Southern California Permanente Medical Group
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $1.6M (2023) to $22.7M (2024) — a 1327% swing with $21.1M absolute change.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1327% 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.
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 $30.7M is at the 25th percentile among 10 Health Maintenance Organization providers.
Total Paid
$30.7M
$30,651,987
Total Claims
3.0M
Beneficiaries
2.9M
1.1 claims/patient
Avg Cost/Claim
$10
🔍 Analysis
Provider Overview
Southern California Permanente Medical Group is a Health Maintenance Organization provider based in Fontana, CA. From the 2018–2024 period, this provider received $30.7M in Medicaid payments across 3.0M claims.
Why This Matters
At $30.7M 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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