In addition, a determination made for the purpose of clause (2) of subsection (a) shall be made in accordance with an economic analysis (including a life-cycle cost analysis) of the facility and consideration of all reasonable and available medical care treatment alternatives (including treatment provided under a contract under
section 1086 of this title or under part A of title XVIII of the Social Security Act (
42 U.S.C. 1395c et seq.)).