Question: Will I receive all medical information from Medicare for each patient that is assigned to me through my accountable care organization (ACO)?
Answer: Medicare will automatically share “almost” all your assigned patient’s medical information with you and your ACO, including medical conditions, prescriptions, and visits to other medical providers.
This will allow the ACO to help coordinate all the assigned patients’ medical needs and track how well the ACO is doing to provide value-based care for all its patients.
The patient, however, may choose to have his or her name and other personal information removed from the information that Medicare shares with the ACO by either calling 1-800-MEDICARE or by signing a form that you must have available in your office or be responsible to mail from your office to the patient.
The patient must return this form to you or call the 1-800 number; otherwise, their medical information will be shared with the ACO automatically starting 30 days from the date they were notified.
The ACO will still get aggregate, but de-identified data, allowing them to know how many patients with specific medical conditions (i.e. diabetes, cancer, hypertension, etc.) they are responsible for, so they can plan for supportive services such as nutritionists, genetic counselors, pharmacists, etc.
Also, Medicare won’t share information about anyone who has ever received treatment for alcohol or substance abuse without written permission from the patient. If your patient has received treatment for alcohol or substance abuse in the past and wants Medicare to share that information with you and your Medicare ACO, the patient must complete the “Alcohol or Substance Abuse Medical Data Sharing Form” and mail it in. Otherwise, do not assume the patient has not received such care in the past if it is not listed in the information sent you. Thus, you will still need to include alcohol and substance abuse questions in your medical history, or this important information may be missed if you assume the lack of such history in the information sent for inclusion in your EMR equates with a negative history.
Mark G. Martens, MD
Chairman, Department of Obstetrics and Gynecology
Jersey Shore University Medical Center
Clinical Professor and Vice Chair
Robert Wood Johnson School of Medicine