ACO
Trinity Integrated Care, LLC
ACO ID: A3454 · Track: EN
MSSP Performance — Key Metrics
Assigned Beneficiaries
110,957 p98
Savings Rate
1.19% p20
Quality Score
88.97 p78
Per Capita Expenditure, Total ($)
$13,274 p62
Generated Savings/Losses ($)
$17,441,735
Earned Savings/Losses ($)
$12,819,675
Updated Benchmark ($)
$13,434 p53
Bottom quartile
Middle
Top quartile
MSSP median shown in gray · Peer median in blue
Program Structure
| Current Track | EN |
| Agreement Type | Renewal |
| Agreement Period | 2 |
| Start Date | 1/1/2020 |
| Risk Model ? | Two-Sided |
| Assignment Type ? | Prospective |
| SNF 3-Day Waiver ? | ✓ |
Financial Performance
Step-by-step savings calculation from historical benchmark to earned savings/losses.
| Step | Description | Value | MSSP Median | Peer Median |
|---|---|---|---|---|
| 1 | Assigned Beneficiaries | 110,957 p98 | 13,159 | 50,640 |
| 2 | Historical Benchmark (per capita) | $11,637 p54 | $11,439 | $11,531 |
| 3 | Regional Adjustment | +$169 | ||
| 4 | Prior Savings Adjustment | +- | ||
| 5 | Adjustment Category | Regional Adjustment | ||
| 6 | Updated Benchmark (per capita) | $13,434 p53 | $13,279 | $13,519 |
| 7 | Total Benchmark (all beneficiaries) | $1,463,704,011 | ||
| 8 | Total Expenditure (all beneficiaries) | $1,446,262,276 | ||
| 9 | Per Capita Expenditure (PY) | $13,274 p62 | $12,693 | $13,228 |
| 10 | Generated Savings / Losses | $17,441,735 | $6,931,306 | — |
| 11 | Savings Rate | 1.19% p20 | 4.21% | 4.70% |
| 12 | Minimum Savings Rate (threshold) | 0.50% | ||
| 13 | Guardrail Applied | — | ||
| 14 | Final Shared Savings Rate | 75.00% | ||
| 15 | Final Shared Loss Rate | 40.00% | ||
| 16 | Earned Savings / Losses | $12,819,675 | $3,685,876 | — |
| Revenue-to-Expense Category | High Revenue | |||
Per Capita Expenditure by Population Segment
Annual per-beneficiary expenditure across benchmark years (BY1–BY3) and the performance year (PY). Includes Parts A and B FFS spending.
| Population Segment | BY1 | BY2 | BY3 | PY | Trend | Risk-Adj. Expected | Difference |
|---|---|---|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) | $84,793 | $87,379 | $93,438 | $99,073 | ↑ | $91,717 | +$7,356 |
| Disabled | $9,473 | $9,838 | $10,303 | $12,221 | ↑ | $11,592 | +$629 |
| Aged, Dual-Eligible | $15,515 | $15,498 | $16,012 | $20,032 | ↑ | $18,877 | +$1,155 |
| Aged, Non-Dual | $9,789 | $10,069 | $10,460 | $12,693 | ↑ | $12,216 | +$477 |
| Total | $13,274 | $12,693 | $13,228 |
Risk Scores
Hierarchical Condition Category risk scores. A score of 1.0 = national average. Below 1.0 means the population is healthier than average.
CMS-HCC Risk Scores
| Population Segment | BY1 | BY2 | BY3 | PY | Trend | Coding Gap | MSSP Med. |
|---|---|---|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) | 1.053 | 1.047 | 1.042 | 0.982 | ↓ | -0.015 | 0.967 |
| Disabled | 0.988 | 1.002 | 0.999 | 0.960 | → | -0.050 | 0.934 |
| Aged, Dual-Eligible | 1.032 | 1.027 | 1.022 | 0.997 | ↓ | -0.034 | 0.954 |
| Aged, Non-Dual | 1.063 | 1.061 | 1.063 | 1.013 | ↓ | -0.015 | 0.983 |
Demographic Risk Scores
Demographic-only risk scores (age/sex/Medicaid status). Compared with HCC risk scores, the difference reflects clinical coding intensity.
| Population Segment | BY3 | PY |
|---|---|---|
| End-Stage Renal Disease (ESRD) | — | 0.997 |
| Disabled | — | 1.010 |
| Aged, Dual-Eligible | — | 1.031 |
| Aged, Non-Dual | — | 1.028 |
Risk Redistribution Weights (PY)
Fraction of the ACO's total risk attributable to each population segment.
| ESRD Weight | 2.1% |
| Disabled Weight | 7.3% |
| Aged Dual Weight | 7.9% |
| Aged Non-Dual Weight | 82.7% |
Beneficiary Demographics
Distribution of 110,957 assigned beneficiaries by age, gender, and race/ethnicity.
