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ACOs: Medicare and MassHealth

As an Accountable Care Organization (ACO), our affiliated doctors, hospitals, and other health care providers come together to provide coordinated, high-quality care to our patients.

ACO certification seal from Health Policy Commission

About ACOs

Improving your care

By participating in an ACO, your primary care physician can enhance the care you receive by coordinating with your other health care providers. Together, they share your health information to better meet your individual needs and care preferences.

The goal of an ACO is for doctors, hospitals, and other health care providers to work closely together to deliver coordinated, high-quality care.

What does “accountable” mean?

ACOs have agreements with insurance companies to provide special services and care coordination for patients. These agreements set performance standards in quality and spending for the ACO. If the ACO is able to meet or exceed these standards for patient care, they may be eligible for shared savings with the insurance company. If they do not meet the standards, they may have to pay money back to the insurance company.

Our commitment to high-quality care

Since 2012, our health system entered into contracts with all the major insurers, including the Centers for Medicare and Medicaid Services (CMS), commercial payers, and MassHealth (state Medicaid program).

After five years in the Medicare Pioneer ACO model, we saved $36.7 million. As a Medicare Next Generation ACO, with an overall quality score of 100% in 2017, we were among the top ACOs in the nation for delivering high-quality care to patients. Today, we participate in the Mass General Brigham Medicare ACO (Medicare Shared Savings Program), as well as the Mass General Brigham MassHealth ACO.

Mass General Brigham Medicare ACO (Medicare Shared Savings Program)

We are committed to improving the health of individual patients and patient populations, while lowering costs.

Many of our affiliated providers are participating in a care coordination program called the Medicare Shared Savings Program (MSSP), designed specifically for Medicare patients and sponsored by Medicare. 

As part of the Mass General Brigham Medicare ACO, your provider may be participating in this program, including providers affiliated with Brigham and Women's Hospital, Massachusetts General Hospital (including Nantucket Cottage Hospital and Martha’s Vineyard Hospital), Newton-Wellesley Hospital, Salem Hospital, Cooley Dickinson Hospital, Emerson Hospital, Pentucket Medical Associates, Milford Regional Physicians Group, Wentworth-Douglass Hospital, and Charles River Medical Associates.

Your Medicare Benefits

Have questions?

For questions on Medicare benefits, please call Medicare at 1-800-MEDICARE (1-800-633-4227).  
(TTY users should call 1-877-486-2048.)

If you have questions, you can call the Mass General Brigham Medicare ACO hotline at 1-800-229-0384.

Mass General Brigham MassHealth ACO

Important information for Mass General Brigham MassHealth ACO members in response to COVID-19 

Mass General Brigham MassHealth ACO is a health plan for MassHealth members offered by Mass General Brigham. It is an Accountable Care Organization or “ACO.” An ACO is a team of doctors, nurses, and other providers who work together to provide coordinated, high-quality care for members. The Mass General Brigham MassHealth ACO offers the same benefits as MassHealth (the Massachusetts Medicaid program).

Our goal is to make sure that you have access to the doctors and caregivers that you need to improve your overall health. A Mass General Brigham PCP will coordinate your care, and you will have access to additional benefits, support programs, and services.

Where to go for care

Primary care

Mass General Brigham MassHealth ACO members must have a primary care doctor at a primary care practice or health center within Mass General Brigham. See the list of primary care practices (PDF)
 
To find the location of your primary care doctor’s office, please use our Find-A-Doctor online search tool.

Hospitals and specialty care

With Mass General Brigham MassHealth ACO, you will have access to the world-class medical experts at our hospitals and organizations. View thelist of the Mass General Brigham MassHealth ACO Members and Provider Organizations. (PDF)
 
You can also go to the many doctors and hospitals that accept MassHealth. To find a hospital or a specialist (e.g., cardiologist, endocrinologist), visit the MassHealth Find a Doctor tool. You do not need a referral for most providers in the Mass General Brigham system.

Behavioral health

You can see any behavioral health provider on the Massachusetts Behavioral Health Partnership (MBHP). For questions or concerns about your mental health care, contact Massachusetts Behavioral Health Partnership (MBHP) at 1-800-495-0086. You can search for a mental health provider using the MBHP provider directory.

Resources for Mass General Brigham MassHealth ACO members

Health survey for members

The Mass General Brigham MassHealth ACO health survey is available for current members.

For more information

Mass General Brigham MassHealth ACO 
399 Revolution Drive 
Somerville, MA 02145

1-800-231-2722 
Monday through Friday, 8:00 am – 5:00 pm

PartnersHealthCareChoiceACO@partners.org

1-800-841-2900 

TTY users should call 1-800-497-4648 

Monday through Friday, 8:00 am – 5:00 pm. 

mass.gov/MassHealth

Phone: 1-866-455-1344 
8:00 am – 5:00 pm 
Fax: 617-526-1980

ATTN: Grievance Coordinator 
399 Revolution Drive, Suite 820 
Somerville, MA 02145

My Ombudsman will work with you to make sure you receive your benefits and exercise your rights within your health plan.

https://myombudsman.org/

1-855-781-9898 (Toll Free)

*For TTY users, use MassRelay at 711 to call the number above. 

info@myombudsman.org