HHAeXchange Blog

Evaluating Your EVV Vendor: 6 Key Considerations

Evaluating Your EVV Vendor: 6 Key Considerations

KimGlenn - Senior Vice President, Government Health Plans, HHAeXchange

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Electronic visit verification (EVV) impacts the lives of many – from homecare providers, to caregivers, to members receiving services in their homes. With EVV implementation for personal care services (PCS) well underway, and the Cures Act deadline for EVV for home health care services (HHCS) fast approaching, many states are now taking a step back and wondering: is our EVV solution working for us, or against us? Could it be doing more?

Finding the right EVV vendor, and getting your networks on board, is no simple task. Perhaps your state is already in full compliance with the PCS mandate, and while you’re curious about other solutions, you fear the potential hassle of making the switch. Or maybe your road to EVV compliance hasn’t gotten any smoother, and you’re desperately seeking other options. Whatever your case may be, it’s worth taking a closer look at the solutions available to you and thinking realistically about what is required to ensure a successful transition.

In this article, we’ll outline the key considerations in evaluating your EVV vendor, and help you determine whether it’s time to make a change.

Key Consideration #1: Vertical Connectivity

Disparate and non-existent EVV systems across providers, financial management service (FMS) entities, and managed care plans make compliance with the Cures Act challenging. Additionally, limited access to detailed visit data can lead to fraud, waste, and abuse; overpayments; compliance risks; and most importantly, your members not getting services they need.

From health plans, to providers, to individuals receiving care, everyone is connected. EVV software that mirrors the homecare ecosystem by connecting all stakeholders in one platform allows for greater visibility and transparency, making it easier to monitor your provider network’s performance and ensure quality of member care.

Key Consideration #2: Tool Functionality

Under the Cures Act, visits must be electronically verified for the type, date, and location of the service performed, the individual receiving the service, the caregiver or aide performing the service, and the time the service begins and ends.

While there are numerous tools that may meet these requirements, not all EVV is created equal. Adopting EVV technology that does the bare minimum could have negative consequences, especially for your providers.

For example, standalone EVV tools often result in cluttered agency environments with disjointed systems. At HHAeXchange, we view EVV as the central engine that drives successful agency management. When a caregiver completes a visit in HHAeXchange, the visit is automatically associated with the schedule and authorization for the services performed. Plan of care tasks and duties are also captured upon clock-out. (To protect caregivers’ privacy, GPS coordinates are captured only at the time of clock-in and clock-out – not before, during, or after the visit). In addition to EVV, our system offers powerful billing, scheduling, payroll, reporting, and compliance capabilities – as well as direct integrations to leading eLearning, patient intake, health screening, and other solution vendors.

“All-in-one” homecare management solutions offer major benefits for both payers and providers, from streamlined processes and greater efficiencies, to enhanced member outcomes.

Key Consideration #3: Price

As with other things in life, “cheapest” does not always mean “best” when it comes to EVV.

A solution should offer more value than EVV compliance alone. So, when evaluating your EVV system, make sure you’re considering the full package. Your EVV tool might be the lowest priced option, but how do your provider networks seem to like it? Does it barely allow their caregivers to clock in and out, or does it meet Cures Act requirements and offer other benefits, like communication, billing, and workflow efficiencies?

Keep in mind that EVV is generally more affordable today than when it was first introduced. You may be pleasantly surprised by the current choices available to you, with enhanced functionality included in the deal. Still, you’ll want to think twice about any promises that seem too good to be true. For all that added functionality to be a benefit, it needs to work.

And remember: the lowest price option may not be the most cost-effective in the long run.

Key Consideration #4: Impact on Member Outcomes

Given the industry shift to value-based care, it’s critical to consider the potential impact of your tech on member outcomes.

When all stakeholders are connected in one system, it allows for greater visibility and access to key metrics that drive quality care. For example, with HHAeXchange’s Care Insights, payers can leverage caregivers’ frequent visits with members to improve health outcomes through real-time change in condition alerts, social determinants of health (SDOH) observation reporting, and gathering in-home health-related metrics over time at member, risk cohort, and population levels.

Caregivers simply record member observations at the time of clock out and that information gets reported back to their agency or health plan care management teams. Decision-makers are alerted to any patients requiring immediate attention, and they can closely monitor those exhibiting changes in condition. With these insights, member risk escalations can more easily be prevented, and hospital readmissions can be reduced.

Key Consideration #5: CMS Outcomes-Based Certification

Has your state achieved CMS outcomes-based certification (OBC) for EVV?

Applying for CMS OBC can be long, expensive, and difficult to navigate, but the benefits – more efficient processes, demonstrated compliance, and enhanced federal financial participation (FFP) – make the effort worthwhile.

The right CMS-certified vendor will support you in your path to compliance and ensure a more effective process for all stakeholders.

Key Consideration #6: Accommodating Self-Direction

Self-direction (also referred to as consumer direction or participant direction) has become an increasingly popular option for individuals wanting more control over their healthcare. According to a recent survey conducted by HHAeXchange, 35% of providers are planning to grow their agency this year by expanding to self-direction.

As more individuals within the Medicaid population choose to receive home and community-based services (HCBS), the success of EVV systems, particularly for self-direction programs, hinges on the participant experience.

In order to accommodate both traditional HCBS and self-direction, your EVV system should include the following key elements:

  • Self-Scheduling (or no-scheduling) Options
  • Participant Review and Approval Capability
  • Flexibility
  • No Geo-fencing
  • Variability
  • Controls for Program Integrity
  • GPS Coordinates Captured Only at Time of Clock-In and Clock-Out

By prioritizing participant autonomy and following best practices, payers can ensure they implement an EVV system that delivers positive outcomes, compliance, reduced risk, and above all, an effective self-direction program that benefits all stakeholders.

Conclusion

The selection of an EVV system is a choice that impacts everyone – from providers, to caregivers, to members. Therefore, rather than evaluating your EVV system based solely on confirmed clock-ins and -outs, look for a solution that connects the entire homecare ecosystem. Your EVV vendor should be evolving with the needs of the industry and of your members.

EVV doesn’t need to be a headache. When the right solution is implemented with the right vendor, all stakeholders can reap the benefits.

If you’re considering making the change…

Through our work with state EVV systems, managed care organizations (MCOs), and large provider agency implementations, HHAeXchange has robust experience in both transitioning users to a new system and onboarding new users to a system for the first time. To learn more about the benefits of our solution, contact us.

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