Sandata CEO, Tom Underwood, interviews with Tim Rowan on the four models that states might use to implement Electronic Visit Verification, in order to comply with the 21st Century CURES Act.
According to Sandata CEO Tom Underwood, there are four models that states might use to implement Electronic Visit Verification, which every state must do by January, 2019 to comply with the 21st Century CURES Act. Three of them lead to failure. We sat down with Underwood after his standing-room-only presentation for the Home Care Association of Florida last month.
The CEO defined EVV as “a modular technology solution that provides transparency into home-based care delivery, supporting provider network optimization while improving the member’s quality of care.” Typical EVV systems include a scheduling module and a visit verification module, usually using a mobile phone or the patient’s phone, though a fixed EVV device is another option.
In December 2016, President Obama signed into law a bill mandating EVV implementation in home care but giving each state leeway in how to comply. Underwood identified four models that have emerged so far among the 18 states that mandated EVV before the CURES law required it.
- Provider Choice Model: (used by three states) In provider choice, the state does not become involved in each provider’s vendor selection.
- MCO Choice Model: (used by three states)In this model, the state allows each Managed Care Organization to decide which vendor it will accept.
- State Choice Model: (used by 10 states)The state Medicaid authority selects one or two approved vendors.
- Open Vendor Model: (used by one state with another in planning stages)This is a hybrid solution. The state selects a single vendor while allowing providers and MCOs to continue using their existing EVV systems.