MSSPA4976 · PY2024 · state n/a

Mary Washington Health Alliance, LLC

★★★☆☆

quality 72/100 (XSPAN star)

Lives (aligned)

15,680

CMS revenue (total spend)

$214.7M

Benchmark

$213.1M

Shared savings earned

paid to the ACO by CMS (PY2024)

Savings generated

gross vs benchmark

Per-capita spend

$13,929

Acute admits /1k

305

ED visits /1k

720

30-day readmit rate

16.2%

Shared savings you retain / yr

$7.4M

3.4% of CMS revenue · keep 55%

FFS care-mgmt revenue / yr

$4.6M

2.1% of CMS revenue

Combined XSpan impact / yr

$11.9M

5.6% of CMS revenue

1 · Reduce avoidable utilization

From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $11.4M/yr.

Avoidable acute admits reduced15%

$7.3M/yr

30-day readmissions reduced20%

on 16.18% measured rate$1.9M/yr

ED visits deflected10%

$1.4M/yr

SNF admits reduced8%

$773.3K/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%$6.2M/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

$1.1M/yr

Care-management codes

Chronic Care ManagementCPT 99490$2.4M

Enrollment (of eligible)30%

$/member/month$62

~3,199 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.

Remote Patient MonitoringCPT 99453 / 99454 / 99457$2.2M

Enrollment (of eligible)25%

$/member/month$91

~1,960 enrolled (50% eligible × 25%). Device supply + 20-min treatment mgmt. Concurrent with CCM allowed.

Remote Therapeutic MonitoringCPT 98977 / 98980—

Wearable Device ReimbursementCPT 99454 (device supply)—

CY2024 national-average code rates — editable. In MSSP, care-management billing also counts toward ACO expenditures; net effect depends on your model.