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MSSPA4657 · PY2024 · serves 2 states
AdvantagePoint Health Alliance - Laurel Highlands, LLC
★★★☆☆
quality 73.1/100 (XSPAN star)
Lives (aligned)
5,808
CMS revenue (total spend)
$70.6M
Benchmark
$72.1M
Shared savings earned
$752.1K
paid to the ACO by CMS (PY2024)
Savings generated
$1.5M
gross vs benchmark
Per-capita spend
$12,391
Acute admits /1k
275
ED visits /1k
595
30-day readmit rate
15.2%
Service area IA, PAOperator Sonia Walker
Shared savings you retain / yr
$2.6M
3.7% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$1.7M
2.4% of CMS revenue
Combined XSpan impact / yr
$4.3M
6.1% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $4M/yr.
Avoidable acute admits reduced15%
$2.7M/yr
30-day readmissions reduced20%
on 15.15% measured rate$646.4K/yr
ED visits deflected10%
$440.5K/yr
SNF admits reduced8%
$238.7K/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%$2.2M/yr
Better care → higher rating → bonus
This ACO: 3★ today. Improving quality lifts your captured shared-savings share.
Extra share from quality gains+10 pts
$404.1K/yr
Care-management codes
$881.6K
Enrollment (of eligible)30%
$/member/month$62
~1,185 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$806.6K
Enrollment (of eligible)25%
$/member/month$91
~726 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.