Leveraging EVV Solutions to Align with a New Era of Healthcare

The Top 3 Reasons You Need EVV Development Support Today

To understand why it’s time to completely rethink your approach to electronic visit verification (EVV) solutions, you have to understand that home health is going through a period of serious change.

Home health care is positioned to address some of healthcare’s most pressing questions. Not only is it the fastest-growing section in the healthcare economy, but an aging population and the “silver tsunami” mean that more seniors will be seeking care at home. The COVID-19 pandemic has accelerated innovation in technology and reimbursement of home health services, catapulting care models like the “hospital-at-home” into new spaces and pushing federal reimbursement standards. Home health spending is expected to outpace all other care categories, reaching $186.8 billion by 2027.

What does this mean for an organization like yours that’s considering electronic visit verification solution development? It means you’re sitting on an opportunity — an opportunity to leverage EVV solutions to align with a new era of healthcare. Companies that step into EVV without experience risk wasting time, resources, and rising opportunity costs. Here are three reasons why. 

#1 The EVV Environment Is Complex and It’s Changing … Fast

If you only walk away with one thing from this article, this is it — the EVV environment is in a state of flux that’s so serious, it’s almost impossible to navigate without specialized support. Here’s what we mean. 

The 21st Century Cures Act set new mandates for individual states to create EVV policies around Medicaid funding. Centers for Medicare & Medicaid Services (CMS) has issued a final rule, updating the Medicare Home Health Prospective Payment System (HH PPS). This rule increases payments to home health agencies and also finalizes regulatory changes around telecommunications technologies, among other updates. 

One challenge for developers like you is that the regulations around EVV vary by state and deadlines differ depending on the program, putting you at risk for compliance issues and avoidable mistakes in product development and marketing. States have multiple EVV models to choose from (more on that in a bit), further complicating the waters you’re stepping into. 

Where Vicert Comes In

Acquiring the knowledge to navigate these nuances and keep up with them as they develop will require most organizations to launch a detailed talent search — one that could take extensive time and internal resources, and even then, retention isn’t guaranteed. 

A partnership with Vicert comes with this expertise already built in because we staff professionals who understand home health and EVV and who dedicate their time to getting ahead of regulatory and technological changes. 

#2 The EVV Models Matter 

Let’s talk a little bit about those EVV models. Understanding these models and how your potential clients are using them will be critical to your development choices. There are five basic EVV models states choose from. 

  1. Open Vendor: In this model, states select an EVV vendor and data aggregator. Providers are free to use state-sponsored vendors at no charge or they can pay and work with a separate EVV vendor. Alternative EVV solutions will usually need to integrate with the state’s data aggregator.  
  2. State-Mandated External Vendor: States that choose this model require that their providers use the state-sponsored, state-funded vendor.
  3. State-Mandated In-house System: In this model, states are building and managing their own EVV system and requiring that their providers use that system. 
  4. Provider Choice: If a state chooses this model, its providers are free to select vendors and cover the costs. In some cases states will raise reimbursement rates to offset the costs to agencies. 
  5. Managed Care Organization (MCO) Choice: In this model, the MCO selects the vendor and handles the costs. States often offer support.

Most states are working with a sponsored vendor, but as you can see, a state’s model will have a significant impact on how you shape your marketing and development efforts. Keep in mind, though, that the models are just the beginning. The deadline for Medicaid personal care services was initially set for January 1, 2020, with Medicaid home health care services set for January 1, 2023. Some states that didn’t make the 2020 deadline are still working on “good faith effort” exemptions. It will be important to keep up with state-by-state tracking of deadlines and models

Where Vicert Comes In

As you build out a state-specific product development strategy, you don’t want to waste time. For example, do you want to focus on meeting the needs of providers in states with an open vendor model, making sure your solution integrates with the state data aggregator, or do you want to build to possibly compete for state-sponsored status? We can help support a faster path to a comprehensive and detailed development strategy that tightly aligns with your national marketing efforts. 

#3 Implementation Considerations Are More Than Most People Realize

Let’s dig a bit into the reality of EVV implementation. This is a highly involved process, which is why we work with five core considerations during the implementation process. 

  • Software Flexibility and Configurability 

However you build your system it has to be flexible and configurable enough to keep pace with tech advancements. This happens best when existing infrastructure is properly leveraged and evaluated in the context of a fast-changing market. 

  • MMIS Interface for Seamless Claim Management

To provide a solution that supports interoperability and works across the entire care continuum, you’ll need a flexible and modular EVV solution. This solution has to accommodate the exchange of information to and from the Medicaid Management Information System (MMIS) and other applications. 

  • Robust Training and Outreach Support 

Your EVV solution won’t reach its full potential unless all stakeholders are on board and informed. This means that all levels of your organizations need to understand and even embrace the benefits of your EVV offering — for both you and the healthcare professionals it supports. 

  • Federal and Security Requirements Compliance

Healthcare continues to face extraordinary security risks, meaning that security matters in solution design. Your solutions need to comply not only with federal regulations like HIPAA and HITRUST but also with state-level and organizational initiatives that often go above and beyond traditional requirements. 

  • Project Management Expertise to Accelerate Implementation

An EVV implementation can fall apart without a clear understanding of user needs and how to execute on a detailed plan in a timely manner. Project management can make or break the success of any EVV program. 

Where Vicert Comes In

These considerations are central to our work in development support and are one reason we’re able to speed your time to market. From discovery sessions to analysis and consulting, we help you build a team, put together the process and tools you’ll need, and then get started on continuous value refinement that lasts the life of the project, no matter how long or short. 

 

We’ve perfected this process by developing over 300 health tech solutions. Through the utilization of the latest digital health technologies, we have been able to deliver solutions from inception to production while standing beside companies throughout their journey.

The best way to get started? Learn more about how we engage with healthcare developers like you, but first, book a call with us.

Author: Dev Team
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