What legal advice would you have for joining an accountable care organization or similar alliance? It seems like skilled nursing facilities are getting the short end of the stick and we’re wondering if we can do anything to make sure we get our fair share of any proceeds.

Negotiating with an accountable care organization or similar alliance is a very tricky and complex situation.  These organizations seek to provide comprehensive, high-quality and coordinated healthcare services at the lowest possible cost.

ACOs look at organizations serving seniors (SNFs, continuing care retirement communities, assisted living and independent living providers) who understand the importance of high-quality, coordinated care at a low cost.

These senior-serving specialists must recognize the new parameters affecting hospitals, such as the negative impact that hospital readmissions have on government payment programs.

Generally speaking, these organizations serving seniors can be at a lower cost than hospital-based care, and this is a major selling point for the ACO allowing you to participate in managing the operations of the ACO, as well as participating in the financial rewards.

Your ability to demonstrate lower cost will enhance your argument to receive funding, as well as increase the ACO utilization of your organization for ACO-controlled patients.

In sum, organizations serving seniors must understand and structure themselves to increase their value to ACOs as well as other managed care payors, allowing them to continue to participate in the changing marketplace for the purchase of healthcare services.