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REACHD0253 · PY2024 · state n/a
North East Medical Services
★★★★★
quality 96/100 (XSPAN star)
Lives (aligned)
6,753
CMS revenue (total spend)
$74.8M
Benchmark
$65.4M
Shared savings earned
-$9.7M
paid to the ACO by CMS (PY2024)
Savings generated
-$9.7M
gross vs benchmark
Per-capita spend
$11,075
Acute admits /1k
158
ED visits /1k
429
30-day readmit rate
n/a (REACH)
Shared savings you retain / yr
$3.6M
4.9% of CMS revenue · keep 55%
FFS care-mgmt revenue / yr
$2M
2.6% of CMS revenue
Combined XSpan impact / yr
$5.6M
7.5% of CMS revenue
1 · Reduce avoidable utilization
From this ACO's own PY2024 utilization & unit costs. Gross avoidable cost: $5.6M/yr.
Avoidable acute admits reduced15%
$3.8M/yr
30-day readmissions reduced20%
14% national avg (not in REACH PUF)$821K/yr
ED visits deflected10%
$376.2K/yr
SNF admits reduced8%
$627.2K/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%$3.1M/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
$560.7K/yr
Care-management codes
$1M
Enrollment (of eligible)30%
$/member/month$62
~1,378 enrolled (68% eligible × 30%). Requires 2+ chronic conditions (~68% of Medicare FFS). Billable alongside RPM.
$937.7K
Enrollment (of eligible)25%
$/member/month$91
~844 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.