The delivery of personal care services (PCS) has undergone a significant transformation in recent years, driven in part by the requirements of the 21st Century Cures Act. This mandate introduced Electronic Visit Verification (EVV) for Medicaid-funded PCS, promoting accountability and compliance with state and federal regulations while enhancing service delivery. As EVV becomes more engrained in the PCS landscape, its role continues to expand to offer operational and workforce advantages.
Why EVV Matters in PCS
EVV systems are essential for verifying that care visits meet Medicaid requirements, tracking the who, what, when and where of service delivery. Initially driven by federal compliance mandates, providers have increasingly embraced EVV for its broader benefits. These include improved scheduling, reduced administrative burdens and enhanced caregiver workflows. For PCS providers, this technology supports timely reimbursements, offers transparency in care delivery and helps mitigate fraud and abuse by providing accurate, verifiable data on care visits.
Fraud and abuse, such as billing for unperformed services or inflating service hours, have historically posed significant risks in PCS. EVV helps prevent these risks by creating an auditable digital record of service delivery. This level of accountability not only ensures compliance but also builds trust among payers, providers and the members they serve.
Challenges in Implementing EVV Solutions
Despite the benefits, EVV systems have often struggled to meet the unique needs of PCS environments:
- Rigid Scheduling: Fixed visit schedules can limit flexibility for caregivers managing dynamic care plans.
- Device Management: Systems requiring specific hardware add logistical complexity and costs.
- Limited Task Tracking: Systems may not capture all activities, such as non-billable training or management tasks, reducing overall operational visibility.
Advanced EVV Solutions at Netsmart
Recognizing these challenges, Netsmart offers an EVV solution tailored to the unique demands of PCS. Part of the CareFabric® platform, it integrates seamlessly into provider workflows and offers several key features:
- Mobile Accessibility: Allows caregivers to document visits and tasks through a mobile app, reducing the need for additional devices.
- Flexible Scheduling and Task Tracking: Supports near real-time adjustments and enables tracking of both billable and non-billable activities, such as training or administrative duties.
- Scalability Across Services: Providers managing both PCS and other services like home health or hospice can standardize workflows, streamlining operations and enhancing staff retention
The Broader Potential of EVV
While EVV is currently mandated for PCS, its benefits are sparking interest across other care domains. Providers are increasingly adopting EVV voluntarily to improve task tracking, workforce management and operational efficiency. The ability to track services in both facility and home settings helps maintain care that is comprehensive and compliant. For patients, EVV ensures that care is delivered as scheduled, aiming to reduce the risk of missed or delayed services. It also promotes transparency, enabling patients and their families to verify the quality and consistency of the care provided.
A Look Ahead
As workforce shortages challenge the PCS industry, the Netsmart EVV solution can help providers simplify operations and improve caregiver satisfaction. By enabling caregivers to manage visits through mobile apps, providers can focus more on delivering quality care and less on administrative complexities.
For PCS providers, the adoption of a robust EVV system is no longer just about compliance—it's about building a sustainable, efficient and caregiver-friendly model for the future while protecting the integrity of care delivery.