The reaction to ACOs? Ouch!

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The reaction to ACOs? Ouch!
The reaction to ACOs? Ouch!

I haven't heard them pronounced this way yet, but long-term care providers might want to consider it when it comes to ACOs. Instead of spelling it out, as in A-C-O, say it phonetically, as in "Ache-O."

That's because those accountable care organizations that everybody is spending megabytes of storage space pontificating about could cause some significant pain in the future.

True, they're still being mapped out, but this much is known for sure: Hospitals and physicians will be the centerpieces (center pools?) of this bundled payment model. If hospitals don't somehow absorb them entirely, long-term care facilities will be a relatively minor offshoot hoping to catch some of Uncle Sam's money downstream.

LTC providers might find arid conditions if they're not careful. Hospitals are already positioning themselves as victims in the design of ACOs. You see, there just isn't going to be that much money to pass along once they're set up, or so their story has started. The American Hospital Association last week issued a report that showed hospitals would have to spend many more times than the government estimated to start one of these ACO things.

Adept at crying "poor" themselves, skilled nursing providers are going to have to grit their teeth and bear it while the AHA does its own poor-mouth tap dance. The flow of funding is being strangled even before it starts. That AHA-sponsored report lists no less than 23 cost centers that will be draining ACO funding, and post-acute care is just one of them.

Thus beginneth the lesson in master manipulation. While many believe long-term care has a slick lobbying arm — and it does —  its luster and power are relatively minor, compared to what the hospitals muster.

The time to really worry, though, will be if the hospitals pull out the old chestnut and say, "Just close your eyes ... this isn't going to hurt a bit."

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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