The reaction to ACOs? Please pass the aspirin

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James M. Berklan, Editor
James M. Berklan, Editor
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 issued a report last month 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” to Uncle Sam and anyone else who will listen 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 fewer 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 hospital lobby can muster.

Hospitals are going to be scrambling for their financial well-being with regard to ACO formation and how to handle federal regulators, something you can relate to on many fronts. But they'll also be looking for “partners” to see where they can save a buck.

The time to really worry will be when they pull out the old chestnut and say, “Just close your eyes … this isn't going to hurt a bit.”
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