Addressing Medicaid Budget Short Falls

Washington, DC (PRWEB) March 22, 2012

It is no secret that current Medicaid budgets are severely strained, and the industry is challenged with improving program integrity and reducing costs while maintaining access to these vital services. One such area which is growing significantly and also challenged with fraud and abuse concerns, is home-based healthcare services. In this care model, healthcare professionals such as nurses, aides and personal care attendants deliver services in the recipient?s home. Nationally, over 12 million recipients received healthcare services in their homes last year delivered by over 33,000 home-based healthcare provider businesses.

Often times, documentation is completed manually, but there are numerous available Electronic Visit Verification systems (EVV) that can provide significant benefit to all stakeholders including the payer, healthcare provider and recipient. These systems electronically verify the time and location of services and facilitate electronic documentation needed to capture services that will also help providers move to EHR?s. Facilitating an effective policy to get the universe of available EVV systems in place for your healthcare providers is probably the most impactful strategy you can implement to improve program integrity while at the same time reducing costs and maintaining access.

The EVV (Electronic Visit Verification) Standards Workgroup has been created to help states develop a policy based on requiring providers to use systems that meet EVV standards. This policy approach enables providers to choose the EVV system which best meets their needs and provides assurances that the systems selected will provide visit verification, thereby employing strong technical controls to minimize fraud and abuse without the state having to incur the upfront cost and risk of selecting a single source EVV system that all providers are forced to change to.

Recently, some states have mistakenly rushed to mandating a ?one-size-fits-all? approach whereby the state is courted by an EVV vendor, issues an RFP, selects a single-source EVV system vendor, and mandating that all providers use that vendor. Unfortunately, this creates unnecessary costs and places the risk and onus of managing this system on the state, thus compounding their already strapped budget situations. Conversely, by setting EVV standards and letting the free market of available EVV systems create competitiveness and spur innovation, that state can enjoy higher provider adoption without unnecessary cost. Often times, single-source policy approaches that mandate a single EVV vendor are having a negative impact on the efficiencies and profitability of the home care and hospice providers in those jurisdictions that already have EVV-capable systems in place and are now being forced to manage multiple systems.

We invite you to hear from providers directly affected by EVV-related policy. Recently at the National HCap Convention in Washington, DC, several homecare and hospice provider executives were engaged in a panel discussion on the merits of EVV systems and the pitfalls associated with jurisdictions mandating a one size must fit all policy approaches. All of the panel participants endorsed a standards based approach that unleashes the benefits of the free market system while meeting the jurisdictions? need to curtail fraud and abuse while directly addressing budget short falls.

The EVV Workgroup strongly encourages you to visit http://evvworkgroup.org/ and click on ?EVV VIDEOS? menu to see excerpts from the HCAP session. Once you have viewed these compelling video segments, you are encouraged to spend time reviewing the other educational and informative materials at the EVV Workgroups site to help direct a standards-based approach to utilizing available EVV to improve program integrity.

Thank you for your leadership in maximizing our valuable healthcare dollars.

About the EVV Standards Workgroup:

The mission of EVV Standards Workgroup for Home Care is to provide education and raise awareness on the merits and advantages of available full-featured EVV solutions to stakeholders including payers, back-office software vendors, homecare and hospice providers, and home care recipients. On behalf of the industry Carewatch, CellTrak Technologies, Dial-n-Document and Sansio are founding members of the Electronic Visit Verification (EVV) workgroup. For more information please visit: http://www.evvworkgroup.org

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