The Arc of Oakland County INC
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $4.7M (2020) to $45.0M (2021) — a 855% swing with $40.3M absolute change.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 855% from 2020 to 2021.
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 Voluntary or Charitable Peers
Total spending distribution among 13 providers in this specialty
This provider's total spending of $170.8M is at the 50th percentile among 13 Voluntary or Charitable providers.
Total Paid
$170.8M
$170,823,209
Total Claims
1.4M
Beneficiaries
130K
10.5 claims/patient
Avg Cost/Claim
$125
#576 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
The Arc of Oakland County INC is a Voluntary or Charitable provider based in Troy, MI. From the 2018–2024 period, this provider received $170.8M in Medicaid payments across 1.4M 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
This provider received $170.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,352 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 7 distinct procedure codes. The top code (H2015 (Comprehensive community support services, per 15 min)) accounts for 83% of total spending.
$142.4M
1.0M claims
$136.67
$96.24
Comprehensive community support services, per 15 min
$142.4M
1.0M claims · 83.4%
$14.2M
179K claims
$79.49
$71.40
Respite care services, per 15 minutes
$14.2M
179K claims · 8.3%
$6.1M
71K claims
$86.74
$88.93
Specialized transportation, waiver, per trip, extra
$6.1M
71K claims · 3.6%
$4.0M
57K claims
$69.83
$124.39
Waiver services, NOS; per 15 min
$4.0M
57K claims · 2.3%
$2.0M
11K claims
$190.20
$249.18
Unskilled respite care, per diem
$2.0M
11K claims · 1.2%
$1.1M
7K claims
$150.05
$83.88
Skills training & development, per 15 min
$1.1M
7K claims · 0.6%
$990K
4K claims
$248.16
$119.19
Respite care services, not in the home, per diem
$990K
4K claims · 0.6%
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