What You Need to Know About Electronic Visit …...What You Need to Know About Electronic Visit Verification April 12, 2017 Darby Anderson serves as Executive Vice President & Chief

What You Need to Know About

Electronic Visit Verification

April 12, 2017

Darby Anderson serves as Executive Vice President &

Chief Development Officer, Addus HomeCare Corporation.

Darby is in his twentieth year operating and developing

business for Addus, today in excess of $400M in annual

revenue. He has led or otherwise been involved in over 30

transactions including an initial public offering.

Darby has also been appointed or elected to board and

advisory committee positions in multiple states through

state administrations or trade associations, including

currently serving as Vice Chairman of the Medicaid

Partnership for Home Based Care.

Addus HomeCare

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Photot

• Why the 21st Century Cures Act matters for home care

• Electronic Visit Verification (EVV) requirements

• Multi-state provider compliance challenges

• Significance of, and preference for, an EVV “Open”

standard

• How to influence an “Open” standard

• EVV options and pros and cons of each

• Why going beyond simple proof of visit can do more for

your agency

• Addendum includes links to additional sites

Agenda


• Addus is a provider of comprehensive personal care services and

other activities of daily living, provided in the home.

• At 12/31/2016, Addus provided personal care services to over

33,000 consumers through 111 locations across 24 states.

• Addus has utilized EVV since 2010 and currently has EVV deployed

with 70% of our caregivers across 13 states including (AZ, CA, GA,

IL, MI, MO, NC, NM, NY, PA, SC, TN & WA).

• We have developed a blended solution utilizing both GPS and IVR

technology that best fits the caregiver schedule and environment,

including urban and rural markets.

• Technology captures time in/out, caregiver mileage & travel time,

care plan task performance and change in condition reporting.

ELECTRONIC VISIT VERIFICATION (EVV) EXPERIENCE

Addus HomeCare


The 21st Century Cures Act is broad-based legislation that

affects the health care industry.

Within its 900+ pages, it touches many topics, including:

• Funding the fight against the opioid epidemic

• Supporting Vice President Joe Biden’s cancer moonshot

• Providing resources to expand precision medicine

• Requiring electronic visit verification (EVV)

• Reforms related to mental health

• Investing in brain research

THE ACT WAS SIGNED INTO LAW ON DECEMBER 13, 2016

What is the 21st Century Cures Act?


• The bill requires each state to institute EVV for Medicaid programs by January 1, 2019, or they will face reduced federal match.

• EVV can improve accountability and combat fraud by electronically verifying that a caregiver is physically present for a visit.

• Expands information captured efficiently in claims/billing submissions.

• For states moving to MLTSS, provides greater opportunity for enhanced care coordination and data sharing.

STATES WILL REQUIRE PROVIDERS TO COMPLY BY JANUARY 1, 2019

Why Does EVV Matter to States?


The requirement for the use of an electronic visit verification system under paragraph (1), a State shall consult with agencies and entities that provide personal care services, home health care services, or both under the State plan (or under a waiver of the plan) to ensure that such system

• Is minimally burdensome;

• Takes into account existing best practices and electronic visit verification systems in use in the State; and

• Is conducted in accordance with the requirements of HIPAA privacy and security law

• Consider a stakeholder process that includes input from beneficiaries, family caregivers, individuals who furnish personal care services or home health care services, and other stakeholders, as determined by the State in accordance with guidance from the Secretary; and

• Ensure that individuals who furnish personal care services, home health care services, or both under the State plan (or under a waiver of the plan) are provided the opportunity for training on the use of such system.

• Shall not apply in the case of a State that, as of the date of the enactment of this subsection, requires the use of any system for the electronic verification of visits conducted as part of both personal care services and home health care services, so long as the State continues to require the use of such system with respect to the electronic verification of such visits.

STATES SHALL CONSULT WITH AGENCIES

Requirements for EVV


With respect to any amount expended for personal care

services or home health care services requiring an in-home

visit by a provider that are provided under a State plan

under this title (or under a waiver of the plan) and furnished

in a calendar quarter beginning on or after January 1, 2019

(or, in the case of home health care services, on or after

January 1, 2023), unless a State requires the use of an

electronic visit verification system for such services

furnished in such quarter under the plan or such waiver, the

Federal medical assistance percentage shall be reduced.

