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MSSPA5040 · PY2024 · serves 2 states
Pioneer Valley Accountable Care, LLC
★★★★☆
quality 83.4/100 (XSPAN star)
Lives (aligned)
28,842
CMS revenue (total spend)
$393.5M
Benchmark
$407.8M
Shared savings earned
$10.5M
paid to the ACO by CMS (PY2024)
Savings generated
$14.3M
gross vs benchmark
Per-capita spend
$13,890
Acute admits /1k
306
ED visits /1k
721
30-day readmit rate
17.3%
Service area CT, MAOperator Brian Banker
Shared savings you retain / yr
$15.3M
3.9% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$8.4M
2.1% of CMS revenue
Combined XSpan impact / yr
$23.7M
6.0% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $23.6M/yr.
Avoidable acute admits reduced15%
$15.1M/yr
30-day readmissions reduced20%
on 17.33% measured rate$4.2M/yr
ED visits deflected10%
$2.7M/yr
SNF admits reduced8%
$1.6M/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%$13M/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
$2.4M/yr
Care-management codes
$4.4M
Enrollment (of eligible)30%
$/member/month$62
~5,884 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$4M
Enrollment (of eligible)25%
$/member/month$91
~3,605 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.