EVV System: What Home Care Agencies Need to Know?

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The 21st Century Cures Act - Bringing Advances to Patients

According to the 21st Century Cures Act, states must require EVV for all personal care services and home care services that require an in-home visit provided and reimbursed under Medicaid. Otherwise, they risk having their Medicaid claims denied.

The main goal of this legislation was to increase choice and access for both patients and service providers and drive quality. 

It was signed into law back in 2016, but the Department of Health and Human Services (HHS) introduced the next phase for the Cures Act in 2020. 

Two transformative sets of rules were finalized with the main goal to empower patients and give them safe, secure, and easy access to their digital health records. But there is more to this Act. 

Ultimately, it aims to enable patients to make better healthcare decisions and put them in control. The rules were announced as the historic ones that will ultimately drive innovations and provide patients with more control. 

For instance, providing service to a person with a disability can be especially delicate, and supervision has been recognized as a way to monitor staff and ensure adequate service quality level. 

Fraudulent care claims were also one of the reasons behind this mandate. 

What Is Electronic Visit Verification (EVV)? 

The 21st Century Cure Act includes the EVV requirement among other provisions. It is a tracking method used for compliance and verification of Medicaid-funded home healthcare visits. 

Under this system states must require EVV use for agencies that conduct in-home visits as part of home healthcare services. The legislation summarizes key data points every system has to collect and verify via electronic means. 

Electronic visit verification for home care agencies is designed to track location information, work performed, hours, and other important aspects when it comes to patient-caregiver information. 

Essentially, every time a person receives a home healthcare service, an electronic verification is required. This way, the type of service performed, the date, location, person providing the service, and the person receiving it can be easily verified. 

The implementation of evv software for home health is part of efforts towards creating a value-based healthcare system and putting patients at the center of their care. It is intended to reduce fraud and neglect as well. 

Protecting patients from neglect and ensuring they receive the care they need is at the heart of this legislation. 

What Are the EVV Requirements?

By the 21st Century Cures Act, states are obliged to require EVV use for Medicaid-funded home health care services that rely on in-home visits by a provider. 

The mandate applies to services that conduct in-home visits and provide support to individuals in their daily living activities (like dressing and bathing) or instrumental activities (preparing meals, taking medication, managing finances, etc.) 

The EVV compliant home health care agencies must be able to electronically capture and verify six key data elements:

1. The type of service performed;
2. The individual receiving the service;
3. The date of the service;
4. The location of service delivery;
5. The individual providing the service;
6. The start and finish time of care delivered.

Also, given the fact that states are designing their own solutions, they may enforce additional, state-specific criteria.

The implementation of electronic visit verification for home care agencies must be in place by January 1st, 2023. Home healthcare service providers have another year to prepare and adopt the best EVV system for home care agencies. 

Furthermore, the government has allowed an additional delay of yet another year, if the hold-up was unavoidable and the state in question has demonstrated a good faith effort to comply with the EVV requirements.

How do EVV Systems Work?

To be EVV compliant, service providers need to implement a state-approved EVV solution. Generally speaking, this type of software relies on a system that electronically verifies things like the service provided, who received the service, and more. 

Usually, this is accomplished by either a web-based device or a telephone. Employee GPS tracking apps and computer software are state of the art technology and the foundation for evv for home health. 

Technology behind EVV for home healthcare agencies allows them to track the location of their mobile teams, determine their compensation, enhance service quality, and even increase efficiency. 

Most EVV solutions use Global Positioning Services (GPS) to verify the location where the service is provided. For example, one of the methods tracks a provider’s location at the start and end of each visit. It also sends this data to the state Medicaid agency. 

In most cases, care providers will be expected to use a mobile phone or a special purpose device in the client’s home to record their visit via an app. 

Alternatively, caregivers can use a client's home phone to call a toll-free number and verify their visit through interactive voice response (IVR). 

State Specific Variations

It is important to note that states have the freedom to decide how to implement EVV software for hospice and other service providers, and build their own systems based on the federal mandate key points. 

CMS has described examples of systems but it doesn’t endorse any approach over another one. As states are not required to use a particular or a uniform system, EVV compliance differs from country to country. 

Nevertheless, states are required to consider existing best practices and EVV systems in use within their borders. They also need to ensure that this tracking system is minimally burdensome for both people receiving the service and the people providing it. 

In addition, the use of electronic visit verification in the home health industry has to be compliant with the privacy and security requirements of the Health Insurance Portability and Accountability Act (HIPAA). 

When researching state rules, home health care agencies need to pay attention to three key pieces of information: 

1. State-approved EVV model;
2. Allowed data collection models (mobile, telephony, or fixed verification device);
3. EVV implementation deadline.

Certain countries like Texas for example, have already implemented a federal EVV mandate for home healthcare visits billed to the state. 

EVV Models 

Medicaid has addressed five major models implemented by states in their Informational Bulletin. Although all of them provide similar solutions, they differ in certain aspects like state involvement in EVV management and vendor selection.

The states have been given flexibility regarding the type of EVV model they want to implement, but the approach they opt for has to meet statutory requirements such as HIPAA privacy and security standards. 

These are five major EVV models states can choose from:

1. Provider Choice Model

This model gives complete freedom to healthcare organizations to choose their vendors, but they also have to cover the costs of the EVV implementation. Some states are considering raising reimbursement rates, in an attempt to compensate agencies’ expenses.

