The healthcare industry has undergone significant transformations in recent years, in no small part due to both advancements in technology and the extraordinary circumstances of COVID, which heralded major changes to the way basic healthcare services are delivered. One such transformation involves the use of Electronic Visit Verification (EVV). The use of EVV, and the landscape of softwares that provide the service, first became popular in 2016 and has since grown exponentially, particularly in response to the COVID pandemic.

Understanding Electronic Visit Verification (EVV)

Electronic Visit Verification software is a technology solution designed to verify that home healthcare visits have occurred as scheduled. This verification process typically involves recording the time, date, location, and type of service provided. EVV protocols and software systems are employed to ensure that healthcare providers deliver services as planned, improving accountability, reducing fraud, and enhancing the overall quality of care.

The implementation of EVV was spurred by the 21st Century Cures Act, passed by Congress in 2016. The legislation mandated that states implement EVV for Medicaid-funded personal care services (PCS) and home health care services (HHCS) to combat fraud and abuse within the system. As a result, EVV has become a regulatory requirement, compelling healthcare providers to adopt and integrate electronic visit verification software into their operations.

The Benefits of Electronic Visit Verification Software

One of the primary benefits of EVV software is its ability to enhance transparency and accountability in home healthcare. By providing accurate and real-time data on service delivery, EVV ensures that patients receive the care they are entitled to while enabling healthcare providers to maintain compliance with federal and state regulations.

1. Fraud Prevention: Fraudulent billing practices, such as billing for services not rendered or inflating service hours, have been longstanding issues in Medicaid-funded home care. EVV software helps mitigate these risks by providing concrete evidence of service delivery, thereby protecting both the patient and the payer.
2. Improved Care Quality: EVV systems contribute to improving the quality of care by ensuring that caregivers are present for the entire duration of the scheduled visit. This verification helps in monitoring and addressing any gaps in care, helping to enhance patient outcomes.
3. Operational Efficiency: For healthcare providers, EVV software streamlines administrative processes by automating timekeeping and billing functions. This automation reduces paperwork, minimizes errors, and accelerates reimbursement processes, ultimately leading to more efficient administrative operations.

The Current Landscape of EVV Software

The EVV market has seen a surge in innovation, with various vendors offering solutions tailored to the needs of different healthcare providers. The largest software provider in this space, which has made inroads as the most widely selected vendor by State governments that mandate EVV, is Sandata. In fact, Sandata’s mandated use is so widespread that many other EVV softwares, including PaSeva, have made sure to store or process EVV data in a format that is compatible with Sandata’s systems, such that the transfer of data is as smooth as possible for home care agencies.

Beyond Sandata, electronic visit verification software solutions range from basic, more affordable mobile apps that caregivers can use to check in and out of visits, to more sophisticated but significantly pricier systems that integrate with other healthcare management platforms.

1. Diverse Solutions: EVV software solutions vary significantly in terms of functionality and complexity. Some systems offer GPS tracking, voice biometrics, and facial recognition to ensure the accuracy of visit verification. Others may integrate with electronic health records (EHR) systems, providing a comprehensive view of patient care. The more features and functionalities the software solution offers, the more expensive it tends to be, which can be a challenge for small- to mid-sized healthcare organizations.
2. Challenges and Adoption: Despite the clear benefits, the adoption of electronic visit verification software has not been without challenges. One major issue resides with the resistance from caregivers who may find the technology intrusive or difficult to use. Additionally, for more complex systems with many features and integrations, the initial implementation can be costly and time-consuming, requiring significant training and adjustments to existing workflows.
3. Compliance and Regulations: As states continue to roll out their own unique EVV mandates, some of which with pre-approved or required vendors, there is an ongoing need for software that complies with varying state regulations. This variability in requirements has led to the development of customizable EVV solutions that can be tailored to meet specific state guidelines. While customization can vastly improve operational efficiency, it is often prohibitively expensive to mid-market home health agencies and can pose challenges to agencies with multi-state operations.
4. Integration with Other Systems: Another critical aspect of the current EVV landscape is the integration of EVV systems with other healthcare technologies. Seamless integration with EHRs, billing systems, and care management platforms is becoming increasingly important for providers looking to create a unified and efficient operational environment, but is not without its own challenges. Highly integrative platforms can be cost-prohibitive, and many times offer either 1) more features than are actually necessary, or 2) features for which a given agency already has a functioning solution in place, creating redundancy and inefficiency.

The Future of EVV Software

As the healthcare industry continues to evolve, so too will electronic visit verification software. As with many industries, emerging artificial intelligence (AI) and machine learning (ML) technologies are expected to play a significant role in the future of EVV, offering predictive analytics that can identify patterns and anomalies in care delivery. Additionally, the growing emphasis on patient-centered care will likely drive the development of EVV systems that are more intuitive and user-friendly for both caregivers and patients.

Moreover, as regulatory requirements become more stringent, the demand for robust and adaptable EVV solutions will continue to rise. Providers who stay ahead of these trends by ensuring adoption of efficient EVV technologies will be better positioned to deliver high-quality care while maintaining compliance with ever-evolving regulations.

Conclusion

Electronic Visit Verification software is an essential component of the modern home healthcare landscape. It addresses critical issues such as fraud prevention, compliance, and care quality, all while improving operational efficiency for providers. As the industry progresses, the ongoing development and refinement of EVV solutions will be crucial in meeting the demands of a rapidly changing home health care environment. For healthcare providers, staying informed and proactive in adopting the latest EVV technologies is key to ensuring success in the years to come.