Age Distribution
Gender
Race / Ethnicity
Special Populations
9.71%
p68 Dual-Eligible (MSSP median: 6.9%)
1.57%
p73 Long-Term Institutionalized (MSSP median: 0.89%)
680 VA Beneficiaries
Enrollment by Category (Person-Years)
| Category | BY3 | PY |
|---|---|---|
| ESRD | 1,004 | 282 |
| Disabled | 17,009 | 8,306 |
| Aged, Dual-Eligible | 8,431 | 5,830 |
| Aged, Non-Dual | 103,320 | 94,538 |
| Total (PY) | 108,956 |
Per Capita Spending by Service Category
Annual per-beneficiary spending by care setting. Bar shows this ACO's share; red marker shows MSSP median share.
| Service Category | This ACO | % Share | MSSP Median | Peer Median | |
|---|---|---|---|---|---|
| Inpatient — All | $3,662 p63 | 26.8% | $3,410 | $3,426 | |
| Inpatient — Short-Term Acute | $3,242 | $2,914 | — | ||
| Inpatient — Long-Term | $40 | $59 | — | ||
| Inpatient — Rehab | $367 | $367 | — | ||
| Inpatient — Psychiatric | $45 | $37 | — | ||
| Hospice | $342 | 2.5% | $258 | $341 | |
| Skilled Nursing Facility | $802 p68 | 5.9% | $655 | $770 | |
| Outpatient | $3,292 p59 | 24.1% | $3,078 | $3,803 | |
| Physician / Supplier (Part B) | $4,486 p55 | 32.9% | $4,341 | $3,953 | |
| Ambulance | $145 | 1.1% | $134 | $141 | |
| Home Health | $523 | 3.8% | $470 | $493 | |
| Durable Medical Equipment | $398 | 2.9% | $405 | $442 |
Utilization — Admissions & Visits
Rates per 1,000 assigned beneficiaries unless otherwise noted.
32.7% ED-to-Hospitalization Conversion Rate
0.76:1 PCP-to-Specialist Visit Ratio
| Metric | This ACO | MSSP Median | Peer Median |
|---|---|---|---|
| Hospital Admissions (per 1,000) | 271 p68 | 251 | 260 |
| Short-Term Acute Admissions (per 1,000) | 252 | 229 | — |
| Long-Term Admissions (per 1,000) | 1 | 1 | — |
| Rehab Admissions (per 1,000) | 15 | 15 | — |
| Psychiatric Admissions (per 1,000) | 4 | 3 | — |
| ED Visits (per 1,000) | 627 p54 | 618 | 658 |
| ED Visits Resulting in Hospitalization (per 1,000) | 205 | 179 | — |
| CT Scans (per 1,000) | 788 p59 | 751 | 817 |
| MRI Scans (per 1,000) | 249 p50 | 247 | 244 |
| E&M Visits — Total (per 1,000) | 12,299 | 12,433 | — |
| E&M Visits — Primary Care (per 1,000) | 3,970 p43 | 4,192 | 3,625 |
| E&M Visits — Specialist (per 1,000) | 5,253 p58 | 4,821 | 4,655 |
| Nurse Practitioner Visits (per 1,000) | 2,925 p72 | 2,464 | 2,768 |
| FQHC / RHC Visits (per 1,000) | 151 p49 | 160 | 404 |
| SNF Admissions (per 1,000) | 49 | 40 | 46 |
| SNF Average Length of Stay (days) | 26 p34 | 27 | 26 |
| SNF Average Payment per Stay | $14,561 p39 | $15,338 | $14,720 |
Provider Composition
Facilities
| Hospitals | 18 |
| Critical Access Hospitals | 5 |
| FQHCs | 1 |
| Rural Health Clinics | 13 |
| Extension of Treatment Areas | 0 |
| Other Facilities | 35 |
Clinicians
| Primary Care Physicians | 2,361 |
| Specialists | 4,744 |
| Nurse Practitioners | 2,363 |
| Physician Assistants | 1,670 |
| Clinical Nurse Specialists | 12 |
CAHPS Patient Experience
Consumer Assessment of Healthcare Providers and Systems survey scores (0–100 scale). Gray marker = MSSP median. Blue marker = peer median.
