Milwaukee County Department on Aging Care Management Organization
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $3.2M (2023) to $56.7M (2024) — a 1659% swing with $53.5M absolute change.
New Entrant
Started billing recently but already receiving millions in Medicaid payments.
First appeared in 2023-01 and has already billed $59.9M, averaging $2.5M/month across 24 months.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1659% from 2023 to 2024.
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.
New Entrant
New Entrant means this provider began billing Medicaid recently but is already receiving millions of dollars in payments. While some new providers legitimately grow fast (e.g., large group practices), this pattern is also common in fraud schemes that set up shell companies to bill aggressively before shutting down.
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.
Compared to Health Maintenance Organization Peers
Total spending distribution among 10 providers in this specialty
This provider's total spending of $59.9M is at the 50th percentile among 10 Health Maintenance Organization providers.
Total Paid
$59.9M
$59,934,661
Total Claims
190K
Beneficiaries
147K
1.3 claims/patient
Avg Cost/Claim
$315
🔍 Analysis
Provider Overview
Milwaukee County Department on Aging Care Management Organization is a Health Maintenance Organization provider based in Milwaukee, WI. From the 2018–2024 period, this provider received $59.9M in Medicaid payments across 190K claims.
Important Context
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
At $59.9M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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