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MSSPA3473 · PY2024 · serves 1 state
Houston Methodist Coordinated Care
★★★★★
quality 95.6/100 (XSPAN star)
Lives (aligned)
49,360
CMS revenue (total spend)
$712.3M
Benchmark
$780.8M
Shared savings earned
$50.4M
paid to the ACO by CMS (PY2024)
Savings generated
$68.6M
gross vs benchmark
Per-capita spend
$14,601
Acute admits /1k
258
ED visits /1k
604
30-day readmit rate
13.9%
Service area TXOperator Julia Andrieni
Shared savings you retain / yr
$22.5M
3.2% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$14.3M
2.0% of CMS revenue
Combined XSpan impact / yr
$36.8M
5.2% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $34.5M/yr.
Avoidable acute admits reduced15%
$24M/yr
30-day readmissions reduced20%
on 13.88% measured rate$5.2M/yr
ED visits deflected10%
$3.8M/yr
SNF admits reduced8%
$1.5M/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%$19M/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
$3.5M/yr
Care-management codes
$7.5M
Enrollment (of eligible)30%
$/member/month$62
~10,069 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$6.9M
Enrollment (of eligible)25%
$/member/month$91
~6,170 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.