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MSSPA4862 · PY2024 · serves 3 states
NJPACO R, LLC
★★★★☆
quality 86.3/100 (XSPAN star)
Lives (aligned)
11,060
CMS revenue (total spend)
$166.3M
Benchmark
$180.4M
Shared savings earned
$10.4M
paid to the ACO by CMS (PY2024)
Savings generated
$14.1M
gross vs benchmark
Per-capita spend
$15,334
Acute admits /1k
304
ED visits /1k
586
30-day readmit rate
16.4%
Service area MA, NJ, NYOperator Vinod Sancheti
Shared savings you retain / yr
$6.2M
3.7% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$3.2M
1.9% of CMS revenue
Combined XSpan impact / yr
$9.4M
5.6% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $9.5M/yr.
Avoidable acute admits reduced15%
$6M/yr
30-day readmissions reduced20%
on 16.36% measured rate$1.6M/yr
ED visits deflected10%
$826.2K/yr
SNF admits reduced8%
$1.1M/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%$5.2M/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
$950K/yr
Care-management codes
$1.7M
Enrollment (of eligible)30%
$/member/month$62
~2,256 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$1.5M
Enrollment (of eligible)25%
$/member/month$91
~1,383 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.