FOR PERSONAL CARE AND HOME HEALTH UNDER MEDICAID

Section 12006. EVV System Required


The bill requires that the following data, electronically

verified, be submitted with every claim:

• The type of service performed

• The individual receiving the service

• The date of the service

• The location of the service delivery

• The individual providing the service

• The time the service begins and ends

What Data Will Need to Be Submitted?


An “open” standard means that providers have the freedom

to choose how to verify and submit the data.

Alternatively, a “closed” standard would mean that the state

would choose which method, or even which vendor, you

would have to use.

If I want to call you on the phone, it doesn’t matter which

device or telephone company you use. That’s an “open”

standard. A “closed” standard would require us both to use

the same carrier and, potentially, the same model phone.

AN “OPEN” STANDARD LETS YOU CHOOSE WHAT’S BEST FOR YOU

What is an “Open” EVV Standard?


An “open” standard gives you flexibility. It:

• Makes it possible for you choose the technology that you

want, to standardize the workflow and processes across

your business, and to reduce training needs.

• Eliminates the possibility of you going backwards in

terms of information and productivity if the state

mandates an inferior method.

• Reduces your risk of being “stuck” with outdated

technology as the market changes.

YOU CAN CHOOSE THE EVV OPTION(S) THAT BEST MEETS YOUR NEEDS

Why is an “Open” Standard a Good Thing?


Providers should take two kinds of action now:

1. Band together with other providers and lobby your state

for an “open” EVV standard.

2. Investigate the different types of EVV and determine

which is best for your agency.

LOBBY YOUR STATE AND INVESTIGATE EVV OPTIONS

What Should Providers Do Now?


EVV options range from simple proof-of-visit to the ability to collect

additional valuable data. But, the EVV decision isn’t stand-alone… you

adopt EVV in a broader context.

For example, EVV as part of a complete care delivery management

solution can also provide operational efficiencies, enable improved care

quality, and deliver better information to your management team.

The main EVV options are:

• Telephony/IVR (via a landline phone)

• A device that is placed in the home

• Mobile apps

IT’S IMPORTANT TO INVESTIGATE EACH & TO THINK BEYOND EVV

What Are the Main Options for EVV?


Pros

• Minimal training... everyone knows how to use a phone• The low-cost option

Cons

• How will you cover clients with no landlines?• 61% of adults over 35 do not have a landline

• People with lower incomes are even less likely to have one

• Risk of fraud: Patients/clients can dial in for caregivers if pass codes are shared without additional safeguards

• Lacks a way to get information to caregivers, limited point-of-care “documentation”, doesn’t cover activities other than visits

• Using client’s phone

ALSO KNOWN AS INTERACTIVE VOICE RESPONSE (IVR)

What Are the Pros & Cons of…

Telephony?


Pros

• One device can be used by many caregivers

• As with paper, the record remains in the home

• May be used for communication with patient/client

Cons

• Need to place and maintain the device in home

• Risk of device not working (device itself or Wi-Fi), or of it being misplaced, lost, or stolen

• Similar risk of shared password fraud as telephony

• All full and part-time users must be trained on the device

• Risk of contamination from handling by many people

• Direct Care Team data collection is limited to in-home activity, e.g., doesn’t cover mileage, caregiver activities other than visits, etc.

INTERESTING, BUT HOW PRACTICAL, REALLY?

What Are the Pros & Cons of….

In-Home Devices?


Pros

• GPS time- and date-stamping on a device the caregiver brings to the visit

• Native mobile apps work in and out of cellular coverage

• Secure two-way communication with caregivers at any time: client info, schedules, care plans, notifications, messages, etc.

• Point-of-care documentation, tracking all activities, accurately calculating mileage, etc.

• Affordable solution for all types of caregivers

• May be part of a Care Delivery Management solution

Cons

• If not a native app, there may be connectivity and security issues

• Training required (more and more people are familiar with mobile)

• Requires a data plan or wifi

THERE ARE DIFFERENCES WHEN VENDORS SAY “MOBILE”

What Are the Pros & Cons of…

Mobile Apps


What Does Your Agency Need to Succeed?

