seamless.
How do I know if my care is at an ACO?
Not every hospital or doctor is part of an ACO. If you're wondering, just ask. Most doctors will know if their group is part of an ACO. To learn more about ACOs, visit Medicare.gov.
Can I still see any doctor?
Yes. Even if your doctor isn't part of an ACO, you can still see any doctor that takes Medicare insurance.