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MSSPA1247 · PY2024 · serves 1 state
RWJBH Accountable Care, LLC
★★★★☆
quality 84.3/100 (XSPAN star)
Lives (aligned)
41,294
CMS revenue (total spend)
$568.2M
Benchmark
$598.3M
Shared savings earned
$11.8M
paid to the ACO by CMS (PY2024)
Savings generated
$30.1M
gross vs benchmark
Per-capita spend
$14,070
Acute admits /1k
255
ED visits /1k
549
30-day readmit rate
15.4%
Service area NJOperator Maruf Rahman
Shared savings you retain / yr
$19.2M
3.4% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$12M
2.1% of CMS revenue
Combined XSpan impact / yr
$31.2M
5.5% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $29.6M/yr.
Avoidable acute admits reduced15%
$19.3M/yr
30-day readmissions reduced20%
on 15.41% measured rate$4.7M/yr
ED visits deflected10%
$2.9M/yr
SNF admits reduced8%
$2.7M/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%$16.3M/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
$3M/yr
Care-management codes
$6.3M
Enrollment (of eligible)30%
$/member/month$62
~8,424 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$5.7M
Enrollment (of eligible)25%
$/member/month$91
~5,162 enrolled (50% eligible × 25%). Device supply + 20-min treatment mgmt. Concurrent with CCM allowed.
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CY2024 national-average code rates — editable. In MSSP, care-management billing also counts toward ACO expenditures; net effect depends on your model.