ABI Outliers

Author

Alan Shulman

Post Acute Residential

State of Jurisdiction

Outliers

benefit_state bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
CA 499 8758 6218118 13 12461 710.0 38.4 674 0.448
NC 23 644 1144265 2 49751 1776.8 11.5 322 0.069
TX 77 1098 1022851 2 13284 931.6 38.5 549 0.069
PA 48 1199 992026 3 20667 827.4 16.0 400 0.103
FL 81 1132 878870 3 10850 776.4 27.0 377 0.103
HI 79 1300 876120 1 11090 673.9 79.0 1300 0.034
CO 27 783 829271 2 30714 1059.1 13.5 392 0.069
AL 19 293 615300 1 32384 2100.0 19.0 293 0.034
AR 28 5331 431422 1 15408 80.9 28.0 5331 0.034
MD 13 339 303552 1 23350 895.4 13.0 339 0.034

Non-Outliers

benefit_state bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
CA 212 2512 2158635 24 10182 859 8.83 104.7 0.247
TX 61 532 492394 7 8072 926 8.71 76.0 0.072
GA 17 655 452571 10 26622 691 1.70 65.5 0.103
FL 153 822 343725 10 2247 418 15.30 82.2 0.103
PA 11 320 296813 4 26983 928 2.75 80.0 0.041
NY 10 292 273443 3 27344 936 3.33 97.3 0.031
AL 7 304 233410 4 33344 768 1.75 76.0 0.041
NC 7 184 232002 2 33143 1261 3.50 92.0 0.021
MA 11 319 218411 2 19856 685 5.50 159.5 0.021
UT 4 97 212430 1 53108 2190 4.00 97.0 0.010
TN 5 232 195902 4 39180 844 1.25 58.0 0.041
US 20 284 184465 3 9223 650 6.67 94.7 0.031
NJ 14 355 172972 3 12355 487 4.67 118.3 0.031
MD 9 202 168537 3 18726 834 3.00 67.3 0.031
MI 8 200 164368 1 20546 822 8.00 200.0 0.010
AR 14 185 115625 2 8259 625 7.00 92.5 0.021
LA 2 50 105000 1 52500 2100 2.00 50.0 0.010
OH 4 79 83166 1 20792 1053 4.00 79.0 0.010
HI 9 104 75826 1 8425 729 9.00 104.0 0.010
MT 3 135 74250 1 24750 550 3.00 135.0 0.010

Post Acute Residential

Provider

Outliers

provider_name bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
CAREMERIDIAN, LLC 466 6733 4296445 7 9220 638.1 66.6 962 0.269
LEARNING SERVICES CORP 121 3537 3986389 8 32945 1127.1 15.1 442 0.308
REMED RECOVERY CARE CENTERS 32 933 720357 2 22511 772.1 16.0 466 0.077
LEARNING SERVICES CORPORATION 36 1075 711373 2 19760 661.7 18.0 538 0.077
NEUROINTERNATIONAL HEALTHCARE 57 916 619754 2 10873 676.6 28.5 458 0.077
BSWIR NEURO TRANSITIONAL 19 293 615300 1 32384 2100.0 19.0 293 0.038
TOUCHSTONE NEURORECOVERY 28 5331 431422 1 15408 80.9 28.0 5331 0.038
CAREMERIDIAN 46 675 389785 1 8474 577.5 46.0 675 0.038
BSWIR NEURO TRANSITIONAL CENTE 18 224 371700 1 20650 1659.4 18.0 224 0.038
NEULIFE NEUROLOGICAL SERVICES 24 216 259116 1 10796 1199.6 24.0 216 0.038

