Policy Makers Should Vet Savings Claims: Halima Ahmadi-Montecalvo, PhD

Policy makers and payers evaluating claims that a health or social care program generated cost savings should scrutinize the methodology behind those figures before accepting them, according to Halima Ahmadi-Montecalvo, PhD, MPH, adjunct professor of public health at the Milken Institute School of Public Health at George Washington University and vice president of research and evaluation at Unite Us.

Which Costs Are Actually Counted

A credible analysis starts with a well-matched comparison group or another rigorous method for estimating what would have happened without the intervention, Ahmadi-Montecalvo said. Without that counterfactual, reported savings are difficult to interpret.

Evaluators should also ask which costs were included in the analysis, she said. Some estimates count only medical claims, while others also factor in screening, patient navigation, technology, program administration, and the social services delivered. Whether implementation and infrastructure costs are treated as a one-time investment or excluded entirely can significantly shift the reported return.

Inclusion and exclusion criteria matter just as much, Ahmadi-Montecalvo noted. Programs targeting patients with extremely high baseline utilization often show large early savings, but those results do not necessarily generalize to a broader population.

Looking Past the Headline Number

Policy makers should look for transparent methodology, adequate follow-up time, and outcomes reported across subgroups rather than relying on a single high-need population, she said. The more important question, according to Ahmadi-Montecalvo, is whether savings are durable and whether a model still delivers value when deployed across a full population rather than a narrow pilot.

Pilots serve a purpose, she said, but scalability should remain the goal. "The goal really is to serve millions versus hundreds and thousands," Ahmadi-Montecalvo said.