Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $1.8M (2018) to $17.1M (2019) — a 867% swing with $15.3M absolute change.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 867% from 2018 to 2019.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
Explosive Growth
Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Compared to Home Health Peers
Total spending distribution among 322 providers in this specialty
This provider's total spending of $156.1M is at the 50th percentile among 322 Home Health providers.
Total Paid
$156.1M
$156,140,672
Total Claims
1.0M
Beneficiaries
48K
21.1 claims/patient
Avg Cost/Claim
$154
#677 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
A-plus Care Hhc is a Home Health provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $156.1M in Medicaid payments across 1.0M claims.
Why This Matters
This provider received $156.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,517 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 4 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 90% of total spending.
$140.4M
964K claims
$145.63
$82.47
Personal care services, per 15 min
$140.4M
964K claims · 89.9%
$15.6M
46K claims
$337.44
$296.27
Personal care services, per diem
$15.6M
46K claims · 10.0%
$125K
733 claims · 0.1%
$16K
171 claims
$93.68
$85.62
Nursing care, in the home, by RN, per diem
$16K
171 claims · 0.0%
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