Non-Outliers

provider_name bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
LEARNING SERVICES CORP 45 1123 1518089 10 33735 1352 4.50 112.3 0.091
SHEPHERD CENTER 45 1728 1356117 29 30136 785 1.55 59.6 0.264
REMED RECOVERY CARE CENTERS 53 1376 1165942 13 21999 847 4.08 105.8 0.118
CAREMERIDIAN LLC 94 972 831049 12 8841 855 7.83 81.0 0.109
CAREMERIDIAN, LLC 116 1082 670008 9 5776 619 12.89 120.2 0.082
BSWIR NEURO TRANSITIONAL 7 96 220800 1 31543 2300 7.00 96.0 0.009
TOUCHSTONE NEURORECOVERY 35 566 215378 4 6154 381 8.75 141.5 0.036
NEULIFE NEUROLOGICAL SERVICES 14 198 203669 1 14548 1029 14.00 198.0 0.009
LEARNING SERVICES CORPORATION 7 165 195966 3 27995 1188 2.33 55.0 0.027
NEURORESTORATIVE 35 325 193475 5 5528 595 7.00 65.0 0.045
WILLOWBROOK REHABILITATION 7 198 163152 1 23307 824 7.00 198.0 0.009
BROOKS REHABILITATION 138 188 107828 4 781 574 34.50 47.0 0.036
BAYLOR INST OF RHB FRISCO 2 50 105000 1 52500 2100 2.00 50.0 0.009
CAREMERIDIAN 8 110 84028 1 10504 764 8.00 110.0 0.009
REMED RECOVERY CARE CENTERS LL 4 79 83166 1 20792 1053 4.00 79.0 0.009
RWW NH RHF BLUE SRP SERVI 7 212 78536 1 11219 370 7.00 212.0 0.009
KAMPFE MANAGEMENT SERVICES 3 135 74250 1 24750 550 3.00 135.0 0.009
RENEY ROCOVERY CARE CENTERS IN 4 109 72542 1 18136 666 4.00 109.0 0.009
LEARNING SERVICES COPR 2 49 70194 1 35097 1433 2.00 49.0 0.009
NEUROINTERNATIONAL HEALTHCARE 11 571 60638 5 5512 106 2.20 114.2 0.045

PCA Services

State of Jurisdiction

Outliers

benefit_state bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
CA 661 65362 2267075 4 3430 34.69 165 16340 0.211
NJ 397 28793 1046246 2 2635 36.34 198 14396 0.105
GA 735 43229 964160 3 1312 22.30 245 14410 0.158
FL 313 35452 851822 2 2721 24.03 156 17726 0.105
TX 376 36690 598570 2 1592 16.31 188 18345 0.105
MI 91 15170 440069 1 4836 29.01 91 15170 0.053
CT 22 58229 379186 1 17236 6.51 22 58229 0.053
NY 136 9410 356214 1 2619 37.85 136 9410 0.053
MN 182 8654 330675 1 1817 38.21 182 8654 0.053
MS 174 11215 278321 1 1600 24.82 174 11215 0.053
VA 104 9158 252355 1 2426 27.56 104 9158 0.053

Non-Outliers

benefit_state bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
TX 952 121039 1410992 21 1482 11.7 45.3 5764 0.093
NY 523 40744 782903 16 1497 19.2 32.7 2546 0.070
MO 642 25955 713350 11 1111 27.5 58.4 2360 0.048
NJ 493 30039 689364 8 1398 22.9 61.6 3755 0.035
IL 485 23213 661460 14 1364 28.5 34.6 1658 0.062
CA 378 18401 464634 29 1229 25.2 13.0 635 0.128
WI 253 14472 441122 5 1744 30.5 50.6 2894 0.022
FL 330 17337 391206 13 1185 22.6 25.4 1334 0.057
GA 275 14349 367837 10 1338 25.6 27.5 1435 0.044
AZ 253 13532 360759 9 1426 26.7 28.1 1504 0.040
MN 64 13277 334340 2 5224 25.2 32.0 6638 0.009
MA 143 13445 328440 7 2297 24.4 20.4 1921 0.031
NE 200 11913 295315 3 1477 24.8 66.7 3971 0.013
OK 129 7752 241512 3 1872 31.2 43.0 2584 0.013
CO 73 6556 240794 3 3299 36.7 24.3 2185 0.013
IN 82 10179 203983 4 2488 20.0 20.5 2545 0.018
ND 42 8710 203756 1 4851 23.4 42.0 8710 0.004
MD 153 9885 202708 7 1325 20.5 21.9 1412 0.031
TN 257 7845 187267 10 729 23.9 25.7 784 0.044
IA 99 4674 143215 6 1447 30.6 16.5 779 0.026

