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The forgotten players in ACO development: nursing homes.

Given the history and dynamics of the Patient Protection and Affordable Care Act, nursing homes have been left out of the business of Accountable Care Organization (ACO) development and implementation over the last year. Only now are ACOs, hospitals, and physicians realizing that an effective ACO needs long-term care and rehabilitation as a key component to maximize shared savings in the ACO environment. This article discusses the history of ACO development, examines why nursing homes may have been left out, and explains why nursing homes are critical participants in ACO effectiveness. The article also discusses how nursing homes will need to position their businesses for ACO participation.