What is the Primary Care ACO Plan?
The Primary Care ACOs are groups of primary care providers or PCPs who, together, form an ACO that is responsible for your care and the coordination of your care. The ACO works directly with MassHealth to provide primary care and to coordinate the full range of services for you, along with its other members. Primary Care ACO Plans work with the MassHealth network of specialists and hospitals and may have certain providers in their “referral circle.” The “referral circle” gives you direct access to certain other providers or specialists without the need for a referral from your primary care provider (PCP). The Massachusetts Behavioral Health Partnership (MBHP) provides behavioral health services.
The ACO practices bring together a care team of providers and assign care coordinators or clinical care managers to oversee your care. For instance, if you need to see your provider for a medical appointment, your PCP may refer you to a provider that is in the MassHealth network.
Choosing an ACO plan that serves the area where you live will help you stay connected to your providers.
If you choose this plan, you need to pick a primary care provider within the Primary Care ACO’s network.
After you have picked one of these plans, you can still switch to another health plan later for any reason during your annual 90-day Plan Selection Period If you are in your Fixed Enrollment Period, you can also change to a new health plan if you meet certain reasons.
Each Primary Care ACO will work with you to help you reach your health goals. For more information about each plan, please click on the plans below or go to MassHealthChoices.com to find and compare plans nearest you.