PCA Services

Provider

Outliers

provider_name bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
HOME CARE CONNECT 695 62433 2271731 4 3269 36.39 174 15608 0.235
HOMELINK 812 79874 2142418 6 2638 26.82 135 13312 0.353
HOME CARE CONNECT LLC 288 15785 712130 2 2473 45.11 144 7892 0.118
ACCORD SERVICES, LLC 584 34430 704159 2 1206 20.45 292 17215 0.118
MSC GROUP, INC 91 15170 440069 1 4836 29.01 91 15170 0.059
FROM THE HEART HOME CARE LLC 22 58229 379186 1 17236 6.51 22 58229 0.059
BAYADA HOME HEALTH HEALTH CARE 290 22740 282314 1 973 12.41 290 22740 0.059

Non-Outliers

provider_name bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
HOMELINK 2183 147638 3658378 101 1676 24.78 21.61 1462 0.334
HOME CARE CONNECT 1393 81173 1768184 39 1269 21.78 35.72 2081 0.129
HOME CARE CONNECT LLC 514 22362 654158 8 1273 29.25 64.25 2795 0.026
BAYADA HOME HEALTH CARE 308 14019 358180 12 1163 25.55 25.67 1168 0.040
COMP X MEDICAL MANAGMENT 215 10198 279405 3 1300 27.40 71.67 3399 0.010
BAYADA HOME HEALTH CARE INC 365 15681 252873 5 693 16.13 73.00 3136 0.017
BEACON CARE 75 8104 248753 6 3317 30.70 12.50 1351 0.020
COMPX MEDICAL MANAGEMENT 189 7848 234115 6 1239 29.83 31.50 1308 0.020
MSC GROUP INC 113 8519 227834 13 2016 26.74 8.69 655 0.043
ASSURED & ASSOCIATES 45 9091 223806 2 4973 24.62 22.50 4546 0.007
MSC GROUP, INC 169 10174 217446 6 1287 21.37 28.17 1696 0.020
SAN DIEGO HOMECARE LLC 89 9082 212686 1 2390 23.42 89.00 9082 0.003
SENIOR HELPERS BOSTON 29 6609 187350 1 6460 28.35 29.00 6609 0.003
BRIGHTSTAR HEALTHCARE 37 4660 165418 1 4471 35.50 37.00 4660 0.003
ARIS AT HOME 46 5966 153427 1 3335 25.72 46.00 5966 0.003
RESCARE HOMECARE 44 32143 137432 1 3123 4.28 44.00 32143 0.003
HEALTH BRIDGE OF ARLINGTON HEI 15 5439 131683 2 8779 24.21 7.50 2720 0.007
PROGRESSIVE MEDICAL LLC DBA OP 105 3992 124434 1 1185 31.17 105.00 3992 0.003
ACCORD SERVICES LLC 53 4821 96994 11 1830 20.12 4.82 438 0.036
X-TREME CARE HOME HEALTH 54 11015 91577 1 1696 8.31 54.00 11015 0.003

Nursing

State of Jurisdiction

Outliers

provider_name bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
MI 150 15674 982219 1 6548 62.7 150 15674 0.125
CA 202 10682 930532 1 4607 87.1 202 10682 0.125
TX 134 16257 776351 2 5794 47.8 67 8128 0.250
GA 173 14050 488149 1 2822 34.7 173 14050 0.125
NY 111 4976 477034 1 4298 95.9 111 4976 0.125
MO 66 460 183960 1 2787 399.9 66 460 0.125
NJ 34 1542 100427 1 2954 65.1 34 1542 0.125

