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MSSPA5069 · PY2024 · serves 12 states
EPC ACO, LLC
Met CMS quality standard
CMS assigned a default reporting score (shared by ~35 ACOs) — not individually star-rated.
Lives (aligned)
16,361
CMS revenue (total spend)
$551M
Benchmark
$661.4M
Shared savings earned
$81.1M
paid to the ACO by CMS (PY2024)
Savings generated
$110.4M
gross vs benchmark
Per-capita spend
$37,028
Acute admits /1k
825
ED visits /1k
1,547
30-day readmit rate
15.1%
Service area AZ, FL, IA, KS, MA, MO, NC, NY, PA, SC, TX, VAOperator Jennifer Marcus
Shared savings you retain / yr
$23.8M
4.3% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$4.8M
0.9% of CMS revenue
Combined XSpan impact / yr
$28.5M
5.2% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $36.6M/yr.
Avoidable acute admits reduced15%
$20.1M/yr
30-day readmissions reduced20%
on 15.05% measured rate$4.8M/yr
ED visits deflected10%
$3M/yr
SNF admits reduced8%
$8.7M/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%$20.1M/yr
Better care → higher rating → bonus
This ACO: not individually rated. Improving quality lifts your captured shared-savings share.
Extra share from quality gains+10 pts
$3.7M/yr
Care-management codes
$2.5M
Enrollment (of eligible)30%
$/member/month$62
~3,338 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$2.3M
Enrollment (of eligible)25%
$/member/month$91
~2,045 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.