Getting Timely Care, Appointments & Information p83 87.6
How Well Providers Communicate p83 95.5
Patient's Rating of Provider p67 93.4
Access to Specialists p74 78.4
Health Promotion & Education p49 65.6
Shared Decision-Making p79 65.7
Health Status / Functional Status p36 74.0
Courteous & Helpful Office Staff p56 86.5
Care Coordination p49 93.2
Stewardship of Patient Resources p1 17.2
Clinical Quality Measures
MSSP quality measures. Measures marked "lower is better" are inverted — a lower score indicates better performance.
| Measure | This ACO | MSSP Median | Peer Median |
|---|---|---|---|
| Overall Quality Score (Composite) p78 | 88.97 | 83.13 | 87.61 |
| All-Cause Unplanned Admissions (risk-adjusted rate) (lower is better) ? p67 | 0.16 | 0.15 | 0.15 |
| Risk-Standardized All-Condition Readmission Rate (lower is better) ? p14 | 31.14 | 36.11 | 37.06 |
| Falls: Screening for Future Fall Risk p69 | 94.93 | 91.53 | 95.30 |
| Influenza Immunization p73 | 75.89 | 70.06 | 72.43 |
| Tobacco Use: Screening & Cessation Intervention p50 | 83.33 | 82.86 | 83.33 |
| Colorectal Cancer Screening p78 | 84.40 | 80.23 | 83.11 |
| Breast Cancer Screening p79 | 86.79 | 82.59 | 84.68 |
| Statin Therapy for CVD Prevention p59 | 88.43 | 87.36 | 87.97 |
| Depression Remission at 12 Months p65 | 18.52 | 14.29 | 10.48 |
Depression Screening & Follow-Up Plan p61 Reporting pathways
| 86.72 | 83.73 | 85.89 |
Diabetes: HbA1c Poor Control (>9%) (lower is better) p42 Reporting pathways
| 7.92 | 8.44 | 6.95 |
Controlling High Blood Pressure p63 Reporting pathways
| 82.39 | 80.24 | 82.10 |
Quality Reporting Flags
Met Quality Performance Standard (QPS)
Met Alternative QPS
Met 40th Percentile Threshold
Met SSP Quality Reporting Requirements
Reported via Web Interface
Reported via eCQM / CQM / Medicare CQM
First-Year ACO Quality Pass
Met Incentive Threshold
Received 40th Percentile Bonus
Disaster / Affected Quality Waiver Applied
Peer Cohort
30 similar very large, ENHANCED-track, above-average acuity, rural infrastructure ACOs
View 30 peer ACOs
A2342A1215A4527A4641A3029A1033A2542A2729A1535A2550A4938A1694A1552A4626A1204A2217A2024A3631A3289A4949A1061A3566A5358A3633A4617A4692A1297A1066A3317A5033
Peers selected using weighted distance across 15 structural features (population acuity, composition, scale, care infrastructure, assignment type) within the ENHANCED track partition. Learn more
All Data
Every labeled MSSP field for this ACO, with national medians and percentiles where a benchmark is available.
Show 185 rows
| Source | Metric | Value | National Median | Pctl. | Raw key |
|---|---|---|---|---|---|
| Beneficiary Demographics | Age 0–64 | 8,751 | 1,168 | N_Ben_Age_0_64 | |
| Beneficiary Demographics | Age 65–74 | 50,436 | 6,091 | N_Ben_Age_65_74 | |
| Beneficiary Demographics | Age 75–84 | 37,655 | 4,264 | N_Ben_Age_75_84 | |
| Beneficiary Demographics | Age 85+ | 14,115 | 1,534 | N_Ben_Age_85plus | |
| Beneficiary Demographics | Aged Dual (BY3) | 8,431 | 796 | N_AB_Year_AGED_Dual_BY3 | |
| Beneficiary Demographics | Aged Dual (PY) | 5,830 | 614 | N_AB_Year_AGED_Dual_PY | |
| Beneficiary Demographics | Aged Non-Dual (BY3) | 103,320 | 11,181 | N_AB_Year_AGED_NonDual_BY3 | |
| Beneficiary Demographics | Aged Non-Dual (PY) | 94,538 | 10,940 | N_AB_Year_AGED_NonDual_PY | |
| Beneficiary Demographics | Asian | 1,066 | 140 | N_Ben_Race_Asian | |
