Medicare Benefit Enhancements & Patient Engagement Incentives

Medicare has started an initiative where health care providers who share a common set of goals aimed at improving patient care can work together more effectively. This initiative brings together health care professionals in an Accountable Care Organization (ACO), to work together with Medicare to give you more coordinated care and services.

Our practice is voluntarily taking part in this new initiative by joining an ACO, Midwest DCE, because we think it will help us provide better quality care for our patients.

Your benefits will NOT change, and you can visit any doctor, other health care professional, or hospital. However, some special features will be available to you at no extra cost:

To help improve the care for Medicare patients, CMS allows participants in ACO REACH to provide benefit enhancements and incentives to Medicare beneficiaries enrolled in our ACO. This includes:

• Free transportation to and from our office for patients who do not have access to existing, available benefits, such as Senior MedExpress, Metroaccess, or Medicaid-covered transportation. The service is not intended to replace existing private transportation. Patients may be sharing a ride with others. Read more.

• No Medicare copays or coinsurance for our primary care services. This includes remaining copays after secondary insurance coverage. Read more.

• Care Management in your home and Post-Hospital Care in your home to help you manage your chronic conditions and avoid hospitalization where possible. Eligibility is based on medical need and on whether you reside in Bluerock’s House Calls service area.

These benefits are only available to patients enrolled in Medicare Part B and enrolled in the ‘ACO REACH’ initiative through Bluerock Care. If you are enrolled in a Medicare Advantage plan (from United, Cigna, Aetna or another plan), we are very happy to serve you but cannot provide these benefits. If you have Original Medicare and a so-called ‘Supplemental plan’, such as Blue Cross Blue Shield, GEHA or United AARP, we can provide these benefits.

Also, the care management benefit is subject to clinical criteria, and the transportation benefit is subject to clinical criteria and/or financial need.

We cannot provide the copays/coinsurance benefit to patients who drop their secondary insurance, or change to a secondary insurance with higher copays.

Within the criteria listed above, benefits are available regardless of race, ethnicity, national origin, religion, gender, sex, age, mental or physical disability, health status, receipt of health care, medical history, genetic information, evidence of insurability, income or geographic location.

Bluerock retains the right to change the clinical and/or other criteria for access to these benefits at any time.