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If there were any doubt, you can erase it now: If you’re a long-term care provider, you MUST make sure you are ingrained in whatever form accountable care organizations take near you in the future. That message came through exceedingly clear from Mark Parkinson, president and CEO of the American Health Care Association, during a free-ranging sit-down Tuesday with reporters.

He spoke of “tremendous implications” for the way the payment system is being shaped. In atypical frankness for a politician or association leader of his stature, he put the profession’s ACO cards on the table.

“We don’t want to be left out,” he said bluntly. “One of the worst things that could happen to our profession is if a large number of ACOs go to some other providers groups for post-acute care.”

It wasn’t always clear when his comments were meant as a reminder to policy makers, an appeal to hospitals (who would presumably be the linchpins to ACOs) or a warning to long-term care providers themselves.

One way or another, even if ACOs — which aren’t scheduled to debut until 2012 — don’t materialize as envisioned, something similar should. “Whether they are developed or not, I think there is a logic to episodic bundled payment,” Parkinson said.

Logic would then follow that there is little time for long-term care operators to waste. Cementing better relationships with hospitals and physicians in their area should begin immediately.