MSSPA3613 · PY2024 · state n/a

Utah Physicians Quality Care

★★★★☆

quality 80.7/100 (XSPAN star)

Lives (aligned)

4,902

CMS revenue (total spend)

$64.2M

Benchmark

$67.5M

Shared savings earned

$1.6M

paid to the ACO by CMS (PY2024)

Savings generated

$3.3M

gross vs benchmark

Per-capita spend

$13,414

Acute admits /1k

262

ED visits /1k

650

30-day readmit rate

15.7%

Shared savings you retain / yr

$2.3M

3.5% of CMS revenue · keep 55%

FFS care-mgmt revenue / yr

$1.4M

2.2% of CMS revenue

Combined XSpan impact / yr

$3.7M

5.7% of CMS revenue

1 · Reduce avoidable utilization

From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $3.5M/yr.

Avoidable acute admits reduced15%

$2.2M/yr

30-day readmissions reduced20%

on 15.69% measured rate$547.5K/yr

ED visits deflected10%

$404.2K/yr

SNF admits reduced8%

$320K/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%$1.9M/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

$347.8K/yr

Care-management codes

Chronic Care ManagementCPT 99490$744K

Enrollment (of eligible)30%

$/member/month$62

~1,000 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.

Remote Patient MonitoringCPT 99453 / 99454 / 99457$681K

Enrollment (of eligible)25%

$/member/month$91

~613 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.