"My first selling point is there is a non-risk option for you to gain some experience without significant downside," he says. "Yes, you might have to make some significant investments. But the world is heading in this direction and we are going to be more accountable for the quality and the cost of the care we deliver."
"Here they are saying 'we will look at your current costs and if you can improve on them you will get some shared savings back. And by the way we will even do it in a non-risk fashion. Over three years if you get more savings you get 50% of that back," he said.
As for alienating specialists, Spahlinger says that the push to keep people out of the hospital is going to go forward with or without ACOs. "CMS is going to pull a bunch of levers over the next five years to try to reduce readmissions and inappropriate care and they are going to micromanage it even if you don't go into this ACO model," he says. "This model allows you to say what our current costs are, we improve upon it and we get 50% of it back."