The Indiana University Health ACO

The Indiana University Health ACO

What is an ACO?

An Accountable Care Organization (ACO) is a group of doctors and other healthcare providers who agree to work together with Medicare to give you the best possible care. ACOs may take different approaches to giving you coordinated care. Some ACOs may have special nurses that help you set up appointments or make sure your medications are in order when you enter or leave a hospital. Other ACOs may help your doctors get you equipment for monitoring your medical conditions better at home, if you need it. Most ACOs use advanced systems that let them more carefully track your care, and make sure your doctor has the most up-to-date information about your health.

The goal of the ACO is to support your doctor in caring for you. ACOs help your doctor and healthcare providers work together more closely, by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions over and over. Working together, your doctors can do more to follow your health, make sure you get the best possible care, and may hire additional staff to help meet your unique care needs, depending on what works best for you.

Doctors and other healthcare providers choose to participate in an ACO because they’re committed to your care experience. They may also be rewarded for offering you better, more coordinated care. If your physician is part of the Indiana University Health ACO, you will be notified, either in person or by letter.

An ACO isn’t the same as a Medicare Advantage Plan or Health Maintenance Organization (HMO). You’re still in Original Medicare, and your Medicare benefits, services, rights and protections won’t change. And you still have the right to use any doctor or hospital that accepts Medicare at any time, the same way you do now.

Call the IU Health ACO at 317-963-4000

 

Frequently Asked Questions:

How do I know my doctor is in the Indiana University Health ACO?

ACOs must provide in-office notification of the provider's participation in the ACO in settings in which the beneficiary receives primary care services. In addition to this, Indiana University Health ACO, Inc. has mailed information to those patients whose doctors and/or other healthcare providers are participating in the Indiana University Health ACO.

If I have not been notified that my doctor is in the ACO, what do I need to do?

You don’t need to do anything. You’ll still be in Original Medicare, and you’ll still have the right to use any doctor or hospital that accepts Medicare, at any time.

Can I still see all of my regular Medicare doctors and healthcare providers?

You still have the right to see any doctor or hospital that accepts Medicare, at any time. You can continue getting care from your doctor at Indiana University Health, or you can choose to see a doctor who doesn’t participate in an ACO. It is your choice.

It’s important to know that:

  • You are still in Original Medicare.
  • You are still entitled to all the same Medicare services, benefits, and protections.
  • You can still go to any doctor, hospital, or other provider that accepts Medicare. Nobody can restrict which providers you see.

Can I still choose to receive services from any new doctor, hospital or healthcare provider that I want to?

You can still choose to go to any doctor, hospital, or other healthcare provider that accepts Medicare. Nobody – not even your current physician – can prevent you from seeing the doctors, hospitals or providers you want.

What information about me will the Indiana University Health ACO have access to?

To help doctors who participate in an ACO give patients like you the best possible care, Medicare wants to share some additional information about your care with them. This information includes things like doctor, hospital, and pharmacy visits in the past and moving forward. This information helps your doctor, and the other ACO providers, track the services you’ve already gotten, understand where you may need more care, and find ways to smooth the path for you if you have to transfer in or out of a hospital, or from the care of one doctor to another.  If you decide you do not want to have the information about your care shared with the ACO, you can do so.

How can I decline to have my personal health information shared?

We value your privacy, so it’s important to know that you can prevent Medicare from sharing this information at any time. 

There are three ways that you can prevent your information from being shared: 

  • You can call 1-800 MEDICARE (1-800-663-4227).  TTY users should call 1-877-486-2048 and tell the operator you are calling about ACOs.  
  • You can complete and sign the “Declining to Share Personal Health Information” form in your doctor’s office. 
  • We can send you a form to sign and return it.

After your form or phone call is received, Medicare will update its records to show that you do not want to have your data shared.  If you call 1-800 MEDICARE, you will receive a letter confirming this change.  It will take about 45 days for this change to take effect. 

What if I change my mind and decide that I do want my personal health information shared in the future?

