Accountable Care Organization
Gibson Area Hospital- ACO/IRCCO Information:
Gibson Area Hospital and Health Services belong to the Illinois Critical Access Hospital Network (ICAHN). This organization started in 2002. The Illinois Rural Community Care Organization (IRCCO) was initiated by ICAHN as an LLC in 2014. One year later, in 2015, the IRCCO became an established Accountable Care Organization (ACO) with Medicare. Gibson Area Hospital and Health Services is committed to delivering high-quality care to our patient population while reducing the cost of health services. Our value-based programs reward health care providers with incentive payments for the quality of care they give to people with Medicare. These programs are part of our larger quality strategy to reform how health care is provided and paid for. The goal of care coordination is to ensure that patients, especially those with chronic conditions, get the right care at the right time while avoiding medical errors and unnecessary duplication of services. Gibson Area Hospital and Health Services are closing the gap in communication between healthcare providers and the care coordination team for our patients to receive the highest quality of care.
What is an ACO?
The Centers for Medicare and Medicaid Services defines Accountable Care Organizations (ACO) as groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated, high-quality care for the Medicare patients they serve. ACOs work to improve chronic disease management, ensure smoother transitions from hospitals to homes, and promote preventive care that keeps patients healthy.
Gibson Area Hospital and Health Services strive to bridge specialty health care to the rural communities we impact. Our coordinated care will continue to be “accountable” for high-quality and low-cost care.
Who is IRCCO and why are they important to me?
Illinois Rural Community Care Organization (IRCCO) is an Accountable Care Organization (ACO). IRCCO is a group of physicians, hospitals, and clinics that voluntarily work together with Medicare to provide high-quality services and care through the Medicare Shared Savings Program (MSSP). The following video summarizes why Gibson Area Hospital and Health Services participates in IRCCO for our patients that reside in rural Illinois.
Jane Video link: https://youtu.be/tIBxrorcUUU
What health information is available to the ACO?
Being a participant in an Accountable Care Organization, Gibson Area Hospital and Health Services receive their patients’ billing history from Medicare. Our Electronic Health Record (EHR) ensures that our patient's health information is safe, secured, and in one place from all of the providers you visit. This includes provider notes from a different hospital or area. Your Primary Care Physician (PCP) will have access to the health information they need to provide the best quality of care to you.
Will my health information be shared FOREVER?
Your health information will not be shared forever. You can always decline or change how you want Medicare to share your health information with an ACO.
- If you want Medicare to share your health information with Gibson Area Hospital and Health Services, call Medicare at 1-800-MEDICARE (1-800-633-4227) and tell them that you would like to share your claims data with the ACO.
- If you do NOT want Medicare to share your health information with Gibson Area Hospital and Health Services, call Medicare at 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week, and tell them you are calling about ACOs to decline your health information.
Who has access to my health information?
The Gibson Area Hospital and Health Services local care coordination team, including our primary care providers, and office staff are authorized to help personalize your health care plan.
Can I continue to visit my Primary Care Physician or will I have to switch to a provider in the ACO?
ACOs are person-centered organizations where the patient and providers are true partners in care decisions. Patients of ACOs maintain all of their original Medicare benefits and are able to see any Medicare provider.
How do I know if I am eligible or qualified for Chronic Care Coordination or Transitional Care Coordination?
Patients eligible for separately payable Chronic Care Coordination (CCC) services are people with Medicare and dual eligible (e.g. Medicare and Medicaid) individuals with two or more chronic conditions expected to last at least 12 months or until the death of the patient, when those conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline. These are the only diagnostic criteria. Examples of chronic conditions include, but are not limited to, the following: Alzheimer’s disease and related dementias, arthritis, asthma, atrial fibrillation, autism spectrum disorders, cancer, cardiovascular disease, chronic obstructive pulmonary disease, depression, substance use disorders, diabetes, hypertension, and infectious diseases such as HIV/AIDS.
**CONNECTED CARE: The Chronic Care Management Resource Updated Information Coming Soon!** Check back here as we update this important information!
How do I schedule my Annual Wellness Visit and who do I contact if I have questions?
You can contact your primary care physician’s office to schedule your annual wellness visit and ask questions. We are here to help!