Two Roadblocks in the Era of Consumer Directed Service

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  • January 12, 2017

Consumer Directed Service (CDS) is not new to the home care industry, yet it’s becoming a focal point in 2017. Home care members are continuing to leverage family members as primary home care providers, and, as a result, are facing payroll and visibility issues.

An upcoming HHAX survey highlights the continued role of CDS, as more than 60 percent of respondents indicated they have used a family member as a primary home care giver.

While leveraging family can be a necessary and useful way to receive convenient in home care, particularly for members in rural areas, it also results in a couple of significant issues for payers and providers.

Check Your Costs

Administratively, many home care providers are wasting significant money on payroll for hundreds of family caregivers. With costs as high as 30 dollars or more for CDS payroll checks every period, home care providers are spending significant money that could be saved.

Through exclusive partnership pricing with ADS, HHAX’s Agency Management Solution can provide cost savings by offering a monthly flat-rate on CDS payroll checks over a per check charge – regardless of the number of pay periods.

The data shows that CDS is not going away anytime soon, and it’s critical that organizations make sure they are effectively controlling payroll costs as they manage home care in this way.

Fraud, Waste and Abuse in CDS

While CDS payroll may be costing providers money, fraud in CDS may be an even larger problem for the home care industry. With little oversight into member care, the provider and ultimately the Medicaid payers, lack insight and transparency into the consumer-directed care that members are receiving.

The result? Hundreds of improperly billed hours, worse member care and, ultimately, more hospital readmissions.

For CDS to be monitored effectively, providers need insight into the home. Implementing Electronic Visit Verification (EVV) is a first step to track arrivals and departures, reducing false claims of time spent with a member. In order to ensure compliance and proper member care, providers need to leverage technology that ensures the home care aid is actively providing the necessary services for the member.

With HHAX, providers and payers are able to better monitor CDS and ensure compliance through collaboration.

Find out how your organization can take the right steps to actively manage consumer directed services.