| Beneficiary Demographics | Black | 5,792 | 673 | N_Ben_Race_Black | |
| Beneficiary Demographics | CBA and VA | 439 | 75 | N_Ben_CBA_and_VA | |
| Beneficiary Demographics | CBA Only | 110,277 | 13,232 | N_Ben_CBA_Only | |
| Beneficiary Demographics | Disabled (BY3) | 17,009 | 1,369 | N_AB_Year_DIS_BY3 | |
| Beneficiary Demographics | Disabled (PY) | 8,306 | 902 | N_AB_Year_DIS_PY | |
| Beneficiary Demographics | Dual-Eligible (%) | 9.71% | 6.89% | p68 | Perc_Dual |
| Beneficiary Demographics | Dual-Eligible (PY) | 10,579 | 1,011 | N_AB_Year_Dual_PY | |
| Beneficiary Demographics | ESRD (BY3) | 1,004 | 80 | N_AB_Year_ESRD_BY3 | |
| Beneficiary Demographics | ESRD (PY) | 282 | 50 | N_AB_Year_ESRD_PY | |
| Beneficiary Demographics | Female | 61,968 | 7,529 | N_Ben_Female | |
| Beneficiary Demographics | Hispanic | 1,158 | 163 | N_Ben_Race_Hisp | |
| Beneficiary Demographics | Long-Term Institutionalized (%) | 1.57% | 0.89% | p73 | Perc_LTI |
| Beneficiary Demographics | Male | 48,989 | 5,674 | N_Ben_Male | |
| Beneficiary Demographics | Native American/Alaska Native | 94 | 28 | N_Ben_Race_Native | |
| Beneficiary Demographics | Non-Dual (PY) | 98,377 | 11,332 | N_AB_Year_NonDual_PY | |
| Beneficiary Demographics | Other | 1,251 | 150 | N_Ben_Race_Other | |
| Beneficiary Demographics | Total Person-Years (PY) | 108,956 | 12,891 | N_AB_Year_PY | |
| Beneficiary Demographics | Unknown | 3,274 | 347 | N_Ben_Race_Unknown | |
| Beneficiary Demographics | VA Only | 241 | 35 | N_Ben_VA_Only | |
| Beneficiary Demographics | White | 98,322 | 11,625 | N_Ben_Race_White | |
| CAHPS Patient Experience | Access to Specialists | 78.39 | 75.90 | p74 | CAHPS_4 |
| CAHPS Patient Experience | Care Coordination | 93.21 | 93.24 | p49 | CAHPS_9 |
| CAHPS Patient Experience | Courteous & Helpful Office Staff | 86.49 | 86.22 | p56 | CAHPS_8 |
| CAHPS Patient Experience | Getting Timely Care, Appointments & Information | 87.60 | 84.11 | p83 | CAHPS_1 |
| CAHPS Patient Experience | Health Promotion & Education | 65.59 | 65.66 | p49 | CAHPS_5 |
| CAHPS Patient Experience | Health Status / Functional Status | 74.02 | 74.69 | p36 | CAHPS_7 |
| CAHPS Patient Experience | How Well Providers Communicate | 95.48 | 94.26 | p83 | CAHPS_2 |
| CAHPS Patient Experience | Patient's Rating of Provider | 93.41 | 92.70 | p67 | CAHPS_3 |
| CAHPS Patient Experience | Shared Decision-Making | 65.71 | 62.57 | p79 | CAHPS_6 |
| CAHPS Patient Experience | Stewardship of Patient Resources | 17.21 | 27.09 | p1 | CAHPS_11 |
| Clinical Quality Measures | All-Cause Unplanned Admissions (risk-adjusted rate) | 0.16 | 0.15 | p67 | Measure_479 |
| Clinical Quality Measures | Breast Cancer Screening | 86.79 | 82.59 | p79 | QualityID_112 |
| Clinical Quality Measures | Colorectal Cancer Screening | 84.40 | 80.23 | p78 | QualityID_113 |
| Clinical Quality Measures | Controlling High Blood Pressure (eCQM) | - | 70.95 | QualityID_236_eCQM | |
| Clinical Quality Measures | Controlling High Blood Pressure (Medicare CQM) | - | 64.97 | QualityID_236_MedicareCQM | |
| Clinical Quality Measures | Controlling High Blood Pressure (MIPS CQM) | - | 74.09 | QualityID_236_MIPSCQM | |
| Clinical Quality Measures | Controlling High Blood Pressure (Web Interface) | 82.39 | 80.24 | p63 | QualityID_236_WI |
| Clinical Quality Measures | Depression Remission at 12 Months | 18.52 | 14.29 | p65 | QualityID_370 |