If you change your mind in the future, you may call our doctor’s office and we will send you a form, called a “Consent to Change Personal Health Information Preference” form that you can complete and mail back to your physician’s office or you can call 1-800 MEDICARE (1-800-663-4227) and tell them that you have changed you mind and that you do want your data shared.   You will receive a letter confirming this change.

How long do I have to respond to say that I do not want my personal health information shared with the participating ACO?

Medicare values your privacy. For that reason, you can prevent Medicare from sharing your personal health information, or otherwise change any of your preferences, at any time.

Just call 1-800 MEDICARE, and they can help you set your preferences the way you want them.  You can also return the “Declining to Share Personal Health Information Form” to our doctor’s office.

I recently enrolled in a Medicare Advantage Plan but I also received a notice that my physician is part of the Indiana University Health ACO, does that change anything?

Because you chose to enroll in a Medicare Advantage Plan, the notice you received about Accountable Care Organizations (ACOs) is no longer accurate. Please disregard it.

What if I am already happy with my care the way it is?

We’re glad you’re having a positive experience already. You can continue to see you doctor the way you have been. Your doctor’s participation in an ACO won’t change your benefits in any way, and decisions about your care stay with you and your doctor.

When my doctor is in an ACO, how does that help him or her?

Doctors in ACOs may have better access to the expertise, staff, and technologies they need to make sure your care is coordinated across all the places you get services. For you, this coordination could mean less paperwork to fill out at the doctor’s office, avoiding unnecessary tests, or more help for you in dealing with any health conditions.

My IU Health doctor’s office sent me a letter, what do I need to do?

You do not need to take any additional steps to continue to receive care from your usual healthcare team. You’ll still be in Original Medicare, and you’ll still have the right to use any doctor or hospital that accepts Medicare, at any time. 

I received a letter that my doctor is participating in the Indiana University Health ACO.  What are the forms included in this letter? Do I have to fill them out?

It’s important to know that your doctor, not you, is participating in an Accountable Care Organization (ACO). You don’t have to fill out any forms or take any action to keep seeing him or her. 

The letter you got should include a form “Declining to Share Personal Health Information,”  

To help give you better care, Medicare would like to share information about visits you made to doctors, hospitals, or pharmacies. This information can help your doctor and other healthcare providers give you the best possible care.

You can choose to prevent Medicare from sharing this information by either by calling 1-800 Medicare; or completing the form you got and returning it to your doctor’s office.  You should fill this form out ONLY if you don’t want Medicare to share information.  

Can I receive a written translation of the letter I received from my doctor?

1-800 MEDICARE cannot provide you with a written version of the letter in at this time. Please know that you can always call 1-800 MEDICARE to get the information verbally, over the phone.

My relative received a letter from the Indiana University Health ACO, but they passed away recently, what do I need to do?

We are sorry to hear about your loss.  These letters were sent because of your relative’s history of receiving care from their physician who is participating in the Indiana University Health ACO.  You don’t need to do anything further – over time your relative will be removed from the list of patients affiliated with the participating physician.


Indiana University Health ACO, Inc.

ACO Name and Location:

  • Indiana University Health ACO, Inc., 340 West 10th Street, Indianapolis, Indiana 46202

ACO Primary Contact:

Organizational Information:

Indiana University Health ACO, Inc.’s Participants:

