If all goes as planned with the 21st Century Cures Act, all Medicaid-reimbursed home care agencies across the country will be required to utilize Electronic Visit Verification (EVV) systems by January 1, 2019.
The purpose of this new mandate is to track and ensure that the visits home care agencies are reporting and billing for are actually taking place and that patients are receiving the care they need. As a result, EVV systems have been developed by vendors to track patient care and service delivery. This includes electronically recording the date and location of the provided service, the exact time of the start and end of care, the signature of the patient receiving care, and verification that the field-staff has delivered the agreed upon care to the patient.
As you can imagine, this creates endless metrics that agencies could be tracking and evaluating to optimize care even further. In football, the players don’t play without keeping score. Why should home health agencies be any different?
By leveraging KPIs and creating benchmarks, overall quality can be improved and the entire care delivery process can be streamlined. The question becomes: how do you determine which KPIs to use to deliver better patient outcomes?
By keeping score on these three delivery of care metrics, you can arm your team with game-winning patient outcomes.
1. Visit Verification – Was it Delivered at the Right Time and Place?
Monitoring ‘‘right place, right time’’ activity is crucial. Are your clinicians where they need to be? Are they arriving and departing on schedule? With EVV, your operations team is notified of each clinician’s arrival and departure from a patient’s home, providing proof of the visit.
Monitoring visit verification also tracks any missed care opportunities. Missed visits have the most potential for negatively impacting the patient. If a visit doesn’t occur at all, it can have several implications. Perhaps the patient doesn’t need the care anymore or they cancelled because they don’t like the staff. By monitoring the activity of clinicians, you can reduce the risk of adverse events that can result from gaps in care and can also address personnel issues.
2. Visit Duration – Was it Delivered According to the Care Plan?
To ensure positive patient outcomes and efficient reimbursement for services, clinicians must follow the correct care plan for each patient. It’s important to monitor if a clinician is under- or over-serving patients. By monitoring the actual length of stay in the patient’s home, versus the scheduled duration, you can receive pertinent information.
If the actual visit time is shorter than what was scheduled, this should prompt questions such as: Has the patient improved and no longer requires as much service? Is the patient telling staff to leave early? Does the patient not like the staff? Is it simply not a good day/time for them?
If the visit time is longer than the scheduled time, it should prompt questions such as: Does the patient require more services or a higher level of care? Has the therapeutic relationship been breached? Is the patient lonely? Was there an emergency in the home?
Knowing the answers to these questions helps operations staff intervene quickly and appropriately. Armed with more accurate information, clinicians can easily adjust plans and service levels to improve client outcomes. Moreover, patients and their families have a transparent view of the care delivered at every visit.
3. Visit Travel Time – Was it Delivered Within the Appropriate Cost Parameters?
The average travel distance and time is important for controlling costs and improving staff productivity. It’s important to track this metric – the time and miles driven to a patient’s home – for every single episode of care. Many states include travel time as part of work hours, resulting in potential overtime. How much of their time is being spent driving verus serving the patient? Is your staff wasting time in the car?
It’s also important to analyze the number of staff visits your agency completes daily. The more you understand these numbers, the better your agency can create the accurate staffing models needed to grow and expand. When you’re tracking the right cost parameter data, you can align your budget with actual costs and minimize potential revenue leaks.
EVV automates the gathering of pertinent service information by capturing time, attendance and care plan information. It gives providers and care coordinators access to service delivery information in real time to ensure there are no gaps in care, including billing errors or potential fraud and abuse. Beyond preventing fraud, EVV also serves as a powerful tool to improve the value of service and quality of life outcomes. By measuring key metrics and KPIs, agencies can exponentially enhance the patient care being offered.
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