"For some groups that have not done any of this, it's a huge marathon," says William DeMarco, a consultant from Rockford, IL, who helps organizations prepare for value-based reimbursement by helping them build ACOs or other value-based operational constructs.
"When we see estimates of what it costs to launch an ACO, they're often in the millions of dollars and have scared the daylights out of a lot of people, and that's before they realize that the ACO is probably not the only thing they'll be spending money on."
DeMarco says such estimates are often overstated. But even if they aren't, focusing on how much it will cost as a reason to delay investment in transformation is counterproductive. "Whether you form an ACO or not, you'll still have to spend money to get ready for reform," he says.
And ACOs get results, he says.
But whether or not you decide to form a full-fledged ACO, building the expertise and knowledge to operate within one is critical and should not be put off.
Make Primary Care a Focus
For instance, regardless of whether an ACO or even participating in Medicare's shared savings program is in your immediate or short-term plans, making primary care a focus, using case managers and paramedics to better coordinate and steer care to lower cost areas will be invaluable.