Non-Outliers

provider_name bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
PA 276 6321 208246 11 755 32.9 25.09 574.6 0.050
FL 97 1708 92402 20 953 54.1 4.85 85.4 0.090
TX 398 1547 79618 22 200 51.5 18.09 70.3 0.100
MD 121 2388 72773 8 601 30.5 15.12 298.5 0.036
CA 122 1301 66688 23 547 51.3 5.30 56.6 0.104
NJ 124 464 45012 9 363 97.0 13.78 51.6 0.041
WI 87 317 36869 7 424 116.3 12.43 45.3 0.032
TN 34 322 33825 6 995 105.0 5.67 53.7 0.027
MO 58 257 33504 9 578 130.4 6.44 28.6 0.041
NC 46 454 30070 7 654 66.2 6.57 64.9 0.032
SC 32 236 28965 2 905 122.7 16.00 118.0 0.009
GA 108 349 23669 9 219 67.8 12.00 38.8 0.041
IL 58 181 22027 6 380 121.7 9.67 30.2 0.027
AZ 92 206 20143 9 219 97.8 10.22 22.9 0.041
MN 81 106 17757 5 219 167.5 16.20 21.2 0.023
NY 36 273 13318 14 370 48.8 2.57 19.5 0.063
IA 19 90 12504 3 658 138.9 6.33 30.0 0.014
MS 59 240 9676 3 164 40.3 19.67 80.0 0.014
CO 29 75 8055 2 278 107.4 14.50 37.5 0.009
ND 29 124 7350 1 253 59.3 29.00 124.0 0.005

Nursing

Provider

Outliers

provider_name bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
HOME CARE CONNECT 257 14433 1038572 2 4041 72.0 128 7216 0.250
MSC GROUP, INC 128 15515 981272 1 7666 63.2 128 15515 0.125
HOMELINK 77 12163 642240 1 8341 52.8 77 12163 0.125
ACCORD SERVICES, LLC 173 14050 488149 1 2822 34.7 173 14050 0.125
HOME CARE CONNECT LLC 105 4969 476758 1 4541 95.9 105 4969 0.125
COMPREHENSIVE COMMUNITY REHAB 66 460 183960 1 2787 399.9 66 460 0.125
COMP X MEDICAL MANAGMENT 34 1542 100427 1 2954 65.1 34 1542 0.125

Non-Outliers

provider_name bills quantity paid patients perbill perunit billsperpatient unitperpatient percent
HOMELINK 511 3434 241970 93 473.5 70.5 5.50 36.92 0.330
HOME CARE CONNECT 310 2409 132120 38 426.2 54.8 8.16 63.40 0.135
HOME CARE CONNECT LLC 135 3133 98558 5 730.1 31.5 27.00 626.60 0.018
MSC GROUP INC 136 824 58604 22 430.9 71.1 6.18 37.45 0.078
MSC GROUP, INC 96 2011 56753 5 591.2 28.2 19.20 402.20 0.018
BAYADA HOME HEALTH CARE 124 1131 49771 11 401.4 44.0 11.27 102.82 0.039
OTOL RX COGNITIVE REHAB SPECIA 23 941 44468 2 1933.4 47.3 11.50 470.50 0.007
ASSURED & ASSOCIATES 28 396 30305 2 1082.3 76.5 14.00 198.00 0.007
JNJ SERVICES, INC, 28 183 26093 1 931.9 142.6 28.00 183.00 0.004
BAYADA HOME HEALTH CARE INC 27 596 21773 3 806.4 36.5 9.00 198.67 0.011
INFUSION PARTNERS MEMPHIS 6 67 21490 2 3581.7 320.7 3.00 33.50 0.007
BAYADA HOME HEALTH HEALTH CARE 260 353 20513 2 78.9 58.1 130.00 176.50 0.007
UNIVERSITY OF KANSAS HOSPITAL 12 136 19440 1 1620.0 142.9 12.00 136.00 0.004
ACCORD SERVICES LLC 40 270 19425 9 485.6 71.9 4.44 30.00 0.032
COMPX-MEDICAL MANAGEMENT 25 258 13247 2 529.9 51.3 12.50 129.00 0.007
BEACON CARE 8 158 6540 5 817.5 41.4 1.60 31.60 0.018
COMP X MEDICAL MANAGEMENT 15 53 6074 5 404.9 114.6 3.00 10.60 0.018
MSC GROUP, INC. 16 71 5707 1 356.7 80.4 16.00 71.00 0.004
CRAIG HOSPITAL 3 5 5703 3 1901.1 1140.6 1.00 1.67 0.011
COMPX MEDICAL MANAGEMENT 10 30 5672 3 567.2 189.1 3.33 10.00 0.011

