Utilization can fall for the wrong reasons—restricted access, unmet need, or shifting risk to families and emergency services. This article explains the guardrails and governance routines that make avoided-cost claims credible, including access measures, safeguarding signals, and cohort integrity checks.
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“Avoided cost” is persuasive only when it’s defined, governed, and tied to delivery practice. This article shows how HCBS and LTSS providers evidence demand reduction credibly using clear counterfactuals, leading indicators, and audit-ready governance that commissioners and MCOs can trust.
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