EVV Upside: New Tech Rules Can Foster Efficiency, Value-Based Partnerships

Amid a rapidly changing business and regulatory landscape, home-based care providers can easily overlook the upcoming implementation of electronic visit verification (EVV) — but these new technology requirements are a revolutionary step toward interoperability and efficiency.

Providers can leverage EVV to win value-based partnerships and streamline workflows, even as they reel from the impact of the Patient-Driven Groupings Model (PDGM), Review Choice Demonstration (RCD), and the various wage laws and scheduling provisions that are popping up nationwide.

“Start small, make sure you’re compliant, align with a good technology partner and then grow from there is probably my single piece of advice, especially for those who are overwhelmed about the future,” Matt Fairhurst, CEO deskless workforce management platform Skedulo, told Home Health Care News.


While it’s not an EVV system, Skedulo offers healthcare scheduling solutions designed to help home health organizations prepare for coming changes.

EVV was born out of the 21st Century Cures Act, which became law in 2016. It requires Medicaid-reimbursed home-based care providers to have caregivers and aides electronically record six data points while in the field caring for patients.

Those data points include the date, time, location and type of service, in addition to receivers and providers of the care. The goal is to cut down on fraud and abuse.


Medicaid-reimbursed personal care agencies are required to be in compliance by Jan. 1, 2020, while Medicaid-reimbursed home health agencies have until Jan. 1, 2023. While the personal care deadline was postponed once, nationwide future delays are unlikely.

For the most part, Medicaid-reimbursed agencies seem to be on track to meet the deadline, according to Darby Anderson, chief development officer at Addus HomeCare Corporation (Nasdaq: ADUS), who is also on the executive committee for the Partnership for Medicaid Home-based Care (PMHC).

“A lot of providers — particularly larger providers — are further along,” Anderson told Home Health Care News. “They’re already using some form of EVV in certain states that have mandated it, or they certainly have taken the steps to understand the technology and are in pretty good shape in terms of using EVV at the point-of-care.”

Addus HomeCare is one of the largest Medicaid home care providers in the country, with more than 90% of the Frisco, Texas-based company’s revenues coming from personal care services. Meanwhile, PMHC is a group of home care agencies, associations, managed care organizations (MCOs) and other groups working together to improve home- and community-based services.

While large providers are ahead of the curve, states and smaller agencies can be a different story, Anderson said.

The 21st Century Cures Act directed states to outline EVV requirements for Medicaid-funded personal care services. However, some states are having trouble making it happen.

“Where some states are struggling is having the personnel to understand the technology and the requirements of the technology when they’re looking at systems,” Anderson said. “I think they are needing a bit more time to understand how the provider utilizing its own system will interface with systems that aggregate EVV data from different providers using different technology.”

Already, six states have been granted good faith exemptions, meaning they will not be subject to the Jan. 1, 2020 implementation date. Another 10 have exemption requests pending.

Meanwhile, some small agencies are pushing back on the mandate for fear that high price tags associated with EVV technology could hurt their business. However, many of those fears are misplaced, according to Andrew Kaboff, chief revenue officer and founder of CellTrak Technologies, a Chicago-based care delivery management technology company that provides EVV solutions, in addition to other offerings.

“For smaller providers, the perception is that EVV is a burden,” Kaboff told HHCN. “But the reality is that they need to look at is as an opportunity to move forward with managing a decentralized careforce.”

Instead of burdening agencies, EVV can help them operate more efficiently, especially because most EVV companies provide additional services, such as communicating schedules, care plans and changes in conditions, Kaboff said.

That’s especially useful for smaller providers who still rely on paper documentation, Anderson said.

“Take a look at what efficiencies you can gain through an electronic system,” he said. “You’re spending a lot of time, energy and personnel costs managing paper. Are you able to reduce administrative costs and improve quality and services with EVV? If you really took a look at the cost of paper processing to the actual costs of these systems, you’d find that they’re not that costly.”

Finally, EVV can help you win managed care relationships, Kaboff believes.

“Managed care is looking not only for EVV ultimately, but they’re going to be looking for ways for you to communicate change of conditions, so look at this as an opportunity,” he said.

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