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MSSPA5191 · PY2024 · serves 1 state
ELEHEALTH MEDICARE ACO LLC
Met CMS quality standard
CMS assigned a default reporting score (shared by ~35 ACOs) — not individually star-rated.
Lives (aligned)
5,603
CMS revenue (total spend)
$73.7M
Benchmark
$75.6M
Shared savings earned
$0
paid to the ACO by CMS (PY2024)
Savings generated
$0
gross vs benchmark
Per-capita spend
$13,465
Acute admits /1k
290
ED visits /1k
655
30-day readmit rate
15.1%
Service area LAOperator Sabrina Hogan
Shared savings you retain / yr
$2.6M
3.5% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$1.6M
2.2% of CMS revenue
Combined XSpan impact / yr
$4.2M
5.7% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $4M/yr.
Avoidable acute admits reduced15%
$2.4M/yr
30-day readmissions reduced20%
on 15.11% measured rate$575K/yr
ED visits deflected10%
$466.4K/yr
SNF admits reduced8%
$522K/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%$2.2M/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
$398.6K/yr
Care-management codes
$850.4K
Enrollment (of eligible)30%
$/member/month$62
~1,143 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$777.7K
Enrollment (of eligible)25%
$/member/month$91
~700 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.