Complying with the Electronic Visit Verification mandate

There’s a right way and a wrong way.

The EVV mandate is here. How you and your organization respond will determine if that means a burden or an opportunity.

Complying with federal requirements regarding Electronic Visit Verification (EVV) for Medicaid personal care services (PCS) and home health services (HHCS) that require an in-home visit by a provider has been a daunting task for many states and providers nationwide. As of November 14th, 30 states have requested exemptions from CMS (Centers for Medicare & Medicaid Services), with more likely requesting exemption prior to the November 30th deadline. In addition to state departments having a difficult time meeting the requirements, many providers have been put in a very difficult position.

Here’s what we learned talk to agencies across the U.S. about EVV.

The SETWorks team has spoken with providers across the nation, and seen providers take a wide range of approaches to meeting the requirements:

1. Some agencies are enhancing their home-grown systems (typically very expensively),
2. Some agencies are attempting to use a state-chosen EVV system (when available)
3. Some agencies are working with their existing software vendor
4. Some are still searching for the right solution, and
5. others are simply lost.

In many cases, the unfortunate circumstance the requirements have put providers into has often led to searches for short-term solutions – reactively trying to meet the looming requirement and not spending enough time strategizing how it integrates into their larger data strategy. This can be detrimental down-stream: Choosing any mission-critical software in a time crunch is never a good idea.

The right software for one agency is not the right one for another, and significant thought and planning is required to fully understand what one’s needs are and what software system is the best fit.

The good news is that the idea of EVV has a lot of potential and should be a value-add for providers and the individuals they serve. When implemented properly, it should not be “yet another task” on a staff’s or supervisor’s schedule to keep track of. This is how:

1. Integrated EVV leads to minimal changes to existing workflows: In advanced electronic client management and documentation systems, the primary addition EVV brings is location tracking, which is something that can often be tracked invisibly/behind-the-scenes. (The exception may be in very rural areas where backup options, such as TVV, are needed). The best systems out there are able to embed location tracking into existing documentation workflows, in which case there is no additional training needed or steps needed for staff to complete their work. Compliance occurs naturally with no extra time commitments from anyone at the organization.
2. Location data helps improve outcomes: Data-driven organizations drive daily decisions from data – they benefit from useful data at their fingertips, and location-of-service data in the proper contexts is precisely this type of data. Location data provides more data points that help supervisors more effectively audit what is happening on their team, which can help identify issues much sooner than would otherwise occur. If real-time alerting is available with your EVV package, supervisors can even be notified instantly of an issue and take action before a situation gets out of hand. Lastly, when aggregating data for external stakeholders or for internal organizational outcomes/KPIs, this data married with other contextual data on staff and service delivery can produce interesting insights for your teams/programs/departments and organization as a whole.

Although a very frequent topic, there appears to be significant internal under-preparation for EVV. Allocating the time necessary to tackle EVV holistically and planning for the data-capture to blend invisibly into your daily operations (complete integration) and for the data to enhance your daily operations is in the purview of every organization.

Our goal at SETWorks has been to achieve this “invisible” integration – to truly offer the best solution possible for IDD agencies and make complying with EVV as painless for providers as possible. If you would like to talk more with us about any of the ideas here or how to easily implement an EVV solution, give us a call we’re happy to chat!