In December of 2016, congress passed the 21st Century Cures Act which requires the electronic verification of Medicaid-funded services for in-home visits by a provider. Over the last few years, states have been planning for how they will implement this new rule which is now a requirement for personal care services beginning January 1, 2021. Verification of home healthcare services has an implementation deadline of January 1, 2023. 

When looking to implement a program that meets EVV requirements, the first step is to determine which model your state is using. That’s why in today’s blog, the team at FOCOS Innovations would like to review the five EVV models so you can better understand the choices that are available to you and give you tips on how to choose the right software for you. Keep reading to learn more and then contact FOCOS Innovations to learn more about our EVV software. 

EVV Models

There are five primary EVV system models. They differ with regard to state involvement in vendor selection and EVV management. According to section 12006 of the Cures Act, states have the flexibility to choose the type of EVV model they wish to implement as long as it meets the legal requirements, including compliance with HIPAA. The model which is selected must be able to provide electronic verification of six key elements including name of individual receiving the service, type of service performed, date of service, location of service, name of the service provider, and service beginning and ending times. 

Provider Choice Model

In this model, providers select their EVV vendor of choice and are responsible for the cost of implementation. They may or may not provide an approved list of EVV vendors, but they do set the requirements and standards for choosing one. Although this model may provide the most freedom for providers to choose their own EVV vendors, it can also make it more difficult for the state to receive and consolidate data from multiple EVV systems. 

Managed Care Plan Choice Model

This model is similar to the provider choice model, with the exception that the EVV vendor is being chosen by the managed care plan. This model may prove to be the most difficult to work with especially if states have multiple managed care plans. That means providers may have to train on and use more than one EVV system, adopt multiple forms of technology, and navigate several vendor helplines. To ensure that this type of model doesn’t negatively affect or hinder EVV implementation, states should take steps to avoid complications by outlining a common reporting framework to receive data.

State-Mandated In-House System

A state-mandated in-house model means the burden is on the state to develop, operate, and manage its own EVV system. The benefit to the state for choosing this model is that it allows for access and standardization of data without a need to aggregate data from multiple sources. However, ease of access comes at a price as the administrative burden on the state would be much greater. For providers and MCPs, having to use an EVV system that has been developed by the state can simplify EVV implementation, however, it can also mean that they are required to use a system that may have limited functionality and doesn’t really work for them. 

State-Mandated External Vendor

In this model, the state contracts with a single EVV vendor to implement a single EVV solution. 

The benefit to the state for choosing this model is that it still prevents the need to aggregate data from multiple sources while reducing the administrative burden required to develop their own EVV system. For providers and MCPs, having to use an EVV system that is chosen by the state may sound easier than finding one on their own, however, it can also mean that they are at the mercy of the state and required to use a system that has been predetermined for them, regardless of if it meets their needs. Providers and MCPs may find that the system they are required to use could lack the ease-of-use and functionality that would make their lives easier.  

Open Vendor Model

This model gives more choice to providers and MCPs in that it gives them the choice of using a state-contracted EVV vendor or they can choose to find their own. This is appealing to those providers and MCPs who already have an existing EVV system since it allows them to continue to use it. Although the state may face some challenges with aggregating data from multiple systems, it offers the most flexibility to the providers and MCPs.

Selecting an EVV Vendor

If your state is among those who give providers and MCPs the option to choose their own vendor, consider it an opportunity to invest in technology that will not only ensure compliance but will offer added functionality to help optimize your business and help you provide better quality of care. 

Most state-sponsored EVV systems are designed to meet the basic requirements but don’t offer much beyond that. If you’re looking for EVV software that can also help streamline operations, simplify reporting, and improve communication, you’ll want to consider the EVV software from FOCOS Innovations. To get a full understanding of all of its features and benefits, contact a member of our team and we would be happy to schedule a free demonstration and answer any questions you may have. 

FOCOS Innovations — The Best Choice For EVV Software

FOCOS Innovations is a leader in service management and EVV software. See what makes our software different from the others and why so many people have turned to us as their EVV vendor of choice. Call today to speak with one of our team members.