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MSSPA4577 · PY2024 · serves 3 states
SOMOS ACCOUNTABLE CARE ORGANIZATION LLC
★★★★☆
quality 81.3/100 (XSPAN star)
Lives (aligned)
6,065
CMS revenue (total spend)
$81.1M
Benchmark
$90.7M
Shared savings earned
$4.7M
paid to the ACO by CMS (PY2024)
Savings generated
$9.6M
gross vs benchmark
Per-capita spend
$13,595
Acute admits /1k
237
ED visits /1k
516
30-day readmit rate
14.2%
Service area GA, NJ, NYOperator OSCAR FUKILMAN
Shared savings you retain / yr
$3M
3.7% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$1.8M
2.2% of CMS revenue
Combined XSpan impact / yr
$4.8M
5.9% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $4.6M/yr.
Avoidable acute admits reduced15%
$2.9M/yr
30-day readmissions reduced20%
on 14.15% measured rate$641.2K/yr
ED visits deflected10%
$400.1K/yr
SNF admits reduced8%
$652.5K/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%$2.5M/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
$461.1K/yr
Care-management codes
$920.3K
Enrollment (of eligible)30%
$/member/month$62
~1,237 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$842.1K
Enrollment (of eligible)25%
$/member/month$91
~758 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.