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MSSPA4949 · PY2024 · serves 1 state
Carilion Clinic Medicare Shared Savings Company, LLC
★★☆☆☆
quality 65.9/100 (XSPAN star)
Lives (aligned)
40,526
CMS revenue (total spend)
$451M
Benchmark
$473.1M
Shared savings earned
$16.2M
paid to the ACO by CMS (PY2024)
Savings generated
$22.1M
gross vs benchmark
Per-capita spend
$11,342
Acute admits /1k
237
ED visits /1k
625
30-day readmit rate
14.8%
Service area VAOperator John Epling
Shared savings you retain / yr
$15.5M
3.4% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$11.8M
2.6% of CMS revenue
Combined XSpan impact / yr
$27.3M
6.1% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $23.9M/yr.
Avoidable acute admits reduced15%
$14.7M/yr
30-day readmissions reduced20%
on 14.79% measured rate$3.4M/yr
ED visits deflected10%
$3.2M/yr
SNF admits reduced8%
$2.5M/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%$13.1M/yr
Better care → higher rating → bonus
This ACO: 2★ today. Improving quality lifts your captured shared-savings share.
Extra share from quality gains+10 pts
$2.4M/yr
Care-management codes
$6.2M
Enrollment (of eligible)30%
$/member/month$62
~8,267 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$5.6M
Enrollment (of eligible)25%
$/member/month$91
~5,066 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.