Current Standards, Accepted Methodology, and Defensible Practices

Accurate and defensible cost research is a cornerstone of a well-supported life care plan. Attorneys on both the plaintiff and defense side increasingly scrutinize not only the clinical recommendations in a life care plan, but also how future medical costs are sourced, calculated, and justified.

So, what are the current, accepted practices in life care planning as we move through 2025 and 2026?

National Practice Standards: What the Data Shows

In 2024, the American Association of Nurse Life Care Planners (AANLCP) conducted a national job survey examining cost research methods and pricing protocols used by practicing life care planners. The results were published in the Spring 2025 issue of the Journal of Nurse Life Care Planning, the profession’s peer-reviewed journal.

This survey provides valuable insight into what courts, opposing experts, and attorneys increasingly recognize as customary, reasonable, and methodologically sound life care planning practices.

Use of National Cost Databases

According to the survey, 94% of respondents reported using national cost databases to research medical and healthcare pricing. Commonly used resources included:

• Veterans Affairs (VA) Reasonable Charges
• American Hospital Directory
• FAIR Health
• Context4Healthcare
• Medical Fees in the U.S. (PMIC)

These databases allow life care planners to rely on transparent, reproducible, and geographically adjusted data, rather than anecdotal or local-only pricing. Less than 5% of respondents indicated that they did not use databases at all—highlighting how firmly database-driven pricing is embedded in modern life care planning.

Percentiles: What Is Considered “Usual, Reasonable, and Customary”?

One of the most litigated aspects of cost research is which percentile is used when pricing future medical care.

The AANLCP survey found:

• 76% of life care planners most commonly use the 75th or 80th percentile
• 10% use the 50th percentile
• Only 2% use the 90th percentile

These findings are consistent with long-standing guidance in life care planning textbooks and peer-reviewed literature. The 75th–80th percentile range is widely accepted as reflecting usual, reasonable, and customary charges, balancing realism with defensibility while avoiding both underestimation and inflation of future medical costs.

Dawn Cook, RN, CLCP, CNLCP: A Consistent and Neutral Approach

Dawn Cook’s life care planning practice aligns squarely with these nationally recognized standards.

For both past medical damages and future medical damages, Dawn Cook:

• Utilizes nationally recognized cost databases
• Applies the 75th or 80th percentile when available
• Uses the same methodology regardless of whether she is retained by plaintiff or defense counsel

This consistency is critical. By applying the same pricing standards across all cases, Dawn Cook provides opinions that are methodologically sound, transparent, and defensible under cross-examination.

Why Methodology Matters to Attorneys

For attorneys evaluating a life care plan expert, cost methodology is not just a technical detail—it directly affects:

• Credibility with opposing counsel
• Admissibility and weight of expert opinions
• Exposure during deposition and trial
• Settlement negotiations and damages analysis

A life care plan grounded in peer-reviewed standards and current professional practice allows attorneys to focus on advocacy, rather than defending the expert’s methodology.

An Unbiased Resource for Both Sides of the Bar

Whether you represent plaintiffs or defendants, Dawn Cook offers objective, evidence-based life care planning rooted in current national practice standards.

Get the unbiased opinions of Dawn Cook, RN, CLCP, CNLCP.

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References

Bate, B., & Roughan, J. (2025). Practice and Protocols. Journal of Nurse Life Care Planning, Vol. XXV(2), p. 21.

• Survey results indicate 76% of respondents use the 75th or 80th percentile when pricing from national databases; 10% use the 50th percentile; and 2% use the 90th percentile.
• Over 30% reported using databases such as Medical Fees in the U.S. (PMIC), VA Reasonable Charges, American Hospital Directory, FAIR Health, and Context4Healthcare. Less than 5% reported not using databases.

Spring 2025 Journal Issue:
https://www.aanlcp.org/wp-content/uploads/2025/05/AANLCP-Spring-2025-Journal.pdf