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Trinsic health care professionals practice value-based health care. This means we focus on quality, not quantity, and patients are true partners in care decisions. Our goal is to help patients improve their health, reduce the effects and incidence of chronic disease, and live healthier lives in an evidence-based way.
Trinsic wants you to understand what it means for you when your health care team joins an accountable care organization. Below are a few questions and answers to aid in your understanding.
Trinsic is focused on improving health in Colorado. We have contracted with the following value-based agreements: Commercial plans include: Aetna, Anthem BCBS, Cigna, United Healthcare and Select Health (individual Exchange plans — 2024).
Medicare Advantage plans include: Aetna, Anthem BCBS, Cigna, Humana, Select Health (2024) and UnitedHealthcare. Trinsic practices may also accept Medicare (MSSP).
An accountable care organization (ACO) is a group of doctors and other health care professionals who agree to work together with Medicare to give you the best possible care. The goal of the ACO is to support your doctor in caring for you by making sure they have the most up-to-date information about your health and your care. This means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions repeatedly.
A CIN and ACO have similar goals although they are structured in different ways. A CIN often serves as the physician network arm of a larger ACO. ACOs are voluntary legal entities comprised of groups of doctors and hospitals that share responsibility for both quality and cost for a specific patient population. Physicians and Advanced Practice Providers (APPs) who are members of an ACO gain access to technology, data and analytics and tools to identify risk and improve health, chronic disease management and prevention. Patients don’t opt into an ACO, a physician or practice does. As a legal entity, a CIN provides leverage to practices to bargain with insurers on behalf of their patients. They also help make IT improvements to ensure patients receive the best care possible.
Health care in America is too expensive and is not keeping patients healthy. The U.S. spends three to four times more on health care than South Korea, New Zealand and Japan and adults in the U.S. are the most likely to have multiple chronic conditions when compared with other nations. This is due to the fact that our health care system is built on reactive, episodic and transactional care. When a health care practice joins an ACO, they are able to join with other physicians and benefit from data and best practices that is more preventative in nature allowing them to spread the financial risk and lower the overall cost of care for patients. The idea behind value-based care is that is rewards quality and efficiency for physicians.
Sharing your health care information helps the ACO track the services you’ve already received, understand where you may need more care, and find ways to smooth the transition from one physician to another—when appropriate.
The ACO shares information regarding past doctor, hospital and pharmacy visits with your health care team. Health care information is shared by the Center for Medicare (and Medicaid) about the health care you have received in the past. This allows your doctors to know if other health care professionals have already conducted tests or diagnostics, to avoid repeating services as well as the opportunity to coordinate your overall plan of care with them.
As a patient, you do not participate in an ACO, only your doctor participates in the ACO. You can always go to any doctor, hospital or other physician that accepts Medicare. Nobody can restrict which health care professional you see.
CMS and Medicare share information about all of the health care services you receive with your physician. This information is not shared with organizations outside of the ACO. You have the right to request that Medicare stop sharing this information at any time. To do this, simply call 1-800-MEDICARE (1-800-633-4227) and tell the operator your health care professional is participating in an ACO and you don’t want to share your health care information with the ACO. Medicare will then update your records to show that you don’t want to share your health care information. It typically takes about 45 days for this change to take effect.