One of the biggest challenges facing states and Managed Care Organizations (MCOs) as payers is coordinating high-quality care for patients in home and community-based settings that’s also efficient, expedited and cost-effective.
Now, using mobile devices and an Electronic Visit Verification (EVV) mobile application, direct care providers check in and out via GPS technology that more accurately records visit location, duration and care tasks as they’re delivered. Plus, with EVV, caregivers now have the most up-to-date patient data right at their fingertips, resulting in greater efficiency — and better and smarter outcomes.
While some resistance remains from smaller health care providers due to cost barriers of technology implementation, drilling down on the overall benefits provides at least a cursory risk-benefit analysis of five ways EVV is transforming home care for patients and caregivers alike:
- Operational efficiency and workflow management. Visits are verified in real-time with EVV systems. Any changes to regular schedules can be quickly identified and addressed, eliminating the need for paper timesheets and other documentation. With EVV, there’s greater visibility into field operations. Planned visits are validated and approved automatically. Care plans, authorizations, narrative notes and time/task flow sheets are all digitized.
- ROI opportunities. EVV reduces unknown missed visits, mileage and paper costs, and refocuses staff from audit preparation duties to activities that generate revenue like filling shifts and making outreach calls.
- Audit assistance. Paper documents that contain times logged and patient signatures are increasingly under scrutiny by auditors. With the accuracy of electronic systems, including times and services generated from the point of care, data integrity cannot be compromised, alleviating auditor concerns. For many agencies operating with paper-based timecards, EVV is a superior risk mitigation tool.
- More accurate billing, faster payment and more accurate payroll Billing and claims processing are fully integrated, resulting in faster reimbursement. Capabilities include electronic Medicaid billing, sync with payroll management software and detailed payroll reports.
- Patient outcomes. There are many ways EVV improves quality of care for patients, including better client-agency communication resulting in a reduction in missed visits/shifts, improved task entry to ensure correct patient services, and validation that patients receive full value for authorized hours of care. Additionally, services entered by the caregiver can be approved or denied at the point of service by the client. EVV is HIPPA compliant, so patient health information is protected.
Today, state Medicaid agencies are collaborating with MCOs and other industry stakeholders to zero in on effective, value-added EVV solutions. The shared goals are to lift burdens on home health agencies and caregivers while improving home and community-based care delivered to Medicaid members.
In the increasingly competitive home care market, technology innovations like EVV are driven by several factors, including growing demand, fewer resources, lower reimbursement rates and an increasing variety of care options. At the forefront is the recent passage of federally mandated regulations that are spurring adoption at breakneck speed.
To combat fraud, waste and abuse, the Centers for Medicare and Medicaid Services (CMS) pushed state-mandated EVV as a risk mitigation tool to help the government curtail billions in medical fraud lost annually. Implementation of EVV for Medicaid-reimbursed home and personal care services became a national requirement in 2016 through the 21st Century Cures Act. Though the initial deadlines were amended in July 2018, personal care services are still required to adopt EVV systems before January 1, 2020, and home health services must have systems in place prior to January 1, 2023. Otherwise, states could face reductions in their federal matching funds.
While the mandate may be the catalyst pushing adoption rates, a closer look at how EVV transforms home health as outlined above also reveals a perfect storm of incentives for states and MCOs to adopt EVV to improve workflows, manage costs and fine-tune coordination of care.
According to a July 2018 report in Becker’s Health IT and CIO report, “[With EVV] clinicians can spend less time on paperwork and more time on patient care, which means better business for home health and hospice agencies.”