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Value-Based Contracts

Contract performance, shared savings, quality bonuses, and provider distribution · Performance Year 2024

Total Contracts
14
↑ 3new this year
Shared Savings Earned
$2.84M
↑ 18.4%vs prior year
Quality Bonus
$640K
↑ 12.1%7 contracts eligible
Risk Corridor Exposure
$180K
↓ 2 contractsin loss band
Active Contracts
Contract Name ↕ Payer Type Performance Period Status Benchmark PMPM Actual PMPM Savings / Loss Quality Score
Medicare ACO REACH Primary CMS / Medicare Shared Savings Jan–Dec 2024 Active $920.40 $848.72 +$71.68
87%
Medicaid Managed Care (Region 4) State Medicaid Capitation Jul 2024–Jun 2025 Active $642.00 $658.40 -$16.40
72%
BCBS Commercial Shared Savings Blue Cross Blue Shield Shared Savings Jan–Dec 2024 Active $512.20 $487.90 +$24.30
91%
Aetna Bundled Payment — Hip/Knee Aetna CVS Health Bundled Jan–Dec 2024 Active $28,400 $26,180 +$2,220
84%
UnitedHealth Medicaid ACO UnitedHealthcare Shared Savings Jan–Dec 2024 Pending Settlement $710.60 $695.10 +$15.50
78%
Contract Detail — Medicare ACO REACH Primary
Medicare ACO REACH Primary
CMS · Shared Savings · Jan–Dec 2024 · 3,840 attributed lives
On Track
Benchmark Cost PMPM
$920.40
CMS risk-adjusted benchmark
Actual Cost PMPM
$848.72
7.8% below benchmark
Gross Savings
$3.30M
$71.68 PMPM × 3,840 × 12
Quality Score vs Target
87% / 85%
Exceeds target
Distribution %
60%
Plan share of savings
Provider Share (40%)
$1.32M
Distributed to 218 providers
Benchmark vs Actual Cost PMPM — Monthly Trend
12-month rolling for Medicare ACO REACH Primary
Benchmark
Actual
Quality Measures vs Target
Diabetes HbA1c Control92% / 88%
Preventive Screenings89% / 85%
30-Day Readmission Rate8.2% / 10%
Medication Adherence76% / 80%
Patient Satisfaction (CAHPS)88% / 82%
ED Utilization Rate420/1K / 480/1K
Provider Savings Distribution
Provider Name Specialty NPI Attributed Lives Savings Contribution Distribution Amount Quality Tier
Dr. Sandra Kim, MDInternal Medicine1234567890342$148,200$59,280Tier 1
Westside Family PracticeFamily Medicine2345678901518$224,100$89,640Tier 1
Dr. Robert Almanza, DOGeriatrics3456789012214$92,600$37,040Tier 2
Northgate Medical GroupMulti-Specialty4567890123687$297,400$118,960Tier 1
Dr. Patricia Moore, MDInternal Medicine5678901234188$81,300$32,520Tier 3
Page Guide

This page tracks all value-based contracts, their performance vs. benchmarks, and shared savings distributions.

  • Click any row in the contract list to see its detail panel below.
  • The KPI cards at the top summarize all contracts combined.
  • Use the Performance Year dropdown to view historical data.
  • The Export button generates a detailed PDF or CSV summary.
  • Shared Savings: Plan earns a % of savings below benchmark. Both upside and downside risk variants exist.
  • Capitation: Fixed PMPM payment. Plan bears full risk for cost overruns.
  • Bundled Payment: Single payment covers all services for a defined episode (e.g., hip replacement).
  • Benchmark PMPM: CMS or payer risk-adjusted target cost per member per month.
  • Actual PMPM: Your plan's actual cost per member per month.
  • Distribution %: Your plan's share of the gross savings pool.
  • Provider Share: Portion distributed to participating providers by their tier.
  • Quality score above target unlocks the quality bonus payment.
  • Monitor capitation contracts monthly — overruns erode margin quickly.
  • Quality score gate must be passed before savings are distributed.
  • Provider tier assignments drive individual distribution amounts — review tier criteria quarterly.
  • For bundled contracts, ensure episode definition matches payer's claims grouper.
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