New England Home Care Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $58.49 per claim for T1502 (Administration of oral, intramuscular, or subcutaneous medication), which is 7.4× the national median of $7.86.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: S5185 at 3.1× median, 1448P at 1.6× median.
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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
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.
Risk Assessment
Bills $58.49 per claim for T1502 (Administration of oral, intramuscular, or subcutaneous medication) — 7.4× the national median of $7.86.
Bills $136.94 per claim for S5185 (Medication reminder service, NOS, per month) — 3.1× the national median of $44.39.
Billing in the top 1% nationally for 1 procedure code: 1448P.
This is a statistical summary, not an accusation. See our methodology.
Compared to Home Health Peers
Total spending distribution among 322 providers in this specialty
This provider's total spending of $400.1M is at the 75th percentile among 322 Home Health providers.
Total Paid
$400.1M
$400,057,183
Total Claims
6.8M
Beneficiaries
527K
12.8 claims/patient
Avg Cost/Claim
$59
#158 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
New England Home Care Inc. is a Home Health provider based in Rocky Hill, CT. From the 2018–2024 period, this provider received $400.1M in Medicaid payments across 6.8M claims.
Why This Matters
This provider received $400.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 50,007 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 12 distinct procedure codes. The top code (T1502 (Administration of oral, intramuscular, or subcutaneous medication)) accounts for 84% of total spending.
$336.0M
5.7M claims
$58.49
$7.86
Administration of oral, intramuscular, or subcutaneous medication
$336.0M
5.7M claims · 84.0%
$25.8M
336K claims
$76.77
$124.86
Nursing care, in the home, by RN, per 15 minutes
$25.8M
336K claims · 6.4%
$17.6M
72K claims
$243.35
$400.25
Nursing care, in the home; per hour
$17.6M
72K claims · 4.4%
$13.2M
396K claims
$33.26
$50.30
Services of a qualified nursing aide, per 15 minutes
$13.2M
396K claims · 3.3%
$5.0M
163K claims
$30.46
$59.83
Skilled services by RN in home health, per 15 min
$5.0M
163K claims · 1.2%
$1.9M
24K claims
$80.32
$49.05
Nursing assessment/evaluation, per visit
$1.9M
24K claims · 0.5%
$525K
29K claims
$18.01
$31.37
Oral medication administration, direct observation
$525K
29K claims · 0.1%
RN services, per 15 minutes
$44K
1K claims · 0.0%
$33K
334 claims · 0.0%
$29K
211 claims
$136.94
$44.39
Medication reminder service, NOS, per month
$29K
211 claims · 0.0%
$16K
203 claims · 0.0%
Home health aide visit, per 15 min
$6K
233 claims · 0.0%
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