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“Care Delivery Management”

“Basic EVV”

• Business Management

• Direct Care Team Management &

Optimization

• Day-to-Day Operations Management

• Tools & Workflow for In-Home Care

• GPS & Real-Time Location Services

• Designed for All Types of Caregivers

• True Mobile App

INC

RE

AS

ING

V

AL

UE

Complete Care Delivery Management Solution

CARE TEAM PORTAL

SERVICES & SUPPORT

MOBILE APPS• EVV via GPS• Document care delivery• Complete assessments• Communicate securely• Track mileage accurately• And more

IVRElectronically verify visits via land lines

Improve collaboration and care by giving the extended care team visibility into the care record

OPERATIONS TEAM PORTALDo real-time care coordination and risk management, field force management,and care delivery optimization

HEALTHLINKTwo-way integration with EMRs for patient information, schedules, care plans, and visit results

Achieve ongoing success with help from home care and mobile experts

IMPROVE CARE, COMMUNICATION AND COMPLIANCE WHILE REDUCING COST

2017 CellTrak Technologies, Inc.

Connects the Field & the OfficeNATIVE MOBILE APPS ENABLE EVV & DOCUMENTATION IN AND OUT OF CELLULAR COVERAGE

CLIENT INFORMATION

UP-TO-DATE SCHEDULES

CARE &/OR SERVICE PLANS

FORMS & ASSESSMENTS

CARE TEAM INFORMATION

ON-SCREEN NOTIFICATIONS & REAL-TIME CONFIGURABLE ALERTS

SECURE MESSAGES & BROADCAST MESSAGES

GPS-BASEDEVV

REAL-TIME ALERTS(OPERATIONAL & CLINICAL)

GPS-BASED TIME & MILEAGE

P-O-C DOCUMENTATION

REAL-TIME LOCATION INFO

SECURE MESSAGES & PHOTOS

CLIENT SIGNATURES


• Receive EVV, and real-time operational and clinical alerts from the POC

• Manage by exception and streamline paper – “clean” visits flow through automatically

• Drill into, report on, and analyze care delivery performance to improve compliance & productivity

• Respond to audits

• Perform IT tasks

Efficient CoordinationOPS TEAM PORTAL PROVIDES VISIBILITY & BUSINESS VALUE

Operations Team Portal is the key to

efficient care delivery. Care Coordinators

use it to monitor, actively manage, and

optimize care and service delivery.


Coordinate Care Across the Entire Team

CARE TEAM PORTAL PROVIDES REAL-TIME CLINICAL AND CARE INFORMATION

2017 CellTrak Technologies, Inc. CONFIDENTIAL

• Give health care team

members access to

client demographic,

clinical, and visit

information in one

secure, central location

• Increase customer

satisfaction with

permission based

access extended to

patients and their

families

Care Team Portal is essential to seamless care

coordination. Care coordinators, professionals, and

with permission, families, can view alerts, vitals,

assessments, trends, and services delivered.

View information from the point-of-care across all disciplines

2016 CellTrak Technologies, Inc. CONFIDENTIAL 23

Home and community care organizations, and payers,

improve health care and service delivery with

CellTrak’s Care Delivery Management solution

CellTrak At-a-GlanceTHE INDUSTRY LEADER IN CARE DELIVERY MANAGEMENT


• 21st Century Cures Act Bill

• Directory of State Associations

• State Medicaid Directors

• CellTrak Information

INVESTIGATE ~ LOBBY ~ CHOOSE THE BEST EVV OPTION

Want More Information?


https://www.congress.gov/bill/114th-congress/house-bill/6

http://www.nahc.org/about/membership-directory/

http://medicaiddirectors.org/about/medicaid-directors

http://www.celltrak.com/

For more information

www.celltrak.com


Darby [email protected]

Lynn [email protected]

What You Need to Know About Electronic Visit …...What You Need to Know About Electronic Visit Verification April 12, 2017 Darby Anderson serves as Executive Vice President & Chief

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