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MSSPA3783 · PY2024 · serves 3 states
Privia Quality Network Gulf Coast II, LLC
★★★★☆
quality 88.7/100 (XSPAN star)
Lives (aligned)
20,860
CMS revenue (total spend)
$235.7M
Benchmark
$262.9M
Shared savings earned
$20M
paid to the ACO by CMS (PY2024)
Savings generated
$27.2M
gross vs benchmark
Per-capita spend
$11,533
Acute admits /1k
202
ED visits /1k
490
30-day readmit rate
15.2%
Service area OR, TX, WAOperator douglas fernandez
Shared savings you retain / yr
$7.3M
3.1% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$6.1M
2.6% of CMS revenue
Combined XSpan impact / yr
$13.4M
5.7% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $11.3M/yr.
Avoidable acute admits reduced15%
$7.7M/yr
30-day readmissions reduced20%
on 15.2% measured rate$1.8M/yr
ED visits deflected10%
$1.3M/yr
SNF admits reduced8%
$467.5K/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%$6.2M/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
$1.1M/yr
Care-management codes
$3.2M
Enrollment (of eligible)30%
$/member/month$62
~4,255 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$2.9M
Enrollment (of eligible)25%
$/member/month$91
~2,608 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.