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MSSPA2098 · PY2024 · serves 11 states
The Accountable Care Organization, Ltd.
★★★★☆
quality 87.5/100 (XSPAN star)
Lives (aligned)
74,586
CMS revenue (total spend)
$922.7M
Benchmark
$980.7M
Shared savings earned
$42.6M
paid to the ACO by CMS (PY2024)
Savings generated
$58M
gross vs benchmark
Per-capita spend
$12,573
Acute admits /1k
237
ED visits /1k
549
30-day readmit rate
14.7%
Service area AR, CA, FL, HI, KS, MI, NC, NY, PA, TX, WAOperator Sam Starbuck
Shared savings you retain / yr
$30.3M
3.3% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$21.7M
2.3% of CMS revenue
Combined XSpan impact / yr
$52M
5.6% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $46.7M/yr.
Avoidable acute admits reduced15%
$30.3M/yr
30-day readmissions reduced20%
on 14.71% measured rate$7M/yr
ED visits deflected10%
$5.2M/yr
SNF admits reduced8%
$4.2M/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%$25.7M/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
$4.7M/yr
Care-management codes
$11.3M
Enrollment (of eligible)30%
$/member/month$62
~15,216 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$10.4M
Enrollment (of eligible)25%
$/member/month$91
~9,323 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.