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MSSPA1290 · PY2024 · serves 2 states
MaineHealth Accountable Care Organization
★★★★☆
quality 83.3/100 (XSPAN star)
Lives (aligned)
36,313
CMS revenue (total spend)
$489.3M
Benchmark
$504.6M
Shared savings earned
$6M
paid to the ACO by CMS (PY2024)
Savings generated
$15.3M
gross vs benchmark
Per-capita spend
$13,829
Acute admits /1k
258
ED visits /1k
844
30-day readmit rate
14.6%
Service area ME, NHOperator Shannon Banks
Shared savings you retain / yr
$16.8M
3.4% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$10.6M
2.2% of CMS revenue
Combined XSpan impact / yr
$27.3M
5.6% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $25.8M/yr.
Avoidable acute admits reduced15%
$16.4M/yr
30-day readmissions reduced20%
on 14.55% measured rate$3.7M/yr
ED visits deflected10%
$3.9M/yr
SNF admits reduced8%
$1.8M/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%$14.2M/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
$2.6M/yr
Care-management codes
$5.5M
Enrollment (of eligible)30%
$/member/month$62
~7,408 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$5M
Enrollment (of eligible)25%
$/member/month$91
~4,539 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.