Accountable Care Organizations (ACOs)
An Accountable Care Organization (ACO) is a group of doctors, hospitals, and/or other health care providers that accept Original Medicare and work together to give you high-quality, coordinated health care. ACOs are not Medicare Advantage Plans.
Starting January 1, 2027, Medicare will explore new ways to improve ACOs like encouraging wider health care provider participation and providing access to new health technology (like smartwatches and other wearable devices to help monitor your health).
How do ACOs support care coordination?
Providers may agree to work together as a group to form an ACO to help coordinate your care. If your provider participates in an ACO, you may get more help managing chronic diseases, more preventive health services, recovery care, and more.
How does it help me if my provider is in an ACO?
Studies show that patients whose providers are part of an ACO often have a better care experience. If your provider is part of an ACO, you may be able to get appointments faster, get answers to medical questions more quickly, and stay more up to date on preventive care (like screenings and checkups). Patients in ACOs also tend to have better management of ongoing conditions like high blood pressure and diabetes. Your providers communicate with each other and partner with you through an accountable care relationship to understand your health history and health care needs. They share information and may use Electronic Health Records (EHRs), so you can avoid repeated medical tests and spend less time on paperwork. ACO systems also monitor Medicare claims data for unusual spending patterns to find potential fraud early.
What ACO programs are available to my provider?
Original Medicare offers several types of ACO programs, including:
- Medicare Shared Savings Program
- ACO REACH (ends December 31, 2026)
- Long-term Enhanced ACO Design (LEAD) (starts January 1, 2027)
Each program follows Medicare’s rules for coordinated care but may have different features.
Will my Medicare coverage, costs, or rights change if I’m in an ACO?
No. Medicare continues to pay your providers the same way it pays any Original Medicare provider—your costs won’t increase because of the ACO. You’ll also have the same coverage and rights you get through Original Medicare, including:
- Freedom to visit any Medicare provider (even if that provider isn’t part of an ACO)
- The option to switch health care providers at any time
Do I get extra benefits if my provider is in an ACO?
If your primary care provider is in an ACO, you may be able to get extra benefits and services to help you stay healthy or manage a chronic condition, like:
- More telehealth services
- Home care after a hospital stay
- Skilled nursing facility or rehabilitation care without the 3-day inpatient hospital stay Medicare usually requires (if you qualify)
- Help with certain copayments
Check with your provider to find out what extra benefits they offer.
How do I know if a provider is in an ACO?
If your primary care provider is part of an ACO, they’ll give you a written notice or letter. You may also find a poster or sign in their office about their ACO participation. There are now hundreds of ACOs across the country.
To find out if a provider participates in an ACO, you can ask your doctor or other health care provider. You can also call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Will Medicare share my information with ACOs?
Yes. One of the most important benefits of an ACO is that your providers can communicate and coordinate your care. To help with that, your ACO providers may ask Medicare for certain information about your care. This helps make sure all the providers involved in your care understand your health needs and can access your health information when they need it to help you.
If you don’t want Medicare to share your information with your ACO providers, call 1-800-MEDICARE (1-800-633-4227) to opt out. Even if you decide to opt out, Medicare may still share general information with an ACO to help measure provider quality. Get more information on how Medicare may use and share your information.