Frequently Asked Questions for Accountable Care Organization (ACO) Patients

What is an accountable care organization (ACO)?

An ACO is a group of doctors and hospitals that work together with you to coordinate your health care in order to ensure you are receiving the care you need. This group shares responsibility for the cost and quality of your care.

Why do I need to see a primary care provider? 

Your primary care provider is the first person you turn to for most of your health concerns. In addition to preventive care, your primary care provider helps you manage chronic diseases and makes sure you address other health issues early on. Studies have shown that people who see a primary care provider regularly enjoy better health. 

Will my doctor be different because I am an ACO member?

ACO patients see the doctor of their choice. ACO providers are dedicated to providing higher quality care because they share responsibility for the cost and quality of care delivered to their patients. In addition to routine care, an ACO provider focuses on preventive care and managing chronic diseases to keep you healthy, and that decreases costs. 

Will being an ACO member increase my health care costs?

There are no additional costs for participating in an ACO. ACOs are not health insurance plans. ACO providers use a value-based model to get paid: They are rewarded for keeping you healthy and out of the hospital. This is different from the fee-for-service model, in which providers are paid based on the volume of care they provide. 

How does being an ACO member change my care? 

You may not notice any changes. Although your physician may refer you to a doctor within the ACO, you still have the ability to see the doctor of your choice. The only difference you may notice is that someone will call you to ensure you are being seen regularly by your primary care provider.

Will my medical information be shared with providers? Who can access my medical information? 

Your group of doctors, nurses, and hospital workers will have access to your medical records and can share that information with each other. This allows providers to view all of your medical history so they can provide high-quality care. But we always respect your privacy preferences. You can choose not to share your medical information. 

How is an ACO different? Why are you calling me about being an ACO member?

You do not enroll in an ACO. Your insurer has attributed your care to University of Iowa Hospitals & Clinics. This means we are responsible for your health, so we want to partner with you to provide whatever care you need. Part of our responsibility is to make sure you see your primary care provider regularly because it is an important part of maintaining your health.

Do I have to do any extra work to be an ACO member?

No. 

Is an ACO a health maintenance or managed care organization? 

No. Unlike managed care, an ACO cannot tell you which health care provider to visit. Your ACO works with you and your provider to ensure you receive the care you need. 

Where can I find more information on my ACO?