The electronic visit verification mandate requires home health and personal care providers to electronically track service visits that are funded under Medicaid. The purpose is to ensure that consumers are getting the care they deserve and Medicaid is being billed properly. EVV both improves quality of care and reduces Medicaid fraud.

The details of the mandate are covered under section 12006(a) of the 21 Century Cures Act. To get started, providers should first become familiar with the EVV model their state is using. The model will influence the EVV vendor you choose. For instance, some states have their own internal EVV system that they develop and manage and they may require providers to use this state-operated system. Other states have adopted an open system, otherwise known as the hybrid model, whereby the state contracts with at least one EVV vendor or operates its own EVV system while still allowing providers to choose their own system. 

Once you know your options, if you have a choice in EVV providers, it’s important to find one that’s right for you. Some EVV providers, like FOCOS Innovations, have developed software containing many value-added features that make it easier to use and provide more benefits to the agency using it. 

Whichever EVV system you choose, it must be able to track the following information with regard to visits conducted as part of personal care services or home health services: type of service performed, date of service, the name of individual receiving the service, location, name of person providing the service, and beginning/end times of service.

Some providers may view the new EVV rules as just another requirement that will make their lives more difficult. One the contrary — being able to electronically document personal care services holds many benefits for the provider. First, it can streamline processes and improve productivity. Filling out paperwork is time-consuming and tedious. Completing documentation using a computer — or better yet a mobile app — can save time at each visit. Not only that, by completing documentation at the point of care, records are more complete and there’s less chance for error. 

Besides helping you do more in less time, EVV software is good for your employees. With less paperwork to do and more time to focus on care, using an electronic system for visit verification can help make their job easier, and ultimately increase employee retention. For agencies, EVV is a tool that will help provide greater transparency and improve accountability of your caregivers.

Traditional care plans often focus on the medical needs of the patient — things like medication, and follow up doctor’s visits, without considering the consumer’s personal goals or desired health outcome. A person-centered care plan, however, takes into account the things that matter most to a person, which oftentimes have more to do with independence and being able to do the things they like to do rather than focusing on symptom management.

An increasing demand on healthcare can have a negative effect on the quality of care received. Caregivers have a lot of responsibilities and are often overworked. This can cause them to lose sight of their purpose and become more task-focused instead of person-focused.

Treating the person as a whole instead of just addressing a condition or symptoms is the right thing to do, both for the consumer and the healthcare industry as a whole. Delivering person-centered care respects people’s needs and wants and allows them to feel empowered to take part in the decisions that are central to achieving better health outcomes.

Person-centered planning can be achieved by taking the time to listen and document what is important to a person and then finding ways to help support them in those activities. Person-centered planning also takes into account a person’s preference for how they receive services and it can be as simple as planning service tasks to occur at times that are convenient for them. 

Providers can better manage client preferences, health information, and track service visit information by using a service scheduling and EVV software like the one from FOCOS Innovations. It has everything you need in one place for easy access to information. Maintain caregiver and client notes, document personal preferences, and allow everyone in the circle of support easy access to the same information through a secure, HIPAA-compliant interface.

HIPAA refers to the Health Insurance Portability and Accountability Act and it outlines a set of standards created to safeguard the privacy and security of protected health information or PHI. Protected health information is anything that can be used to identify a consumer such as name, address, email, or telephone number. 

HIPAA was adopted in 1996, but over the years it has gone through several modifications. Today, there are now four parts, or four HIPAA rules, including the HIPAA privacy rule, HIPAA security rule, HIPAA breach notification rule, and the HIPAA omnibus rule. These four rules form the foundations of HIPAA compliance. For more information on each of these rules, click on the links above to be taken to the HHS website.

According to 25 CFR 160.103, covered entities and business associates must comply with HIPAA rules. Under the law, covered entities are defined as health care providers such as doctors, dentists, nursing homes, and pharmacists. Health insurance companies, government programs such as Medicaid and Medicare, and HMOs are also considered covered entities. Finally, health care clearinghouses such as billing services and repricing companies are also considered covered entities. 

Business associates are also required to comply with HIPAA law. These associates are not members of a covered entity, but perform certain functions on their behalf. For instance, third-party claims processing, legal services, or financial services that have access to consumers’ protected health information are also required to comply.

There are several ways to ensure you’re protecting the privacy and rights of consumers. First, one of the most important things you can do is provide thorough and ongoing training to your staff. Caregivers, support staff, and anyone who comes into contact with personal medical records must learn the importance of protecting sensitive information and understand how they can play a role. 

One of the biggest risks to consumer privacy is through access to electronic records.  One of the easiest ways to prevent this from happening is through the use of HIPAA-compliant software. Under the HIPAA rule, software must have administrative safeguards such as log in monitoring and data backup as well as access authorization controls.  

Besides making sure you have software with built-in security measures, you should also verify that you’re using anti-virus software and a firewall to help protect your data from outside threats. Sometimes the smallest things can make the biggest impact — just making sure to use strong passwords (and change them often) will go a long way in enhancing security.