  • Indiana University Health, Inc.
  • Indiana University Health North Hospital, Inc.
  • Indiana University Health West Hospital Inc.
  • Cardiothoracic Surgeons Inc.
  • Clarian Transplant Institute, Inc.
  • Indiana University Psychiatric Associates, Inc.
  • Indiana University Radiology Associates, Inc.
  • I.U. Anesthesiology Associates, LLC
  • Indiana University Pain Medicine Center, LLC
  • I.U. Anesthesiology Associates - ICU, LLC
  • Indiana University Eye Care, Inc.
  • Indiana University Medical Genetics Service, Inc.
  • University Clinical Pathology Associates, Inc.
  • University Dermatology, Inc.
  • University Family Physicians Inc.
  • University Medical Diagnostic Associates, Inc.
  • University Obstetricians - Gynecologists Inc.
  • University Orthopaedic Associates, Inc.
  • University Otolaryngology Associates Inc.
  • University Physiatric Associates, Inc.
  • University Plastic Surgery Associates, P.C.
  • University Radiation Oncology Associates, Inc.
  • University Surgeons, Inc.
  • University Urologists, Inc., P.C.
  • University Vascular Surgery P.C.
  • Indiana Clinic - Neurology, LLC
  • ICEM - Wishard LLC
  • Indiana University Health Care Associates, Inc.
  • Indiana Clinic - Critical Care LLC
  • Indiana Clinic - Urology, LLC
  • Thomas A. Brady Sports Medicine Center P.C.
  • Oncology & Hematology Associates, LLC
  • HealthNet, Inc.
  • Arnett Clinic, LLC
  • Indiana University Health Arnett, Inc.
  • Indiana University Health Ball Memorial Physicians, Inc.
  • Indiana University Health Ball Memorial Hospital, Inc.
  • Indiana University Health Southern Indiana Physicians, Inc.
  • Indiana University Health Bedford Physicians, LLC
  • Indiana University Health Morgan Physicians, LLC
  • Southern Indiana Pediatrics, LLC
  • Orthopedics of South Central Indiana, LLC

Indiana University Health ACO, Inc.’s Governing Body:

  • Jonathan Gottlieb, M.D

    • Voting Member and Chair, Indiana University Health, Inc.

  • Michelle A. Janney, PhD, RN

    • Voting Member, Indiana University Health, Inc.

  • Dennis Murphy

    • Voting Member, Indiana University Health, Inc.

  • Ryan Kitchell

    • Voting Member, Indiana University Health, Inc.

  • Kishan Patel, M.D.

    • Voting Member, Arnett Clinic, LLC

  • Stephen Pollom, M.D.

    • Voting Member, Indiana University Health Care Associates, Inc.   

  • Michael Ober, M.D.

    • Voting Member, Indiana University Health Care Associates, Inc. 

  • Arthur Coffey, M.D.

    • Voting Member, Indiana University Health Care Associates, Inc.

  • Peter Sallay, M.D.

    • Voting Member, Thomas A. Brady Sports Medicine Center, P.C.   

  • Donald Trainor, M.D.

    • Voting Member, HealthNet, Inc.

  • Charles Lugar

    • Voting Member, Medicare Beneficiary Representative

Key Clinical and Administrative Leadership:

  • John F. Fitzgerald, M.D., CEO
  • Lori Luther, Chief Financial Officer
  • Deanna Willis, M.D., Chief Medical Officer
  • Michael Jackson, Chief Compliance Officer
  • Derek Empie, General Counsel
  • Neil Pickett, Chief of Staff
  • Jeffrey Rothenberg, M.D, Medical Director, Quality Improvement

Associated Committees and Committee Leadership

  • Finance and Savings Distribution Committee: ​John Fitzgerald, M.D., Chair
  • Patient Engagement; Patient Experience/Satisfaction Committee: Josh Georgen, Chair
  • Communications and Marketing Committee: Neil Pickett, Chair
  • Medical Management and Quality Committee: Deanna Willis, M.D., Chair

Types of ACO participants, or combination of participants, that formed the ACO

  • ACO Professionals in a group practice arrangement
  • Network of individual practices of ACO professionals
  • Partnership or joint venture arrangements between hospitals and ACO professionals
  • Hospital employing ACO professionals
  • Federally Qualified Health Center (FQHC)

Information Related to Indiana University Health ACO, Inc.’s Qualification for Medicare Shared Savings Program Pre-Participation and Participation Waivers:

The Board of Directors for Indiana University Health ACO, Inc. (“IU Health ACO”) has approved execution of a Memorandum of Understanding Regarding Contribution of Support Services by and among IU Health ACO and Indiana University Health, Inc. (“IU Health”) and Indiana University Health Care Associates, Inc. d/b/a IU Health Physicians (“IU Health Physicians”). In order to assist IU Health ACO in its pursuit of the Medicare Shared Savings Program’s three-part aim of (1) better care for individuals, (2) better health for populations, and (3) lower growth in Medicare Parts A and B expenditures, IU Health and IU Health Physicians have agreed to provide certain support services to IU Health ACO for startup and ongoing operations of IU Health ACO. The support services include:

  • Personnel resources
  • Information technology resources
  • Patient communication media, including patient notifications, printings and mailings, website development, call center training, Service Excellence training, and facilities signage

Amount of Shared Savings / Losses

  • Performance Year 1:  $0
  • Performance Year 2:  $0
  • Performance Year 3:  $0

​Quality Performance Results

 

2012 Reporting Period

 

2013 Reporting Period

 

2014 Reporting Period

 

 

ACO Performance Rate

Mean Performance Rate for All ACO’s

ACO Performance Rate

Mean Performance Rate for All ACO’s

ACO Performance Rate

Mean Performance Rate for All ACO’s

Getting Timely Care, Appointments, and Information 

 

 

 

 

78.44

80.13

How Well Your Doctors Communicate 

 

 

 

 

92.69

92.39

Patients’ Rating of Doctor 

 

 

 

 

92.58

91.58

Access to Specialists 

 

 

 

 

87.67

83.97

Health Promotion and Education

 

 

 

 

55.88

58.29

Shared Decision Making 

 

 

 

 

72.30

74.60

Health Status / Functional Status        

70.65

71.10

Standardized, All-Condition Readmissions (ACO-8)

15.01

15.42

14.82

14.90

15.25

15.15

ASC Admissions – COPD or Asthma in Older Adults (ACO-9)

1.76

1.13

1.40

1.17

1.50

1.08

ASC Admissions – Heart Failure (ACO-10)

1.15

1.09

1.19

1.20

1.11

1.19

Percent of PCPs Who Qualified for EHR Incentive Program (ACO-11)

60.33

63.37

76.96

66.21

89.55

76.71

Medication Reconciliation 

 

 

 

 

60.35

82.61

Falls: Screening for Fall Risk 

 

 

 

 

48.06

45.60

Influenza Immunization

 

 

 

 

66.99

57.51

Pneumococcal Vaccination

 

 

 

 

79.38

55.03

Adult Weight Screening and Follow-up

 

 

 

 

44.47

66.75

Tobacco Use Assessment and Cessation Intervention

 

 

 

 

91.04

86.79

Depression Screening

 

 

 

 

12.11

39.27

Colorectal Cancer Screening

 

 

 

 

57.77

56.14

Mammography Screening

 

 

 

 

66.35

61.41

Proportion of Adults who had blood pressure screened in past 2 years

 

 

 

 

45.74

60.24

Beneficiaries with diabetes who met of all the following criteria:

 

 

 

 

31.23

25.41**

Hemoglobin A1c Control (HbA1c) (<8 percent)

 

 

 

 

75.06

 

Low Density Lipoprotein (LDL) (< 100 mg/dL)

 

 

 

 

64.41

 

Blood Pressure (BP) < 140/90

 

 

 

 

73.61

 

Tobacco Non-Use

 

 

 

 

83.54

 

Aspirin Use

 

 

 

 

90.21

 

Percent of beneficiaries with diabetes whose HbA1c in poor control (>9 percent)

 

 

 

 

14.53

20.35

Percent of beneficiaries with hypertension whose BP < 140/90

 

 

 

 

71.36

68.02

Percent of beneficiaries with IVD with complete lipid profile and LDL control < 100mg/dl

 

 

 

 

66.67

57.29

Percent of beneficiaries who use Aspirin or other antithrombotic

 

 

 

 

90.75

80.79

Beta-Blocker Therapy for LVSD

 

 

 

 

88.97

82.71

Percent of beneficiaries with CAD who met all of the following criteria:

 

 

 

 

65.94

66.9**

Drug Therapy for Lowering LDL-Cholesterol

 

 

 

 

71.81

 

(ACE) Inhibitor or (ARB) Therapy for Patients with CAD and Diabetes and/or (LVSD)

 

 

 

 

78.81

 

*Measure is part of either the Diabetes Composite measure or the Coronary Artery Disease Composite measure
**Mean is not available for the individual measures making up the Diabetes composite or the Coronary Artery Disease composite