Medicare plan shift leaves some patients confused [The Daily Star, Oneonta, N.Y.]

Feb. 5—Recently Bassett Healthcare Network contacted some Medicare patients about the Bassett Accountable Care Partners, LLC, an entity known as an accountable care organization.

Ziggy Sigurd Rahmas said he received two emails from Bassett Healthcare Network about being placed in the ACO. He said he didn't want to be placed in a different Medicare program, and called Medicare to let them know that he wanted to keep his original Medicare.

According to a Centers for Medicare & Medicaid Services spokesperson, an ACO is not "a Medicare Advantage Plan, which is an alternative to Original Medicare, offered by private companies approved by Medicare. It also isn't an HMO plan, or an insurance plan of any kind."

Rahmas said he "felt like Bassett was volunteering me to be in this program and I should get to say whether I want to be in it or not."

Gabrielle Argo, interim network manager, marketing and communications at Bassett Healthcare Network, said "Members in the Bassett Accountable Care Organization are based on an attribution formula at Medicare that links patients into an ACO that provides the majority of their care. Bassett doesn't place anyone into the ACO."

She said, "Patients always have the option to request that Medicare does not share their information." People who don't want their information shared, can call 1-800-MEDICARE (1-800-633-4227).

"It is important to understand that patients who see providers in ACOs do not have any changes to their Medicare benefits whatsoever," she said.

The CMS spokesperson said "an ACO is a group of doctors, hospitals, and/or other health care providers that work together to improve the quality and experience of care for beneficiaries. These organizations may help health care providers better coordinate beneficiaries' care and are intended to give them better quality care. Coordinated care saves time and costs by avoiding repeated tests and unneeded appointments. It may make it easier to spot potential problems before they become more serious—like drug interactions that can happen if one doctor isn't aware of what another has prescribed."

The spokesperson said Medicare evaluates ACOs yearly to make sure they meet these goals. If the ACO does a good job meeting these goals, it is entitled to a financial bonus from Medicare. If the ACO doesn't do a good job, it may owe money to Medicare. An ACO is part of the Medicare Shared Savings Program.

Argo said Bassett has been part of the Medicare Shared Savings Program since 2014.

Patients who have further questions can call 607-547-4725 to speak with an expert on Bassett Healthcare Network's Population Health team, Argo said.

Vicky Klukkert, staff writer, can be reached at vklukkert@thedailystar.com or 607-441-7221. Follow her @DS_VickyK on Twitter.

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