Acute Rehab

State of Jurisdiction

Outliers

benefit_state bills LOS paid patients perbill perday billsperpatient daysperpatient percent
TX 36 770 1210040 8 33612 1571 4.50 96.2 0.258
CA 53 401 898001 6 16943 2239 8.83 66.8 0.194
AZ 16 139 676261 4 42266 4865 4.00 34.8 0.129
GA 11 274 481065 3 43733 1756 3.67 91.3 0.097
PA 11 221 283718 2 25793 1284 5.50 110.5 0.065
AL 14 56 210055 2 15004 3751 7.00 28.0 0.065
VA 8 50 141452 1 17681 2829 8.00 50.0 0.032
OK 7 33 135762 1 19395 4114 7.00 33.0 0.032
IA 9 47 132320 1 14702 2815 9.00 47.0 0.032
FL 6 17 113760 1 18960 6692 6.00 17.0 0.032
AR 4 94 109989 1 27497 1170 4.00 94.0 0.032
KS 9 22 100956 1 11217 4589 9.00 22.0 0.032

Non-Outliers

benefit_state bills LOS paid patients perbill perday billsperpatient daysperpatient percent
CA 908 3558 2461947 168 2711 692 5.41 21.2 0.126
TX 610 2948 2241014 128 3674 760 4.77 23.0 0.096
FL 312 1699 1344498 65 4309 791 4.80 26.1 0.049
AZ 369 1293 1160601 64 3145 898 5.77 20.2 0.048
IL 333 1248 1012253 64 3040 811 5.20 19.5 0.048
PA 1149 993 998610 58 869 1006 19.81 17.1 0.043
GA 178 882 710607 46 3992 806 3.87 19.2 0.034
NY 364 2298 707051 77 1942 308 4.73 29.8 0.058
MO 288 1206 675143 71 2344 560 4.06 17.0 0.053
IN 224 855 609260 42 2720 713 5.33 20.4 0.031
AR 77 612 573929 22 7454 938 3.50 27.8 0.016
TN 68 1003 561510 30 8258 560 2.27 33.4 0.022
VA 147 655 484289 30 3294 739 4.90 21.8 0.022
NJ 217 820 476907 48 2198 582 4.52 17.1 0.036
WI 100 435 455572 19 4556 1047 5.26 22.9 0.014
AL 79 583 426249 24 5396 731 3.29 24.3 0.018
MN 100 554 396302 19 3963 715 5.26 29.2 0.014
IA 106 422 373628 26 3525 885 4.08 16.2 0.019
NC 152 718 369225 33 2429 514 4.61 21.8 0.025
NE 99 460 349651 24 3532 760 4.12 19.2 0.018

