Accountable care organizations (ACOs) and their potential impacts on rural health management and practice

The Accountable Care Organization (ACO) model of patient centered care is hot topic in the literature and among policy makers. ACO executive personnel are in the developmental stages of advancing management and practice innovations that seek to optimize integrated patient-centered care. Their emerging policies will have wide-ranging and serious implications as to whether or not an ACO will actually achieve quality integrated care while lowering costs. As the ACO model is increasingly being adopted nationwide, there is a growing need to assess and better understand how and to what extent ACOs will involve rural health partners. Are rural health organizations and communities positioned to transition toward an effective ACO model? One significant obstacle in terms of optimizing rural ACOs participation and efficiency has been a lack of leadership, according to scholarly rural health literature. Adoption and implementation of ACOs by rural providers will require informed leadership and creativity to mitigate economic, geographic, cultural as well as legal and regulatory barriers; subsequently, best practices must to be identified and disseminated. Moreover, collaboration and discussion will be key factors in determining future ACO outcomes. This presentation highlights qualitative data provided by ACO administrative personnel describing their challenges and opportunities in establishing ACOs. This information is highly valuable to managers and administrators of Rural Health Clinics (RHCs), Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), as well as other rural health partners. As ACO implementation moves forward, understanding ACO leadership risks, opportunities, rewards, and challenges in the early phases of adoption can play a vital role in ongoing rural health strategic planning.