| Clinical Quality Measures | Depression Screening (eCQM) | - | 56.73 | QualityID_134_eCQM | |
| Clinical Quality Measures | Depression Screening (Medicare CQM) | - | 79.70 | QualityID_134_MedicareCQM | |
| Clinical Quality Measures | Depression Screening (MIPS CQM) | - | 61.02 | QualityID_134_MIPSCQM | |
| Clinical Quality Measures | Depression Screening (Web Interface) | 86.72 | 83.73 | p61 | QualityID_134_WI |
| Clinical Quality Measures | Diabetes: HbA1c Poor Control >9% (eCQM) | - | 27.96 | QualityID_001_eCQM | |
| Clinical Quality Measures | Diabetes: HbA1c Poor Control >9% (Medicare CQM) | - | 29.76 | QualityID_001_MedicareCQM | |
| Clinical Quality Measures | Diabetes: HbA1c Poor Control >9% (MIPS CQM) | - | 24.41 | QualityID_001_MIPSCQM | |
| Clinical Quality Measures | Diabetes: HbA1c Poor Control >9% (Web Interface) | 7.92 | 8.44 | p42 | QualityID_001_WI |
| Clinical Quality Measures | Falls: Screening for Future Fall Risk | 94.93 | 91.53 | p69 | QualityID_318 |
| Clinical Quality Measures | Influenza Immunization | 75.89 | 70.06 | p73 | QualityID_110 |
| Clinical Quality Measures | Overall Quality Score (Composite) | 88.97 | 83.13 | p78 | QualScore |
| Clinical Quality Measures | Risk-Standardized All-Condition Readmission Rate | 31.14 | 36.11 | p14 | Measure_484 |
| Clinical Quality Measures | Statin Therapy for Cardiovascular Disease Prevention | 88.43 | 87.36 | p59 | QualityID_438 |
| Clinical Quality Measures | Tobacco Use: Screening & Cessation Intervention | 83.33 | 82.86 | p50 | QualityID_226 |
| Demographic Risk Scores | Aged, Dual-Eligible (PY) | 1.031 | 1.014 | Demog_RiskScore_AGDU_PY | |
| Demographic Risk Scores | Aged, Non-Dual (PY) | 1.028 | 1.005 | Demog_RiskScore_AGND_PY | |
| Demographic Risk Scores | Disabled (PY) | 1.010 | 0.979 | Demog_RiskScore_DIS_PY | |
| Demographic Risk Scores | End-Stage Renal Disease (ESRD) (PY) | 0.997 | 0.987 | Demog_RiskScore_ESRD_PY | |
| Financial Performance | Adjustment Category | Regional Adjustment | — | FinalAdjCat | |
| Financial Performance | Advance Investment Payment | ✗ | ✗ | AIP | |
| Financial Performance | AIP Balance | - | $1,393,483 | AIPBalance | |
| Financial Performance | AIP Owed | - | $890,006 | AIPOwe | |
| Financial Performance | AIP Recouped | - | $280,273 | AIPRecoup | |
| Financial Performance | Assigned Beneficiaries | 110,957 | 13,159 | p98 | N_AB |
| Financial Performance | Benchmark Minus Expenditure | $17,441,735 | $7,074,069 | BnchmkMinExp | |
| Financial Performance | Disaster Adjustment | $0 | $0 | DisAdj | |
| Financial Performance | Earned Savings / Losses | $12,819,675 | $3,685,876 | EarnSaveLoss | |
| Financial Performance | Final Shared Loss Rate | 40.00% | 40.00% | FinalLossRate | |
| Financial Performance | Final Shared Savings Rate | 75.00% | 50.00% | FinalShareRate | |
| Financial Performance | Generated Savings / Losses | $17,441,735 | $6,931,306 | GenSaveLoss | |
| Financial Performance | Guardrail Applied | - | ✗ | Guardrail | |
| Financial Performance | Historical Benchmark (per capita) | $11,637 | $11,439 | p54 | HistBnchmk |
| Financial Performance | Mid-Year Termination Impact | $0 | $0 | Impact_Mid_Year_Termination | |
| Financial Performance | Minimum Savings Rate (threshold) | 0.50% | 2.00% | MinSavPerc | |
| Financial Performance | Per Capita Expenditure (PY) | $13,274 | $12,693 | p62 | Per_Capita_Exp_TOTAL_PY |
