MSSPA2695 · PY2024 · serves 3 states

Northeast Medical Group ACO, LLC

★★★★☆

quality 86.5/100 (XSPAN star)

Lives (aligned)

25,119

CMS revenue (total spend)

$376.4M

Benchmark

$393M

Shared savings earned

$6.5M

paid to the ACO by CMS (PY2024)

Savings generated

$16.6M

gross vs benchmark

Per-capita spend

$15,274

Acute admits /1k

262

ED visits /1k

694

30-day readmit rate

14.5%

Service area CT, NY, RIOperator Rajlakshmi Krishnamurthy

Shared savings you retain / yr

$12.8M

3.4% of CMS revenue · keep 55%

FFS care-mgmt revenue / yr

$7.3M

1.9% of CMS revenue

Combined XSpan impact / yr

$20.1M

5.3% of CMS revenue

1 · Reduce avoidable utilization

From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $19.6M/yr.

Avoidable acute admits reduced15%

$12.7M/yr

30-day readmissions reduced20%

on 14.53% measured rate$2.9M/yr

ED visits deflected10%

$2.2M/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%$10.8M/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

$2M/yr

Care-management codes

Chronic Care ManagementCPT 99490$3.8M

Enrollment (of eligible)30%

$/member/month$62

~5,124 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.

Remote Patient MonitoringCPT 99453 / 99454 / 99457$3.5M

Enrollment (of eligible)25%

$/member/month$91

~3,140 enrolled (50% eligible × 25%). Device supply + 20-min treatment mgmt. Concurrent with CCM allowed.

Remote Therapeutic MonitoringCPT 98977 / 98980—

Wearable Device ReimbursementCPT 99454 (device supply)—

CY2024 national-average code rates — editable. In MSSP, care-management billing also counts toward ACO expenditures; net effect depends on your model.