Whether Available Alternatives Are More Economical in the

30.7.2 - Whether Available Alternatives Are More Economical in the Individual Case (Rev. 261, Issued: 10-04-19, Effective: 11-05-19, Implementation: 11-05-19) A3-3132.6.B, SNF-214.6.B If the A/B MAC (A) determines that an alternative setting is available to provide the needed care, it considers whether the use of the alternative setting would actually be more economical in the individual case. EXAMPLE 1: If a patient's condition requires daily transportation to the alternative source of care (e.g., a hospital outpatient department) by ambulance, it might be more economical from a health care delivery viewpoint to provide the needed care in the SNF setting. EXAMPLE 2: If needed care could be provided in the home, but the patient’s residence is so isolated that daily visits would entail inordinate travel costs, care in a SNF might be a more economical alternative.