Hi janet23. Yes, tell your representatives in Congress!!! I started this thread because I became aware of the planned changes to Medicare through an article on an investment site. I also got a letter from my "previous" primary care provider telling me that she is part of an ACO and I "still have the right to self-refer to any doctor I wish".
In researching I found that Medicare will be transitioning all Original Medicare to ACOs over the coming years, because Medicare is changing how they pay - they will pay "by the head" and not "by fee-for-service".
QUESTION: Once the transition is complete to ACO with new payment structure (payment by head count), if you go outside the ACO for expertise who will pay them???? To me it seems that to maximize profits, the clinic has the interest to acquire as many patients as possible despite lacking sufficient number of doctors and expertise to meet patient needs. They will not want you to go outside their network of doctors and hospitals.

I need Mayo because I have a complex lung cancer, something Mayo is studying. Mayo's immediate diagnosis and prompt solution saved me a lot of grief and pain. My local clinic lacks expertise and solutions, but I could self-refer because I had original Medicare

If you have an orphan disease, no one but a sub-specialist in this rare disease column is QUALIFIED to render an opinion on your symptoms and certainly not in a crisis so, considering the fee the specialist would charge for his highly educated opinion, would you really trust an ACO who may be a general practitioner or a physician’s assistant deciding when you need to see a specialist? This ACO is fine for healthy people who might want an annual health screen but, it is a proposition no one with a complex health issue(s) should consider. They’ve been working hard in destroying our once excellent Medicare product for decades now.