Steven A. Harris, a healthcare attorney in Chicago, made six points on drawing up contracts for accountable care organizations for physicians in a column in the American Medical News.
1. Create a business plan. Create a well-defined business plan that addresses the many different relationships an ACO may have. "The flexibility inherent in the ACO model provides physicians with options that suit their professional, economic and tax-planning needs," Mr. Harris wrote.
2. Include internal and external relationships. Material on both internal and external relationships should go into the contract. "Internally, there are a multitude of relationships within the ACO that should be clarified in writing," Mr. Harris wrote.
3. Sign agreements with all ACO members. Such agreements should detail clinical, administrative and financial aspects of the relationship. Members should have agreements governing the relationships among themselves that detail their expectations and responsibilities.
4. Create an ACO board. "The board will serve as the collective voice of the ACO," Mr. Harris wrote. The agreement with the board should outline what it can and cannot do, voting requirements, who may serve, meeting schedule and use of subcommittees.
5. Sign participation agreements with payors. The payors will probably require participation agreements with individual physicians as well as with the ACO. "Typically, [payors] do not deviate from their standard contract language, but there is occasionally room to negotiate, depending on the payers' interest in the ACO and its individual members," Mr. Harris wrote.
6. Provide for flexibility. "Contracts governing the relationship should be flexible enough to allow the ACO to evolve with changes in federal and state laws and regulations," Mr. Harris wrote.
Read the American Medical News column by Steven Harris on ACOs.
Related articles on setting up ACOs:
ACOs: 5 Tips to Avoid Anticompetitive Behavior
Physician Integration: Hospital Medical Leaders Share Challenges, Strategies6 Building Blocks of a Technology Framework for ACOs