MSSPA1066 · PY2024 · state n/a

Essentia Health

★★★★☆

quality 87.6/100 (XSPAN star)

Lives (aligned)

28,317

CMS revenue (total spend)

$366.6M

Benchmark

$389.4M

Shared savings earned

$16.7M

paid to the ACO by CMS (PY2024)

Savings generated

$22.7M

gross vs benchmark

Per-capita spend

$13,228

Acute admits /1k

245

ED visits /1k

751

30-day readmit rate

13.8%

Shared savings you retain / yr

$12.6M

3.4% of CMS revenue · keep 55%

FFS care-mgmt revenue / yr

$8.2M

2.2% of CMS revenue

Combined XSpan impact / yr

$20.8M

5.7% of CMS revenue

1 · Reduce avoidable utilization

From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $19.3M/yr.

Avoidable acute admits reduced15%

$12.4M/yr

30-day readmissions reduced20%

on 13.83% measured rate$2.7M/yr

ED visits deflected10%

$2.7M/yr

SNF admits reduced8%

$1.6M/yr

ED cost per visit$1,300

2 · How MSSP pays you

FFS shared savings + separately-billable care-management codes.

Shared-savings rate you keep55%

BASIC 40% → ENHANCED 75%$10.6M/yr

Better care → higher rating → bonus

This ACO: 4★ today. Improving quality lifts your captured shared-savings share.

Extra share from quality gains+10 pts

$1.9M/yr

Care-management codes

Chronic Care ManagementCPT 99490$4.3M

Enrollment (of eligible)30%

$/member/month$62

~5,777 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.

Remote Patient MonitoringCPT 99453 / 99454 / 99457$3.9M

Enrollment (of eligible)25%

$/member/month$91

~3,540 enrolled (50% eligible × 25%). Device supply + 20-min treatment mgmt. Concurrent with CCM allowed.

Remote Therapeutic MonitoringCPT 98977 / 98980—

Wearable Device ReimbursementCPT 99454 (device supply)—

CY2024 national-average code rates — editable. In MSSP, care-management billing also counts toward ACO expenditures; net effect depends on your model.