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MSSPA2542 · PY2024 · serves 1 state
Baylor Quality Health Care Alliance LLC
★★★★★
quality 94.2/100 (XSPAN star)
Lives (aligned)
115,862
CMS revenue (total spend)
$1.4B
Benchmark
$1.5B
Shared savings earned
$77.8M
paid to the ACO by CMS (PY2024)
Savings generated
$105.9M
gross vs benchmark
Per-capita spend
$12,363
Acute admits /1k
241
ED visits /1k
562
30-day readmit rate
14.8%
Service area TXOperator Edwin Lee
Shared savings you retain / yr
$46.2M
3.3% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$33.7M
2.4% of CMS revenue
Combined XSpan impact / yr
$79.9M
5.7% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $71.1M/yr.
Avoidable acute admits reduced15%
$48.5M/yr
30-day readmissions reduced20%
on 14.76% measured rate$11.2M/yr
ED visits deflected10%
$8.3M/yr
SNF admits reduced8%
$3.1M/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%$39.1M/yr
Better care → higher rating → bonus
This ACO: 5★ today. Improving quality lifts your captured shared-savings share.
Extra share from quality gains+10 pts
$7.1M/yr
Care-management codes
$17.6M
Enrollment (of eligible)30%
$/member/month$62
~23,636 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$16.1M
Enrollment (of eligible)25%
$/member/month$91
~14,483 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.