The Lancaster General Health Community Care Collaborative (Lancaster General Health CCC) is our Accountable Care Organization (ACO).

Frequently Asked Questions

To ensure you have the right resources and information We have included the Accountable Care Organizations (ACO) Frequently Asked Questions as well as a few of our own.

What is an Accountable Care Organization (ACO)?

An Accountable Care Organization is a group of doctors, hospitals and other health care providers who agree to work together to give you improved health services and care. The ACO supports your doctor by making sure they have the most up-to-date information about your health care and services. In addition, the ACO can provide your doctor increased access to the expertise, staff, and technology needed to make sure your care is coordinated across all the places you get services. This is important to help you get the right care at the right time and to keep you healthy.

How will you know if your doctor has elected to participate in an ACO?

You will see signage in your provider's office informing you of our ACO, if your doctor or health care provider has elected to participate in the Lancaster General Health Community Care Collaborative — a care coordination program from Medicare. The goal of the Lancaster General Health CCC is to provide you with improved coordinated care across care settings including hospital stays, doctors’ offices, rehabilitative centers, and long-term care facilities.

If you still are not sure if your doctor has elected to participate in an ACO, just ask at your next primary care visit.

How will your doctor’s participation in the Lancaster General Health CCC benefit you?

For the purpose of care coordination, Medicare will share certain information about your medical care with your doctor and the ACO, including medical conditions, prescriptions, hospital stays and doctor visits. This is important so that your doctor will have the information needed to track the services you have already received, 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. For you, this care 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.

Are Medicare benefits changing because of the Lancaster General Health CCC?

No. Your Medicare benefits and the cost of your coverage are not changing. You still have the right to choose to receive care from any doctor or hospital that accepts Medicare, at any time.

What rights do you have if your doctor is participating in the Lancaster General Health CCC?

You will continue to receive the same rights enjoyed by all people with ‘Fee for Service’ Medicare. Since your right to privacy remains very important, Medicare and the Lancaster General Health CCC have put safeguards in place to make sure all your health information is protected. Also, Medicare will not share any information about alcohol and drug treatment history, if you have received such treatment, unless you choose in writing to share it.

Can you still see your regular doctor?

Yes. You will continue to be able to see any doctor or health care provider who accepts Medicare.

What do you need to do if you are notified that your doctor is participating in The Lancaster General Health CCC?

It is important to understand that your doctor, not you, is participating in the Accountable Care Organization, so you do not need to take any additional steps unless you choose not to allow Medicare to share your information for the purposes of care coordination.

How can you ask Medicare not to share your information with your doctor and The Lancaster General Health CCC?

You can choose to prevent Medicare from sharing your general health information for the purpose of care coordination with your doctor and the ACO by calling 1-800-MEDICARE (800-633-4227). TTY users should call 877-486-2048.

Is there a deadline if you choose to decline?

If you choose to prevent Medicare from sharing your health information with your doctor and The Lancaster General Health CCC, Medicare needs to be notified of your decision. However, if you do not decline now, you can choose to decline at any time in the future.

If I previously declined to share information by completing and submitting the "Declining to Share Personal Health Information" form that was mailed to me, or by calling Medicare, can I opt back in?

Yes. Simply call 1-800-MEDICARE (800-633-4227) and tell them that you have changed your mind, and that you do want your data shared.

Medicare Shared Savings Program Participation Waiver Disclosures

The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain federal fraud and abuse laws that might otherwise limit innovations by ACOs participating in the Medicare Shared Savings Program ACO Model (See “Final Waivers in Connection with the Shared Savings Program” (80 Fed. Reg. 66,726 (Oct. 29, 2015))).  Pursuant to the notice, Lancaster General Health Community Care Collaborative, LLC (“LGHCCC”) seeks waiver for the arrangement described below:

LGHCCC has developed a program of clinical integration (“CIP”) designed to: (i) improve the quality of and access to, and control the cost of, health care for the patients and populations served by LGHCCC’s participating providers and Lancaster General Health; (ii) improve the health of such patients and populations; (iii) monitor the health care services provided directly or indirectly through and arranged for by LGHCCC; (iv) integrate and coordinate the provision of such health care services by, and establish collaboration and accountability for such health care services by and among, participating providers; and (v) improve the patient experience for individuals receiving such health care services.

As part of the CIP, LGHCCC has entered into agreements, as recently amended, (the “Participating Provider Agreements”) with providers in LGHCCC’s community (the “ACO Participants”) for the purposes of functioning as a clinically-integrated network focused on implementing evidence-based medical practice, clinical guidelines, disease management programs and other quality improvement programs developed and implemented by LGHCCC.

The Board of Managers of LGHCCC (the “Board”) has determined that the obligations of LGHCCC and the ACO Participants, as specifically described in the amended Participating Provider Agreements,  constitute an arrangement that is reasonably related the purposes of the MSSP in that the ACO Participants agree, among other commitments, to actively and meaningfully participate in the CIP, including all initiatives, efforts, and requirements related to the design, development, implementation, and operation of LGHCCC’s CIP, including, without limitation:

  • Committing to accomplishing and demonstrating the triple aim of improved patient experience of care, improved health of populations, and lower per-capita cost of care;
  • Actively participating in governance matters, LGHCCC committees, and workgroups;
  • Encouraging investment in infrastructure and redesigned care processes for high-quality and efficient service delivery for patients, including Medicare beneficiaries, by requiring adherence to LGHCCC-adopted clinical protocols, clinical performance initiatives, measures and metrics designed to improve the quality of health care services rendered by ACO Participants.

If you have any questions and would like to contact the Lancaster General Health CCC, please call 717-544-8282 or email info@LGHealth.org.

For general information on ACOs, please contact Medicare at 800-MEDICARE (800-633-4227).

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