Articles

Cost Modelling for Small and Rural HCBS Providers: Avoiding Market Exit and Access Gaps
Uniform HCBS rates often fail small and rural providers, creating access gaps and fragile networks. This article explains how cost models can reflect scale, geography, and coverage realities without undermining fairness or accountability. Read more...
Setting HCBS Rates Under Cost Pressure: Inflation, Wage Floors, and Market Sustainability
HCBS rate setting increasingly happens under inflationary pressure, workforce shortages, and political constraint. This article explains how commissioners can model rates under stress, adjust assumptions transparently, and evidence decisions when funding growth cannot fully match cost growth. Read more...
Cost Modelling for Value-Based HCBS Contracts: Linking Outcomes to Payment Without Breaking Delivery
Value-based purchasing can improve HCBS outcomes—or quietly destabilize delivery if incentives are mispriced. This article explains how to build cost models for outcomes-linked contracts, how to protect access and safeguarding, and what commissioners should demand in audit-ready evidence. Read more...
HCBS Rate Setting Mechanics: Building Defensible Unit Rates and Service Packages
Rate setting in HCBS is not a spreadsheet exercise—it is a governance decision about access, workforce stability, and service integrity. This article explains how unit rates and service packages are built, how assumptions are tested, and what commissioners should be able to evidence when rates are challenged. Read more...