Section 12006(a) of the 21st Century Cures Act mandates that states implement Electronic Visit Verification (EVV) for all Medicaid personal care services (PCS) and home healthcare services (HHCS) that require an in-home visit by a provider. EVV is a weapon in the war to eliminate healthcare fraud, waste and abuse while enabling new and better methods to track, manage and optimize service delivery. EVV is implemented with systems that enable healthcare service professionals to electronically capture activity details for a visit on a mobile device. As a result, EVV solutions log details such as the time that a visit began and ended, services rendered, the individuals who gave and received services, location of service delivery and other pertinent details.
In EVV’s phased-rollout, January 2019 was a key milestone where it became mandatory for Medicaid funded home-health services, with plans to make EVV mandatory for all Medicaid-funded personal care services beginning in 2021. Bottom line: The EVV train is leaving the station and it’s a mandatory ride for providers – ready or not. Interestingly, state-specific Interpretations of EVV predominately fall into one of two categories – Open or Closed. Open means providers have a choice in what state-approved EVV solution they implement, whereas in a Closed model the state has made the decision on their behalf.
In open-market states, EVV solutions are most commonly sourced from a wide spectrum of options ranging from basic, free packages from the state, to enterprise-level options with a price tag to match. Either extreme might prove tempting, however, EVV implementation stories from the front-lines have shown there are very important things for providers to keep in mind when considering EVV alternatives:
1. Free Does Not Mean No Cost
Free and low-cost EVV alternatives, some of which include the devices, may seem to be attractive, especially given how important cost-control is for providers. Further, many low or no-cost EVV solutions “look shiny” and “on paper” say all the right things. All that glitters is not gold, and these options may have serious shortcomings that include:
Like with other forms of technology, users will occasionally require support. Good support is critical to staying up and running because downtime can affect not just business processes but a patient’s access to care. Therefore, beware of free alternatives which seem to offer attractive functionality but provide no indication of additional support. It may become critical down the line. Need support from a state-funded solution? Be prepared to wait in line.
State-provided mobile devices can be lost, stolen or out of power just when needed. These issues all add up to bad user-experiences for all stakeholders including disability support professionals, patients and guardians alike. These failures can degrade the quality and consistency of service delivery, outcomes and the provider’s financial performance.
Users collect a range of important information on an EVV device which will need to be transmitted elsewhere. Some solutions do not work off-line and the system may lose data that was entered offline. These delays or worse, gaps in data-collection, can cause claim payments to be delayed or rejected and affect payroll logs, creating an array of negative financial consequences.
Proprietary EVV systems have a vested interest in maintaining top-of-the-line security and compliance standards. However, free systems may not have the same design and testing protocols as those from commercial sources. If the security model has vulnerabilities, EVV systems that were mandated to cut down on fraud many actually increase the likelihood of fraud or exposure.
2. “Beast of Burden” or Game-Changer…Your Choice
Yes, EVV is mandatory and yes, it adds a significant new layer of compliance obligations that healthcare providers must absorb and deploy. The reality is that providers who look at EVV only from a compliance perspective have tunnel vision, viewing it as a new “tax” on service delivery and business operations. These providers are missing a rare opportunity for strategic innovation that comes from a different perspective. Healthcare thought leaders view EVV as an opportunity to transform patient care and outcomes, create more time for service professionals, and make the new EVV data pool visual and interactive, enabling data-driven innovations.
Solutions such as IntelliCloud EVV™ reflect a new mindset that transforms the “EVV burden” into an engine for strategic innovation, creating new capabilities and making life easier. This “compliance with benefits” mindset puts providers and patients first. Look for these capabilities in your EVV buyer’s journey:
Eliminate Tracking Requirements for State-Provided Devices
Many states have strict tracking requirements for the devices they provide that can easily get lost, stolen or otherwise misplaced. Software-based solutions like IntelliCloud EVV eliminate the asset-tracking burden on providers by automating the process entirely using existing mobile devices. The result is that providers spend more time with patients without worrying about accidentally forgetting to log any critical details.
Make Data an Asset for the Organization
EVV data is a goldmine. If an EVV solution makes the data collected interactive, visual and easy to analyze, it can be a mission-critical asset that gives providers insights into how to improve service delivery and outcomes, allocate resources and reduce risks.
3. Choose the Right Model for You
At the opposite end of the spectrum, enterprise-level EVV systems go so far beyond EVV fundamentals that many capabilities, while paid-for, go unused or bring huge change-management and training burdens with a big cost. Often, these unused features drive up the price tag and users are left paying for things they don’t use. Ideally, the right EVV system provides compliance, innovation and makes data come alive without any additional bloat by providing:
- An agnostic EVV platform that easily integrates with existing systems
- Visual EVV data in a model that drives innovation
- A simple user experience for both patients and providers that minimizes training and makes things easy
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