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REACHD0061 · PY2024 · state n/a
CVS Accountable Care Organization, Inc.
★★★★★
quality 97/100 (XSPAN star)
Lives (aligned)
211,985
CMS revenue (total spend)
$3.3B
Benchmark
$3.2B
Shared savings earned
-$77.2M
paid to the ACO by CMS (PY2024)
Savings generated
-$77.2M
gross vs benchmark
Per-capita spend
$15,664
Acute admits /1k
255
ED visits /1k
602
30-day readmit rate
n/a (REACH)
Shared savings you retain / yr
$122.6M
3.7% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$61.6M
1.9% of CMS revenue
Combined XSpan impact / yr
$184.2M
5.5% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $188.6M/yr.
Avoidable acute admits reduced15%
$126.7M/yr
30-day readmissions reduced20%
14% national avg (not in REACH PUF)$27.5M/yr
ED visits deflected10%
$16.6M/yr
SNF admits reduced8%
$17.7M/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%$103.7M/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
$18.9M/yr
Care-management codes
$32.2M
Enrollment (of eligible)30%
$/member/month$62
~43,245 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$29.4M
Enrollment (of eligible)25%
$/member/month$91
~26,498 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.