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MSSPA2528 · PY2024 · serves 2 states
Capital Health Accountable Care Organization, LLC
★★★☆☆
quality 79.4/100 (XSPAN star)
Lives (aligned)
8,950
CMS revenue (total spend)
$112.6M
Benchmark
$119.6M
Shared savings earned
$2.7M
paid to the ACO by CMS (PY2024)
Savings generated
$7M
gross vs benchmark
Per-capita spend
$12,896
Acute admits /1k
241
ED visits /1k
542
30-day readmit rate
16.3%
Service area NJ, PAOperator David Dafilou
Shared savings you retain / yr
$3.9M
3.5% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$2.6M
2.3% of CMS revenue
Combined XSpan impact / yr
$6.5M
5.8% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $6M/yr.
Avoidable acute admits reduced15%
$3.8M/yr
30-day readmissions reduced20%
on 16.31% measured rate$994.5K/yr
ED visits deflected10%
$615.2K/yr
SNF admits reduced8%
$568.9K/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%$3.3M/yr
Better care → higher rating → bonus
This ACO: 3★ today. Improving quality lifts your captured shared-savings share.
Extra share from quality gains+10 pts
$600.6K/yr
Care-management codes
$1.4M
Enrollment (of eligible)30%
$/member/month$62
~1,826 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$1.2M
Enrollment (of eligible)25%
$/member/month$91
~1,119 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.