2. Managed Care Plan (MCP) Choice

In this approach, Managed Care Plans (MCPs) select and reimburse EVV vendors. When it comes to states with multiple MCPs, home health care agencies may face higher administrative costs. 

They may have to adopt multiple forms of technology, and integrate multiple EVV systems with scheduling or payroll software. 

3. State Mandated In-House System

Within the state mandated in-house system, states are to develop and manage their own EVV solutions that all home care agencies must use. In comparison to other models, this one places a greater administrative burden on the state.

For example, training development and its conduct to state staff, providers, and individuals is the state's responsibility. 

4. State Mandated External Vendor Model

State mandated external vendor model requires service providers to use a state-sponsored vendor. State contracts with a single EVV vendor, and that vendor is to implement a single electronic visit verification solution. 

This type of approach ensures standardization and access to all data by the state. Again, it is the state's responsibility to provide education on the EVV operations. 

5. Open Choice Model

Under this model, the state selects an EVV vendor that agencies can use free of charge. Service providers can also choose to work with another vendor instead of a state-sponsored one, but in that case they have to cover the expenses. 

Healthcare organizations that opt for alternative solutions need to be aware that they have to use the ones that can integrate with the state’s data aggregator. 

How Can Right EVV Solutions Benefit Home Care Agencies?

In addition to enabling healthcare organizations to remain in compliance with federal mandates, the electronic visit verification system helps in supporting and running home health care providers. 

In addition to acting as a time and attendance verification tool, intelligent EVV tools will help your business stay in regulation and assure your patients receive the care they need. But, utilizing the best EVV system for home care comes with even more benefits.

Let’s dive deeper into the advantages of using electronic visit verification. 

Improved Client Care 

One of the most important advantages to this software is that EVV compliant home health care agencies can easily monitor patient visits, eliminate fraud and protect them from inadequate care. 

Vendors can also utilize EVV systems to review the latest patient health data, reports and other important notes in an instant. 

Ultimately, this can lead to improved efficiency in providing home healthcare services and better care for clients. 

Accurate Recording of Billable Hours 

Advanced tech solutions provide businesses with numerous advantages. In this particular case, EVV for home health care agencies can easily log visits and record billable hours in real-time, and they can do it more accurately as well.

Making sure your field employees are paid properly is important for their motivation and productivity, and this smart system can help compensate your workforce fairly. 

It will optimize the payroll process and help eliminate overbilling and falsely filed invoices. 

Enhancing Employee Safety 

Apps with GPS tracking can do more than help health organizations manage their remote personnel. Mobile teams in the home healthcare industry face unique challenges, and sometimes they have to provide care in remote or even potentially dangerous locations. 

EVV systems can help agencies improve their staff’s safety by providing an additional layer of security. Tracking employee location is critical for managing their safety. 

With real-time location visibility, both agencies and mobile teams can rest assured knowing that field workers’ location is being accurately monitored. 

Integration With Scheduling Tools and Other Apps

There are even more perks if you implement an EVV system for home care. Modern EVV software solutions can be easily integrated with scheduling tools, and other apps agencies are using. 

These integrations can help with daily workflow automation beyond attendance recording and verifying an in-home visit. 

From scheduling and calculating mileage reports, to sending tasks and notes to caregivers, integrated approach offers numerous possibilities to the entire process of providing in-home care. 

Verifying Payroll  

EVV in home health care agencies can be integrated with payroll systems to streamline the process of doing payroll and easily verify staff’s compensations. 

As mentioned earlier, EVV technology can record billable hours in real time, verify them with GPS, and then export this information into a particular payroll system. 

Such integrations eliminate the manual work and save huge amounts of time. And in addition to verifying hours of work and payroll, they also make the entire process more accurate.

Retaining Top Talent

Smart digital tools are unparalleled in their ability to optimize business operations using a data-driven approach. In addition to streamlining financial aspects of business and managing employees, there is another major benefit to this tracking system that often gets neglected. 

Collecting and storing important patient data like their habits and preferences can help caregivers personalize their approach and deliver quality service. It can also improve matching the care provider with a client. 

EVV for home healthcare agencies has the potential to provide mobile workers with more information on their patients, enabling them to get to know the persons they work with better and perform an even better job. 

Also, less time spent on paperwork with this smart system means more time on patient care.

Ultimately, all of these benefits lead to an increased work satisfaction and improves employee retention. Therefore, adopting smart tech solutions can be a great way for agencies to retain their top talent.

Reduced Costs 

Optimized business operations mean cuts in costs. For starters, EVV for home health providers allows them to reduce payroll expenses. Costly, time-consuming paperwork can finally be eliminated.

Also, agencies that still use paper-based timesheets are more prone to facing potentially expensive errors. 

With the right system in place, it is possible to eliminate these issues and avoid additional expenses that come with paper consumption and administrative errors.

Selecting a Technology Partner 

Ultimately, service providers that want to stay ahead of the curve need to be ready to comply as soon as EVV is rolled out in their state. In order to do so, it is necessary to understand the new EVV system, adopt an intuitive, easy-to-use software, and train your staff. 

For instance, recording information about care visits needs to be simple and efficient, and so does registering a caregiver's location. This will help make the transition to this novel tracking method as smooth as possible for everyone involved. 

With an EVV implementation in home health agencies, patients can expect improved service quality and ultimately better health outcomes. On the other hand, this software can help agencies automate and streamline workflows.

Meeting the mandatory EVV requirements is a great opportunity for service providers to embark on the digital transformation journey. When choosing a technology partner, make sure you understand what your business needs and opt for a system that can address several issues at once.