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MSSPA3834 · PY2024 · serves 5 states
CareMax National Care Network, LLC
Met CMS quality standard
CMS assigned a default reporting score (shared by ~35 ACOs) — not individually star-rated.
Lives (aligned)
73,142
CMS revenue (total spend)
$985.8M
Benchmark
$1.1B
Shared savings earned
$49.9M
paid to the ACO by CMS (PY2024)
Savings generated
$67.9M
gross vs benchmark
Per-capita spend
$13,718
Acute admits /1k
297
ED visits /1k
645
30-day readmit rate
15.9%
Service area FL, MA, NH, RI, TNOperator Kristin Shaw
Shared savings you retain / yr
$37.7M
3.8% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$21.3M
2.2% of CMS revenue
Combined XSpan impact / yr
$59M
6.0% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $58.1M/yr.
Avoidable acute admits reduced15%
$37.3M/yr
30-day readmissions reduced20%
on 15.9% measured rate$9.4M/yr
ED visits deflected10%
$6M/yr
SNF admits reduced8%
$5.4M/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%$31.9M/yr
Better care → higher rating → bonus
This ACO: not individually rated. Improving quality lifts your captured shared-savings share.
Extra share from quality gains+10 pts
$5.8M/yr
Care-management codes
$11.1M
Enrollment (of eligible)30%
$/member/month$62
~14,921 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$10.2M
Enrollment (of eligible)25%
$/member/month$91
~9,143 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.
Part of a 2-ACO family run by Kristin Shaw
combined: 80,520 lives · $51.3M earned · 6 states
CMS reports each ACO separately by legal entity. This operator's Medicare-FFS footprint spans the ACOs below — Medicare Advantage / commercial lives are not in the CMS PUFs and are not shown.