| Financial Performance | Prior Savings Adjustment | - | $156 | PriorSavAdj | |
| Financial Performance | Reduced Shared Savings | ✗ | ✗ | ReducedSS | |
| Financial Performance | Regional Adjustment | $169 | $182 | RegAdj | |
| Financial Performance | Revenue-to-Expense Category | High Revenue | — | Rev_Exp_Cat | |
| Financial Performance | Savings Rate | 1.19% | 4.21% | p20 | Sav_rate |
| Financial Performance | Total Benchmark (all beneficiaries) | $1,463,704,011 | $177,890,820 | ABtotBnchmk | |
| Financial Performance | Total Expenditure (all beneficiaries) | $1,446,262,276 | $167,748,494 | ABtotExp | |
| Financial Performance | Updated Benchmark (per capita) | $13,434 | $13,279 | p53 | UpdatedBnchmk |
| Per Capita Expenditure by Population Segment | Aged, Dual-Eligible (BY1) | $15,515 | $15,751 | Per_Capita_Exp_ALL_AGDU_BY1 | |
| Per Capita Expenditure by Population Segment | Aged, Dual-Eligible (BY2) | $15,498 | $15,879 | Per_Capita_Exp_ALL_AGDU_BY2 | |
| Per Capita Expenditure by Population Segment | Aged, Dual-Eligible (BY3) | $16,012 | $16,313 | Per_Capita_Exp_ALL_AGDU_BY3 | |
| Per Capita Expenditure by Population Segment | Aged, Dual-Eligible (PY) | $20,032 | $18,934 | Per_Capita_Exp_ALL_AGDU_PY | |
| Per Capita Expenditure by Population Segment | Aged, Non-Dual (BY1) | $9,789 | $9,631 | Per_Capita_Exp_ALL_AGND_BY1 | |
| Per Capita Expenditure by Population Segment | Aged, Non-Dual (BY2) | $10,069 | $9,541 | Per_Capita_Exp_ALL_AGND_BY2 | |
| Per Capita Expenditure by Population Segment | Aged, Non-Dual (BY3) | $10,460 | $10,288 | Per_Capita_Exp_ALL_AGND_BY3 | |
| Per Capita Expenditure by Population Segment | Aged, Non-Dual (PY) | $12,693 | $12,059 | Per_Capita_Exp_ALL_AGND_PY | |
| Per Capita Expenditure by Population Segment | Disabled (BY1) | $9,473 | $10,226 | Per_Capita_Exp_ALL_DIS_BY1 | |
| Per Capita Expenditure by Population Segment | Disabled (BY2) | $9,838 | $10,191 | Per_Capita_Exp_ALL_DIS_BY2 | |
| Per Capita Expenditure by Population Segment | Disabled (BY3) | $10,303 | $10,605 | Per_Capita_Exp_ALL_DIS_BY3 | |
| Per Capita Expenditure by Population Segment | Disabled (PY) | $12,221 | $12,075 | Per_Capita_Exp_ALL_DIS_PY | |
| Per Capita Expenditure by Population Segment | End-Stage Renal Disease (ESRD) (BY1) | $84,793 | $84,276 | Per_Capita_Exp_ALL_ESRD_BY1 | |
| Per Capita Expenditure by Population Segment | End-Stage Renal Disease (ESRD) (BY2) | $87,379 | $84,661 | Per_Capita_Exp_ALL_ESRD_BY2 | |
| Per Capita Expenditure by Population Segment | End-Stage Renal Disease (ESRD) (BY3) | $93,438 | $88,267 | Per_Capita_Exp_ALL_ESRD_BY3 | |
| Per Capita Expenditure by Population Segment | End-Stage Renal Disease (ESRD) (PY) | $99,073 | $93,398 | Per_Capita_Exp_ALL_ESRD_PY | |
| Per Capita Spending by Service Category | Ambulance | $145 | $134 | CapAnn_AmbPay | |
| Per Capita Spending by Service Category | Durable Medical Equipment | $398 | $405 | CapAnn_DME | |
| Per Capita Spending by Service Category | Home Health | $523 | $470 | CapAnn_HHA | |
| Per Capita Spending by Service Category | Hospice | $342 | $258 | CapAnn_HSP | |
| Per Capita Spending by Service Category | Inpatient — All | $3,662 | $3,410 | p63 | CapAnn_INP_All |
| Per Capita Spending by Service Category | Inpatient — Long-Term | $40 | $59 | CapAnn_INP_L_trm | |
