As the way people in the U.S. access their healthcare continues to change, your Benefit Fund is working closely with our participating providers to improve your care, most recently through the creation of Accountable Care Organizations (ACOs). As you may know, an ACO is a group or network of doctors who work together to help ensure patients receive the best possible care. In 2014, we entered into our first ACO agreement with Montefiore Medical Center, and in January 2016, we partnered with the Union and Northwell Health (formerly the North Shore-LIJ Health System) to create our second ACO. We will soon launch new partnerships with the Mount Sinai Health System and AdvantageCare Physicians.
What does this mean for you? If you receive most of your healthcare services from Mount Sinai providers, for example, or from any group with whom we partner in the future, you will be automatically enrolled in their 1199SEIU ACO program. We will send you a letter that explains how the program works. You will have a care management team of nurses, pharmacists, social workers and health educators who can work together to create a personalized plan to help you manage a chronic condition, recover from a serious illness, or transition back home or to another setting after a hospital stay. These healthcare providers will be able to access specific information—such as the dates you visited a doctor or hospital, the treatment you received, any tests or screenings you underwent and the prescriptions you received—which can eliminate duplicate medical tests and referrals, and helps ensure you get the care you need when you need it.
Your healthcare benefits will not change, and you can opt out of the program at any time by calling our Member Services Department at (646) 473-9200. All of your information is protected under regulations of the Health Insurance Portability and Accountability Act (HIPAA), and the only people who see it are your healthcare providers.