As the cost of health care and personal services continue to escalate and the concern of fraud in the home health industry continues to grow, agencies are under increasing pressure from payers to provide proof that the in-home services they bill were in fact delivered.
A driving factor in this growing demand for Electronic Visit Verification (EVV) is the 21st Century Cures Act – which requires states to establish EVV requirements for Medicaid-funded personal care and home care services.
Agencies naturally are concerned. With budgets already stretched thin, there is worry that meeting the EVV mandate will simply add yet another cost that further eats away at profits. And yet, EVV can bring a level of visibility to the delivery and management of care. This visibility may in turn yield unexpected – and potentially significant – gains in productivity, communication, cost, and care outcomes.
There are many EVV solutions available in the market, each with varying levels of functionality. To make a well-informed decision on EVV, it’s helpful to first understand the options out there, so agencies can make the decision that’s right for their business.
Comparing the Different Types of Electronic Visit Verification Solutions
At its core, EVV is designed to prove that care was delivered in the home of a client. EVV typically uses one of five technologies to do this:
- Electronic random number match devices
- Biometric recognition
- Onsite dedicated tablets
- Mobile devices
These solutions are not all equal, and each has its unique advantages and disadvantages.
For example, while electronic random number match devices and biometric recognition can securely verify that a caregiver was on site, they have several limitations, including:
- Unable to verify the services provided during a visit
- Unable to track individual caregiver locations in the field
- Lack of data that can be used to optimize care delivery and care coordination
Whether onsite dedicated tablets are better at addressing the challenges above depends largely on the type of software installed on them. Additionally, they bring an increased risk of misplacement or theft, making these solutions less practical – and more costly – than they initially seem.
Ultimately, these disadvantages make these three solutions significantly less practical and costlier than they would appear. Agencies may instead prefer to focus on the two most widely implemented EVV solutions: telephony and mobile devices.
Telephony: The Low-Cost Solution
Telephony-based systems are commonly used in the home setting, primarily because they incur a minimal cost per visit and don’t require the agency to install or service any devices.
With this method, the caregiver uses a client’s landline phone to dial a toll-free number at the start of the visit and again upon completion of service delivery.
Historically, this has been an uncomplicated way to validate that a caregiver was at the client’s location. However, with the evolution of mobile phones, fewer homes still use landlines. Therefore, agencies must be ready with an alternate EVV method to verify visits with clients without landlines.
Telephony faces other limitations as well, including:
- Ease of circumvention (e.g., a client could make the initial call if a caregiver were running late)
- Lack of secure communication with care team members or the agency
- Unable to record travel expenses or use GPS services
Because telephony requires supplemental paper systems and incurs costs related to manual reviews – not to mention the potential need to pay for additional technology to cover visits to homes without land telephone lines – agencies may miss key opportunities to drive cost or productivity improvements to their care delivery.
Mobile Devices: Leveraging Modern Technology
The newest EVV option leverages mobile technology – specifically, smartphones and tablets. Most commonly, Mobile Visit Verification uses the GPS functionality of a smart phone or tablet to track the location of the caregiver. More complex EVV systems may also include the ability to schedule updates, document at the point of care, track mileage and travel costs, and allow caregivers and office staff to communicate in real time.
For even more power, Mobile Visit Verification solutions frequently combine mobile applications with back-office portals, providing additional functionalities such as:
- Real-time visit and patient-trend alerts, enabling office staff to respond to events in the field
- Real-time caregiver location tracking, enabling office staff to monitor the safety of their field staff
- Electronic storage of historical care data, ensuring the entire care team is informed of the client’s progress
- Advanced reporting and analysis capabilities, to build a foundation for ongoing optimization of care delivery management
These more comprehensive Mobile Visit Verification solutions go far beyond simple proof of visit. Instead, agencies willing to invest in a complete solution may find they are far better equipped to:
- Improve compliance via real-time proof of visits, care, and service plan delivery
- Reduce costs by more accurately tracking travel, automating workflows, and eliminating paperwork
- Facilitate communication between office and field staff, via secure messaging
- Improve quality of care by providing caregivers with complete information at the point-of-care
Making the Right EVV Choice for Your Home Care Agency
When selecting an EVV solution for your agency, ask yourself which functionalities would benefit your business, your staff, and your clients. Would a robust solution that goes beyond the minimum proof-of-visit requirement be an advantage?
Whatever EVV solution your agency chooses, it must help improve your bottom line by: documenting that a visit took place, ensuring that caregivers provided the expected services, allowing for timely and accurate documentation of the activities performed, and ensuring compliance with legislation and/or funders’ requirements.
The right EVV solution can provide caregivers with the critical information they need while helping your agency improve productivity, performance, and patient outcomes — all positively contributing to your overall success.
Home health and community care leaders rely on CellTrak’s Care Delivery Management solution to achieve objectives; optimize workflows; and improve results in terms of compliance, cost, care, and communication. Learn how you can improve health care and service delivery by contacting us today.