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MSSPA3236 · PY2024 · serves 2 states
PQN - Georgia, LLC
★★★★★
quality 91.7/100 (XSPAN star)
Lives (aligned)
32,466
CMS revenue (total spend)
$340.6M
Benchmark
$380.3M
Shared savings earned
$29.2M
paid to the ACO by CMS (PY2024)
Savings generated
$39.7M
gross vs benchmark
Per-capita spend
$10,710
Acute admits /1k
214
ED visits /1k
502
30-day readmit rate
15.9%
Service area GA, TNOperator Zia Khan MD
Shared savings you retain / yr
$10.5M
3.1% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$9.4M
2.8% of CMS revenue
Combined XSpan impact / yr
$20M
5.9% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $16.2M/yr.
Avoidable acute admits reduced15%
$10.6M/yr
30-day readmissions reduced20%
on 15.87% measured rate$2.7M/yr
ED visits deflected10%
$2.1M/yr
SNF admits reduced8%
$831.8K/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%$8.9M/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
$1.6M/yr
Care-management codes
$4.9M
Enrollment (of eligible)30%
$/member/month$62
~6,623 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$4.5M
Enrollment (of eligible)25%
$/member/month$91
~4,058 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.