What is a Direct Contracting Entity?
Medicare has started an initiative where health care providers who share a common set of goals aimed at improving patient care can work together more effectively. A Direct Contracting Entity (DCE) brings together a group of doctors, hospitals and/or other healthcare providers who agree to work together with Medicare to provide you with more coordinated care according to your individual medical needs and treatment choices.
What is Iora Health Network?
Iora Health Network is the Direct Contracting Entity that some Iora and One Medical primary care providers participate in. See above for a list of current participating providers.
Why did Iora and One Medical join a DCE?
Iora and One Medical are participating in this initiative because both believe it will bring better quality of care to our patients. Patients who participate in this initiative may benefit from care coordination and preventative services or reduced out-of-pocket expenses from duplicate tests and duplicate paperwork that may cost you time and money.
Why did I receive a letter saying I am part of Iora Health Network?
Medicare requires an annual beneficiary letter be sent to each patient who is part of the program. There are two ways a patient can become aligned to the program:
If I am in the program, can I continue seeing my specialists without needing referrals/authorizations? Can I choose a new primary care provider?
Yes, your insurance remains Original Medicare, and your benefits do not change. You retain the freedom to seek care from any Medicare provider without any additional need for referrals or authorizations. You have the option to designate a new primary care provider by visiting mymedicare.gov if you choose, but are not required to do so.
How can I learn more?
If you have other questions about Iora Health Network or Direct Contracting, you can contact us at 1-617-655-9595, or you may call Medicare at 1-800-MEDICARE.