Home Health Providers: How to Choose Your EVV Solutions

For home health providers, EVV compliance is required by January 1, 2023. How to comply is up to you. It’s time to talk about technology – In this post, we will share a few things to consider as you evaluate the best options for your agency to comply. EVV technology choice is important. It’s not simply about reviewing a checklist of features, but rather considering what path forward will best complement and strengthen your existing operational workflows.

Technology Options Simplified

Providers have two options with respect to technology that supports EVV compliance: implement either a payor-procured system or an alternate EVV solution. You may hear this second option referred to as “Alternate EVV” or “Third-party EVV.” Depending on the state you operate in, there are three potential compliance scenarios:

• Open state with optional EVV solution: Providers choose whether to use the state solution or an alternate solution to comply. State aggregator is used for oversight.
• Open state with no state-procured solution: Providers choose an EVV solution that can meet state requirements. State aggregator is used for oversight.
• Closed state: Mandates a state-procured EVV solution for all providers.

The vast majority of states, with only a handful of exceptions, operate an open EVV model, which means that each provider impacted by EVV can choose the technology solution that works best for them. State-procured solutions are paid for by the state and made available free of charge to providers for compliance. Alternate solutions are purchased directly by each agency provider.

Many might wonder, if given a free option and a paid option, why anyone would choose anything but “free!” The answer: it’s not always that simple. “Free” in terms of acquisition cost is not the same as “free” to your agency. So how should you weigh the decision for your specific situation?

Evaluate Both Direct and Indirect Costs of EVV

Certainly, the direct cost of purchasing an alternate EVV solution exceeds the cost of using a state solution. However, the costs which can often be hidden in any technology implementation are the indirect or “soft” costs, such as administrative hours, increased headcount, or slower claims reimbursement- just to name a few. If it takes you extra time to manage manual entry or increases your administrative burden, is that really a win for your agency? The cost to deploy an alternate system could easily offset the cost of implementing a more complex and inefficient workflow.

Consider the systems that you already have in place to manage scheduling, payroll, and billing. If you implement a state-procured solution that is disconnected from your back office, you will likely be compelled to manually enter information into one or the other to see the full picture and manage visit data effectively.

Consider the cost to train and maintain multiple systems for EVV compliance. If you bill to multiple states or payors with different requirements, each will offer their own free system to manage visits. This can quickly become complex for an agency with multiple service lines, and operations in multiple states. Not to mention the cost of training caregivers on multiple EVV applications, and then asking them to choose the application based on which client they visit that day.

Agency Characteristics Will Affect Your Decision

State and payor-procured systems can work for basic compliance, especially for providers who may be delivering a narrow set of EVV mandated services in a simple compliance environment where they bill to a single payor or operate only in one state. An agency that only has a small number of visits affected by the EVV mandate could find that the free system does the job and the small number of transactions don’t drive a heavy administrative workload. Or, if your agency has only a few caregivers delivering impacted services, it might be that having that group following a separate workflow is manageable.

In my experience, agencies with a more complex compliance environment will benefit from considering an Alternate EVV solution which of course offers EVV compliance, but also minimizes operational impact and provides benefits beyond compliance. For providers who face compliance complexity, it’s good to employ one system that meets the requirements in many different scenarios - such as operating in multiple states, with multiple payors, or both mandated and non-mandated lines of service.

If you are an agency that must meet a more complex set of requirements, what do you need to think about?   One key consideration is whether the EVV solution can work with your existing Electronic Medical Record (EMR) systems already in place.

Assess the Impact of Integrated vs Non-Integrated Systems

Let’s dig into integration with existing systems and talk about how it can affect your agency. We have seen that the main technology driver of back office workflow challenges is lack of integration with existing systems. Payor-procured technology is non-integrated, which means that the system doesn’t easily exchange information with your existing payroll, scheduling, or billing systems. The implication is that your back-office team might need to develop a new way of working. This could mean a new workflow for scheduling, or a unique and separate workflow for visits depending on whether they are EVV mandated or non-mandated. It could also cause a different workflow depending on payor. You can see the potential need for manual intervention with multiple non-standard processes.

On the contrary, implementing a solution that integrates with systems already deployed at your agency means minimal changes to existing scheduling, billing and payroll processes. This choice enables providers to focus on straightforward compliance – collecting the correct visit information and relaying that to the provider – without trying to completely retool all existing processes. In this manner, change can be gradual and much easier to digest.

Three Best Practices for Smooth EVV Implementation:

For agencies with an established operational workflow, a non-integrated approach with many disconnected systems causes challenges. I’ve been working with numerous providers in many states over the last several years. Many had implemented EVV prior to the mandate and are still progressing towards streamlined compliance. I’ve witnessed the benefits and pitfalls of different approaches to compliance, and want to share a few best practices that I’ve learned along the way

• Implement One System for All Visits

First, to capture EVV visit information in the field- use one system for all visits, regardless of payor, regardless of whether it’s an EVV-mandated visit. This approach simplifies the workflow for caregivers, reduces the need for extra training, and allows you to realize the benefits of EVV across your operation.

• Prioritize An Integrated Approach

Second, prioritize interoperability. Think about the systems you already have in place, and the workflow you have already established, and choose an EVV solution that fits in well with your current workflow for scheduling, billing, and payroll.

• Simplify Agency Operations

Finally, consider both direct and indirect costs of your EVV solution. Integrated EVV can help reduce administrative work by making caregiver documentation easy and by minimizing manual entry and by-hand reconciliation for back office employees.

As you evaluate your options for EVV compliance, remember that “free” isn’t always free. Implementing a system that has zero direct cost doesn’t necessarily translate into a reduced cost of implementation overall. You don’t need to scrap your existing workflows and start over. Most agencies want to comply with minimal disruption and use EVV as an opportunity to realize some operational benefits as well. So, weigh the considerations above and focus on those few key best practices, and you will be well on your way to finding the best-fit technology

CellTrak has helped countless personal care and home health providers simplify EVV compliance. Our team is available as your resource and we are happy to share our expertise. Contact us for guidance as you work towards EVV compliance.