What is an Accountable Care Organization (ACO)?
An ACO (Accountable Care Organization) is a group of doctors, hospitals, and other healthcare providers who agree to work together, along with Medicare, in order to provide high quality, carefully coordinated care to their Medicare patients. The goal is to ensure timely and effective care while reducing unnecessary spending costs that occur when tests and services are duplicated.
What is preventative care and why do I need it?
Preventative care is what we do to prevent or delay medical problems. For example, a family history of a breast cancer could prompt your physician to encourage mammograms at an earlier age in order to catch the illness when it is still in early stages and treatable. Or, if your routine blood tests show signs of an illness, your doctor can diagnose and treat the illness much earlier than if you didn’t have routine visits. In this way, you may be able to avoid major medical problems, and you’ll be more independent and have a better quality of life as a result.
Why do I need a personalized plan, and who will pay for it?
During an Annual Wellness Visit (AWV), you and your provider will consider your risk factors and make a personalized plan. Preventative care isn’t the same for everyone. What’s best for you depends upon your medical history, your family’s medical history, and your lifestyle. Medicare will pay the entire cost of this visit if:
- You have had Medicare Part B coverage for more than 12 months, AND
- You have not had a Medicare Initial Preventative Physical Examination or Annual Wellness Visit within the last 12 months.
If you are not sure if these are true for you, please ask your provider.
What will happen during an Annual Wellness Visit, and what do I need to bring?
During your Annual Wellness Visit, your provider will gather information about your unique health situation. We’ll discuss what medical situations you may need to watch for, and how we can help prevent them. You might be given an immunization, but you will not receive a physical exam at this time. A physical exam may follow your annual wellness visit, as you and your provider put your personal plan into action.
Things you will need to bring to your Annual Wellness Visit include:
- Any medical records you have, including immunization records.
- Any family history you have, in as much detail as possible.
- A complete listing of medications you take, including vitamins, supplements, and herbs. For each medication, write down how often and how much of each medicine you take.
- A list of healthcare providers and suppliers currently involved in your care.
Remember, no one approach is right for everyone, and personalized care gives you the best opportunity for success. To schedule your Annual Wellness Visit (AWV), call your clinic today.
The goal of the ACO is to support our providers in communicating better with each other in order to avoid ordering duplicate tests or screenings. Working together, our providers and our Population Health Nurse can do more to follow our patient’s health and to make sure they get the best possible care.
Star Valley Health chooses to participate in an ACO because we are committed to providing patients with a better care experience. We look forward to continually improving the care that we provide our patients and are excited to be a part of the positive changes taking place in healthcare within our country. Although this program is currently focused on Medicare patients, in the future, the benefits of an ACO system could be applied to improve the wellness of all patients.
What is a Population Health Nurse?
ACO’s utilize a Population Health Nurse role to personally coordinate patient care and health maintenance of each Medicare patient in the community.
The key to achieving this goal is by having the Population Health Nurse perform Annual Wellness Visits with Medicare Part B patients. It is in the Annual Wellness Visit that the Population Health Nurse will form a relationship with the patient and together, with the patients’ provider, they can formulate a Personalized Prevention Plan for each patient. Every Medicare patient that visits with our Population Health Nurse will leave our clinic with a personalized health prevention plan, empowering each patient to take charge of their own health and wellness.
Below is additional information regarding the services available through the guidance of the Population Health Nurse. Click the image to see more information about the topic listed. For further information or if you have questions, please call 307-885-5852.