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MSSPA3759 · PY2024 · serves 1 state
Riverside Health Source, LLC
★★★★★
quality 92.9/100 (XSPAN star)
Lives (aligned)
19,666
CMS revenue (total spend)
$227.6M
Benchmark
$232.1M
Shared savings earned
$0
paid to the ACO by CMS (PY2024)
Savings generated
$0
gross vs benchmark
Per-capita spend
$11,865
Acute admits /1k
221
ED visits /1k
679
30-day readmit rate
13.9%
Service area VAOperator Sally Ryan
Shared savings you retain / yr
$7M
3.1% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$5.7M
2.5% of CMS revenue
Combined XSpan impact / yr
$12.7M
5.6% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $10.7M/yr.
Avoidable acute admits reduced15%
$6.9M/yr
30-day readmissions reduced20%
on 13.91% measured rate$1.5M/yr
ED visits deflected10%
$1.7M/yr
SNF admits reduced8%
$625.1K/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%$5.9M/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
$1.1M/yr
Care-management codes
$3M
Enrollment (of eligible)30%
$/member/month$62
~4,012 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$2.7M
Enrollment (of eligible)25%
$/member/month$91
~2,458 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.