| Per Capita Spending by Service Category | Inpatient — Psychiatric | $45 | $37 | CapAnn_INP_Psych | |
| Per Capita Spending by Service Category | Inpatient — Rehab | $367 | $367 | CapAnn_INP_Rehab | |
| Per Capita Spending by Service Category | Inpatient — Short-Term Acute | $3,242 | $2,914 | CapAnn_INP_S_trm | |
| Per Capita Spending by Service Category | Outpatient | $3,292 | $3,078 | p59 | CapAnn_OPD |
| Per Capita Spending by Service Category | Physician / Supplier (Part B) | $4,486 | $4,341 | p55 | CapAnn_PB |
| Per Capita Spending by Service Category | Skilled Nursing Facility | $802 | $655 | p68 | CapAnn_SNF |
| Program Structure | ACO ID | A3454 | — | ACO_ID | |
| Program Structure | ACO Name | Trinity Integrated Care, LLC | — | ACO_Name | |
| Program Structure | Agreement Period | 2 | 2 | Agreement_Period_Num | |
| Program Structure | Agreement Type | Renewal | — | Agree_Type | |
| Program Structure | Assignment Type | Prospective | — | Assign_Type | |
| Program Structure | Current Track | EN | — | Current_Track | |
| Program Structure | Risk Model | Two-Sided | — | Risk_Model | |
| Program Structure | SNF 3-Day Waiver | ✓ | ✗ | SNF_Waiver | |
| Program Structure | Start Date | 1/1/2020 | — | Current_Start_Date | |
| Provider Composition | Clinical Nurse Specialists | 12 | 0 | N_CNS | |
| Provider Composition | Critical Access Hospitals | 5 | 0 | N_CAH | |
| Provider Composition | Extension of Treatment Areas | 0 | 0 | N_ETA | |
| Provider Composition | FQHCs | 1 | 0 | N_FQHC | |
| Provider Composition | Hospitals | 18 | 0 | N_Hosp | |
| Provider Composition | Nurse Practitioners | 2,363 | 215 | N_NP | |
| Provider Composition | Other Facilities | 35 | 0 | N_Fac_Other | |
| Provider Composition | Physician Assistants | 1,670 | 89 | N_PA | |
| Provider Composition | Primary Care Physicians | 2,361 | 206 | N_PCP | |
| Provider Composition | Rural Health Clinics | 13 | 0 | N_RHC | |
| Provider Composition | Specialists | 4,744 | 300 | N_Spec | |
| Quality Reporting Flags | Disaster / Affected Quality Waiver Applied | ✗ | ✗ | DisAffQual | |
| Quality Reporting Flags | First-Year ACO Quality Pass | ✗ | ✗ | Met_FirstYear | |
| Quality Reporting Flags | Met 40th Percentile Threshold | ✓ | ✓ | Met_40pctl | |
| Quality Reporting Flags | Met Alternative QPS | - | ✓ | Met_AltQPS | |
| Quality Reporting Flags | Met Incentive Threshold | ✗ | ✗ | Met_Incentive | |
| Quality Reporting Flags | Met Quality Performance Standard (QPS) | ✓ | ✓ | Met_QPS | |
| Quality Reporting Flags | Met SSP Quality Reporting Requirements | ✓ | ✓ | Met_SSP_quality_reporting_requirements | |
| Quality Reporting Flags | Received 40th Percentile Bonus | ✗ | ✗ | Recvd40p | |
| Quality Reporting Flags | Reported via eCQM / CQM / Medicare CQM | ✗ | ✗ | Report_eCQM_CQM_MedicareCQM | |
| Quality Reporting Flags | Reported via Web Interface | ✓ | ✓ | Report_WI | |
| Risk Redistribution Weights | Aged Dual Weight | 0.08% | 0.06% | RR_weight_AGDU_PY | |
| Risk Redistribution Weights | Aged Non-Dual Weight | 0.83% | 0.85% | RR_weight_AGND_PY | |
| Risk Redistribution Weights | Disabled Weight | 0.07% | 0.06% | RR_weight_DIS_PY | |
| Risk Redistribution Weights | ESRD Weight | 0.02% | 0.03% | RR_weight_ESRD_PY | |
| Risk Scores | Aged, Dual-Eligible (BY1) | 1.032 | 0.994 | CMS_HCC_RiskScore_AGDU_BY1 | |
| Risk Scores | Aged, Dual-Eligible (BY2) | 1.027 | 0.988 | CMS_HCC_RiskScore_AGDU_BY2 | |
