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Anthony Cirillo

Accountable Care for Long-Term Care

By October 23, 2010

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I am speaking and attending the American Health Care Association conference in Long Beach, California this upcoming week. As I reviewed the sessions being offered, I was surprised by what was not being covered.

As healthcare reform is interpreted one of the things that the industry is grappling with is this notion of accountable care organizations (ACO). It has been better defined in the hospital sector and would include multiple providers and physicians being responsible for the health of a population and being paid as one, a bundled payment.

There is no lacking for information on the hospital provider side. There is an ACO Summit and an ACO Magazine for starters. But what constitutes an ACO for long-term care providers. It may progress like this (though it is certainly not linear):

  • Non-medical home care
  • Adult day care
  • Adult medical day care
  • Medical home care
  • Independent living community
  • Continuing Care Retirement community
  • Assisted Living
  • Skilled Nursing care
  • Hospice

If you look at aging as a continuum of care then it is only logical that an ACO model would develop here as well. But with wide speculation in the hospital industry you can only imagine the vast confusion on the long-term side.

So what is a provider to do? Some are posturing. Some are acquiring.

On the upper end of care, skilled nursing, some facilities are seeking Joint Commission accreditation so that they are positioned (by demonstrating their quality and safety) to be part of say a hospital provider's ACO. Other organizations have a mindset of acquisition. Own more of the continuum, be your own ACO, keep all the money. Gentiva is an example.

However it shakes out, long-term care needs to think about their own interpretation of the accountable care organization. By controlling more of the continuum of care, organizations will be prepared for the implications of healthcare reform and they will be assuring the filling of their pipeline as people progress from one level of care to another. At the same time, the consistency of the brand experience over time will help develop loyalists and ambassadors for organizations that will continue to fill the pipeline for years to come.

My advice to all levels of providers is to start seriously thinking about where you fit in the continuum of care and start to build the alliances and relationships you need for future viability and success.

For more information, check out this article on Accountable Care Organizations and the accompanying glossary.


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