PCMA Cooperative, LLC

High Needs REACH ACO

PCMA Cooperative is committed to providing high-quality
medical care focused on your unique health needs.

One of the ways we do this is by participating in a
High Needs REACH ACO. This is a program by
Medicare that focuses on realizing equity, access, and
community health by encouraging health care
providers – including primary and specialty care
doctors, hospitals, and others – to come together to
make care accessible, affordable, and effective.

When patients participate in an ACO, their quality of care improves in the
following ways:
Patients are less likely
to get repeat medical
tests or unnecessary
medical services
 
Clinicians consider a
patient’s entire health
history when developing a
treatment plan and how it
will complement plans by
other doctors for different
health issues
Doctors and other
health care professionals
communicate and
collaborate with each
other to improve their
patients’ long-term health
and prevent serious health
issues or hospitalizations

Focusing on outcomes and continuity

When ACOs provide higher quality, coordinated care that improves patient health outcomes and reduces
Medicare spending, they may be eligible to share in a portion of those savings. Conversely, ACOs could pay
a penalty if they provide fragmented care that increases Medicare costs.

ACOs can invest any financial rewards they receive into more patient care services and support, or they
can share a portion with health providers participating in the ACO.

Many ACOs are dedicated to reaching and caring for people who historically have not been able to get
health care that meets their needs. Providers in an ACO may help underserved populations, for example,
by making it easier to get care, such as by offering at-home or telehealth visits.

Additionally, ACOs may examine social factors that may have an effect on someone’s health – like safe
housing and access to nutritious food – and connect their patients with social services in their area.
Because ACOs provide more coordinated care and individualized treatment plans, underserved patients
are less likely to get lost in the health care system.

Public Reporting
 
An ACO is not an insurance plan. Patients who have Original Medicare and have doctors in an ACO
retain all of their rights and privileges under Original Medicare, including the freedom to see any
health care provider that accepts Medicare, even if that provider is not part of an ACO. And they
can opt out of Medicare sharing certain health information by calling
1-800-MEDICARE (1-800-633-4227)
TTY users can call
1-877-486-2048

© 2024 PCMA Cooperative. All rights reserved.

Privacy Policy   Terms of Use