REACHD0025 · PY2024 · state n/a

VillageMD Primary Providers ACO II, LLC

★★★★★

quality 99/100 (XSPAN star)

Lives (aligned)

25,755

CMS revenue (total spend)

$396.6M

Benchmark

$436.9M

Shared savings earned

$40.2M

paid to the ACO by CMS (PY2024)

Savings generated

$40.2M

gross vs benchmark

Per-capita spend

$15,399

Acute admits /1k

262

ED visits /1k

570

30-day readmit rate

n/a (REACH)

Shared savings you retain / yr

$14.1M

3.6% of CMS revenue · keep 55%

FFS care-mgmt revenue / yr

$7.5M

1.9% of CMS revenue

Combined XSpan impact / yr

$21.6M

5.4% of CMS revenue

1 · Reduce avoidable utilization

From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $21.7M/yr.

Avoidable acute admits reduced15%

$15.3M/yr

30-day readmissions reduced20%

14% national avg (not in REACH PUF)$3.3M/yr

ED visits deflected10%

$1.9M/yr

SNF admits reduced8%

$1.2M/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%$11.9M/yr

Better care → higher rating → bonus

This ACO: 5★ today. Improving quality lifts your captured shared-savings share.

Extra share from quality gains+10 pts

$2.2M/yr

Care-management codes

Chronic Care ManagementCPT 99490$3.9M

Enrollment (of eligible)30%

$/member/month$62

~5,254 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.

Remote Patient MonitoringCPT 99453 / 99454 / 99457$3.6M

Enrollment (of eligible)25%

$/member/month$91

~3,219 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.