Acute Rehab

Provider

Outliers

Provider_name bills LOS paid patients perbill perday billsperpatient daysperpatient percent
MEMORIAL HERMANN TIRR 38 816 1094251 8 28796 1341 4.75 102.0 0.258
SANTA CLARA VALLEY MEDICAL 47 358 792176 5 16855 2213 9.40 71.6 0.161
SSH PHOENIX 12 101 473410 3 39451 4687 4.00 33.7 0.097
GRADY MEMORIAL HOSPITAL CORP 13 101 384799 3 29600 3810 4.33 33.7 0.097
SHEPHERD CENTER 7 397 375581 2 53654 946 3.50 198.5 0.065
OU MEDICAL CENTER 15 54 236075 2 15738 4372 7.50 27.0 0.065
KINDRED HOSPITAL BREA 2 48 225778 1 112889 4704 2.00 48.0 0.032
SSH PHOENIX DOWNTOWN 4 38 202851 1 50713 5338 4.00 38.0 0.032
CARILION ROANOKE MEM HOSP 8 50 141452 1 17681 2829 8.00 50.0 0.032
THE NEBRASKA MEDICAL CENTER 9 47 132320 1 14702 2815 9.00 47.0 0.032
ALLEGHENY GENERAL HOSPITAL 8 32 114145 1 14268 3567 8.00 32.0 0.032
AVENTURA HOSPITAL 6 17 113760 1 18960 6692 6.00 17.0 0.032
LOMA LINDA UNIVERSITY MEDICAL 6 43 105824 1 17637 2461 6.00 43.0 0.032
WESLEY MEDICAL CENTER 9 22 100956 1 11217 4589 9.00 22.0 0.032

Non-Outliers

Provider_name bills LOS paid patients perbill perday billsperpatient daysperpatient percent
MEMORIAL HERMANN TIRR 155 1816 1806608 42 11656 995 3.69 43.2 0.031
SHEPHERD CENTER 131 1999 955304 38 7292 478 3.45 52.6 0.028
SANTA CLARA VALLEY MEDICAL 125 538 564655 22 4517 1050 5.68 24.5 0.016
SAINT JOSEPHS HOSPITAL MEDICAL 98 449 418443 15 4270 932 6.53 29.9 0.011
JFK JOHNSON REHAB INSTITUTE 51 553 316721 12 6210 573 4.25 46.1 0.009
SHIRLEY RYAN ABILITY LAB 62 542 308976 12 4983 570 5.17 45.2 0.009
CRAIG HOSPITAL 54 563 235635 19 4364 419 2.84 29.6 0.014
WAKEMED 90 340 216751 21 2408 638 4.29 16.2 0.016
UPMC MERCY 239 190 211485 8 885 1113 29.88 23.8 0.006
LOMA LINDA UNIVERSITY MEDICAL 36 142 196852 6 5468 1386 6.00 23.7 0.004
UNIVERSITY OF UTAH HOSPITAL 70 189 196074 11 2801 1037 6.36 17.2 0.008
MARY FREE BED REHABILITATION H 37 244 171336 6 4631 702 6.17 40.7 0.004
SSH PHOENIX 32 131 151816 5 4744 1159 6.40 26.2 0.004
REGIONAL ONE HEALTH 8 150 147121 6 18390 981 1.33 25.0 0.004
SENTARA NORFOLK GENERAL HOSPIT 21 167 145443 4 6926 871 5.25 41.8 0.003
SPAULDING REHAB BOSTON 35 243 138239 7 3950 569 5.00 34.7 0.005
UNIVERSITY OF AL HOSPITAL 25 108 137869 6 5515 1277 4.17 18.0 0.004
ST VINCENT HOSPITAL 21 87 136114 4 6482 1565 5.25 21.8 0.003
BIR JV LLP 25 166 133464 4 5339 804 6.25 41.5 0.003
SKYLINE MEDICAL CENTER 13 75 132398 3 10184 1765 4.33 25.0 0.002