As healthcare providers you have seen a multitude of changes occurring over the last few years. Some of these changes last and some don’t. This tends to make one hesitate before acting to see if those changes will in fact stick. The conventional wisdom is that you don’t want to go charging headlong down a path with time and resources before you know it is the right thing to do.

One of the changes that has come down recently is the Affordable Care Act. There were many discussions concerning the legality and constitutionality that have been laid to rest by the United States Supreme Court.

Since that was decided, different facets of the Affordable Care Act have been bantered around. I have been closely following the Accountable Care Organizations. ACO’s are one way CMS has been promoting as a means to cutting federal cost in healthcare.

When the idea of ACO’s first began in 2011 no one really had any idea what they were, or what they were supposed to look like. Many different forms talked about. The idea of shared savings was one of the prevailing themes. ACO’s can be and are owned by a variety of entities. Hospitals, Physicians and even commercial payers are part of a variety of groups involved.

If you are located in an urban area, you probably have heard of, or even had dealings with, an ACO since that is where they were spawned.  If you have been tracking the growth of this industry, you will know that they are making their way into the more rural parts of the country.

When this initiative first began the people running ACO’s, while they felt like this was a worthwhile endeavor to embark upon, they along with everyone else were in unchartered waters. What I was reading and hearing was that the time for a skilled nursing provider to sit at the table of an ACO and negotiate their place had not begun. As I mentioned in the opening paragraph things change and this too has changed. NOW is the time to start reaching out to the ACO’s and figuring out how a skilled provider can fit into the picture.

If you don’t know how to begin, you are not alone. Simply start by asking questions. Ask what they think one such as you can do to be an attractive partner to their organization. Keep in mind, they may not be able to answer your questions but at least you have begun.

There are a few things that I think are important to remember as you do this. The fact that they may not know what to tell you is not the worst thing that could happen. In fact, this gives you the opportunity to help shape the conversation and the eventual outcome. Next, always remember this will be a data driven conversation. Having command of your data and being able to articulate the true meaning of those metrics, will be essential to your success. Lastly, you do not have to go into this with your hat in your hand. You provide an important piece to the continuum of care that is an ACO. Hospitals and physicians alike do not know how to provide the special nature of the service you provide. This whole thing is about saving dollars, and no one knows how to do that better, in your industry, than you. Be confident that you bring something very valuable and meaningful to the table.

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