| Risk Scores | Aged, Dual-Eligible (BY3) | 1.022 | 0.983 | CMS_HCC_RiskScore_AGDU_BY3 | |
| Risk Scores | Aged, Dual-Eligible (PY) | 0.997 | 0.954 | p63 | CMS_HCC_RiskScore_AGDU_PY |
| Risk Scores | Aged, Non-Dual (BY1) | 1.063 | 0.993 | CMS_HCC_RiskScore_AGND_BY1 | |
| Risk Scores | Aged, Non-Dual (BY2) | 1.061 | 0.992 | CMS_HCC_RiskScore_AGND_BY2 | |
| Risk Scores | Aged, Non-Dual (BY3) | 1.063 | 0.996 | CMS_HCC_RiskScore_AGND_BY3 | |
| Risk Scores | Aged, Non-Dual (PY) | 1.013 | 0.983 | p65 | CMS_HCC_RiskScore_AGND_PY |
| Risk Scores | Disabled (BY1) | 0.988 | 0.974 | CMS_HCC_RiskScore_DIS_BY1 | |
| Risk Scores | Disabled (BY2) | 1.002 | 0.967 | CMS_HCC_RiskScore_DIS_BY2 | |
| Risk Scores | Disabled (BY3) | 0.999 | 0.965 | CMS_HCC_RiskScore_DIS_BY3 | |
| Risk Scores | Disabled (PY) | 0.960 | 0.934 | p60 | CMS_HCC_RiskScore_DIS_PY |
| Risk Scores | End-Stage Renal Disease (ESRD) (BY1) | 1.053 | 1.011 | CMS_HCC_RiskScore_ESRD_BY1 | |
| Risk Scores | End-Stage Renal Disease (ESRD) (BY2) | 1.047 | 1.011 | CMS_HCC_RiskScore_ESRD_BY2 | |
| Risk Scores | End-Stage Renal Disease (ESRD) (BY3) | 1.042 | 1.006 | CMS_HCC_RiskScore_ESRD_BY3 | |
| Risk Scores | End-Stage Renal Disease (ESRD) (PY) | 0.982 | 0.967 | p57 | CMS_HCC_RiskScore_ESRD_PY |
| Utilization — Admissions & Visits | CT Scans (per 1,000) | 788 | 751 | p59 | P_CT_VIS |
| Utilization — Admissions & Visits | E&M Visits — Primary Care (per 1,000) | 3,970 | 4,192 | p43 | P_EM_PCP_Vis |
| Utilization — Admissions & Visits | E&M Visits — Specialist (per 1,000) | 5,253 | 4,821 | p58 | P_EM_SP_Vis |
| Utilization — Admissions & Visits | E&M Visits — Total (per 1,000) | 12,299 | 12,433 | P_EM_Total | |
| Utilization — Admissions & Visits | ED Visits (per 1,000) | 627 | 618 | p54 | P_EDV_Vis |
| Utilization — Admissions & Visits | ED Visits Resulting in Hospitalization (per 1,000) | 205 | 179 | P_EDV_Vis_HOSP | |
| Utilization — Admissions & Visits | FQHC / RHC Visits (per 1,000) | 151 | 160 | p49 | P_FQHC_RHC_Vis |
| Utilization — Admissions & Visits | Hospital Admissions (per 1,000) | 271 | 251 | p68 | ADM |
| Utilization — Admissions & Visits | Long-Term Admissions (per 1,000) | 1 | 1 | ADM_L_Trm | |
| Utilization — Admissions & Visits | MRI Scans (per 1,000) | 249 | 247 | p50 | P_MRI_VIS |
| Utilization — Admissions & Visits | Nurse Practitioner Visits (per 1,000) | 2,925 | 2,464 | p72 | P_Nurse_Vis |
| Utilization — Admissions & Visits | Psychiatric Admissions (per 1,000) | 4 | 3 | ADM_Psych | |
| Utilization — Admissions & Visits | Rehab Admissions (per 1,000) | 15 | 15 | ADM_Rehab | |
| Utilization — Admissions & Visits | Short-Term Acute Admissions (per 1,000) | 252 | 229 | ADM_S_Trm | |
| Utilization — Admissions & Visits | SNF Admissions (per 1,000) | 49 | 40 | P_SNF_ADM | |
| Utilization — Admissions & Visits | SNF Average Length of Stay (days) | 26 | 27 | p34 | SNF_LOS |
| Utilization — Admissions & Visits | SNF Average Payment per Stay | $14,561 | $15,338 | p39 | SNF_PayperStay |
Methodology
Data source: MSSP ACO Performance PY2024
(dataset ID: mssp-performance).
Vintage: PY2024.
Downloaded: 2026-04-13.
Rows in source: 476.
MSSP ACO Performance reports financial and quality performance for Accountable Care Organizations participating in the Medicare Shared Savings Program. Savings/losses are calculated against risk-adjusted, regionally-weighted benchmarks.