FOR BENEFICIARIES
Working together for better health
If you have traditional Medicare (also known as Medicare fee-for-service), you may have a provider who chooses to participate in an accountable care organization (ACO). Providers in the Portland, Oregon metro area can choose to be part of the Tuality Health Plan Services (THPS) network.
THPS is not a Medicare Advantage or HMO plan. Having a provider working with THPS does not affect your Medicare benefits or the cost of your coverage.
Medicare beneficiaries have the freedom to seek the services and providers of their choice.
Learn about ACOs
What is an Accountable Care Organization (ACO)?
Accountable Care Organizations (ACOs) are groups of doctors, hospitals and other health care providers, who come together voluntarily to give coordinated, high-quality care to the Medicare patients they serve.
Our focus at THPS ACO is:
- Better patient experiences
- Improving the health of our patients
- Lowering the overall cost of care
How are you connected to this ACO?
Your doctor has chosen to participate in THPS. Because of this, there are many benefits available to you to help keep you as healthy as possible. THPS is a group of doctors, hospitals and other health professionals that work together to provide efficient, high-quality and coordinated care to patients with Medicare fee-for-service as their insurance.
Medicare beneficiary notice
If your doctor chooses to participate in an ACO, you will be notified. This notification might be a letter, written information provided to you when you see your doctor, a sign posted in a hospital, or it might be a conversation with your doctor. THPS ACO is required to send a form notice to you each year. A link to that form is below.
Opting out of an ACO
Beneficiaries have the right to contact Medicare at any time with questions or concerns, or to opt out of data sharing with the ACO.
- If you wish to continue participation as is, there is nothing you need to do.
- If you wish to continue seeing all of your same providers, you may do so and there is nothing you need to do.
- If you wish to opt out of sharing your claims data, you may do so and continue to see your same providers.
- If you wish to not have your clinical data shared, you can call Medicare and tell them your health provider is part of an ACO and you don’t want Medicare to share your health care information. Only you can make this call, so we encourage you to do so, if that is your wish.
- Call 800 MEDICARE (800-633-4227)
- TTY users 1-877-486-2048
Additional resources and information about ACOs
Local State Health Insurance Assistance Program (SHIP)
Social Security Administration
800-772-1213
Medicare
1-800-MEDICARE (633-4227)
Medicare Rights Center
800-333-4114
National Council on Aging
Finding care
How to select a primary care provider
Medicare-fee-for-service beneficiaries can log in to Medicare.gov and choose their primary clinician. This is the health care provider you believe is responsible for coordinating your overall care.
For more information, refer to the following resource:
Register for MYMedicare.gov and Choose Your Primary Clinician English / Spanish