Interview with Richard Keller

President, All Metro Health Care

About All Metro Health Care

While some homecare agencies are already in compliance with the 21st Century Cures Act Electronic Visit Verification (EVV) mandate, others have yet to begin the implementation process. For many agencies, just getting started with EVV is the hardest part!

HHAeXchange interviewed Richard Keller, President of All Metro Health Care, a provider of homecare services in Florida, New York, and New Jersey, and part of Simplura Health Group. Keller shares his agency’s journey to EVV compliance, lessons learned, and tips for a successful EVV implementation.

What was your agency doing before EVV?

Prior to implementing our current EVV solution, we tracked attendance with a mostly home-grown method of paper timesheets, along with a few processes living in a legacy tool. This made for a lot of manual effort and duplication, not to mention a lack of consistency across the 16 branches we operate in Florida, New York, and New Jersey. As the business scaled, we realized we needed to get everyone under one EVV platform. Obviously, there was also a federal EVV mandate to comply with, but we wanted to take the time to be strategic about our decision and ensure the system we chose was right for our business structure and needs.

What EVV solution did you end up choosing and why?

All Metro uses HHAeXchange for our practice management solution. We run our scheduling, billing and payroll all through HHAeXchange, so it made sense to leverage their EVV solution to supplement the scheduling workflow. Their system has several methods of EVV (caregiver mobile app, telephony, and FOB) to accommodate the diverse needs of our caregivers. It also helps that they are connected with managed care organizations, as it makes the process more seamless. We simply submit our visit confirmations and send our claims through the HHAeXchange platform, and they take care of the rest.

How did you go about implementing EVV? Are there things that you can attribute to your success?

I think it’s an intensive process for agencies of all sizes, but it certainly was for us given we have multiple offices in multiple states. Being on a home-grown system originally, there were a lot of workflows that weren’t clearly written out, so we had to ensure everything was documented before transitioning to the new platform. Internally, we assigned a team that was dedicated to getting EVV implemented. This team worked hand-in-hand with HHAeXchange’s implementation team. It’s important to make sure your EVV provider is a true partner who can offer you support and resources throughout the implementation process, and beyond — that is key to a successful EVV adoption.

For smaller agencies that might not have the resources to designate an entire internal team to EVV, I would recommend assigning at least one project manager to implementation and the communications surrounding it — it’s a big commitment, but it will pay off in the long run.

Do you have advice for agencies just getting started with EVV?

First and foremost, I think approaching EVV implementation from a “change management” perspective can be helpful. We all know that change takes time, so take it day by day. Break the project up into manageable, bite-sized pieces. If your team isn’t the most tech-savvy, consider rolling out EVV to a small subset of your staff first. Take their feedback, make improvements where possible, and then roll it out at large. I think it’s also important to communicate to your staff and caregivers that while this change might take some getting used to, it will ultimately allow them to do their jobs better. EVV doesn’t have to be viewed negatively just because it’s mandated—it can be an amazing tool for success that everyone from agency management to schedulers to caregivers can benefit from.

At the end of the day, it’s really all about planning and good communication.

How has adopting EVV benefited your agency and caregivers?

EVV helps improve our accountability to deliver on the care we are committed to providing. There’s no guesswork, no waiting around; we’re now able to be more proactive than reactive. EVV allows us to scale our ability to ensure consistent service. These days, no one should be relying solely upon the client to call them if an aide isn’t there. The doctor has prescribed the patient a certain amount of care, and it’s our responsibility to provide it.

EVV is also helping us with the shift to value-based care payments. It provides the mechanism to capture all sorts of data. EVV breaks down the barriers between the agency and caregivers, allowing caregivers to be more involved in the care of their patient. So not only does it enable us to capture the clock-in/out information and tasks performed — EVV can be a conduit to capture changes in condition as well as certain quality measures. It provides the necessary infrastructure to support value-based contracting.

Our staff understands that the EVV mandate isn’t about “big brother”; it’s about ensuring quality of care. Most importantly, EVV has enabled us to stay true to our mission, and that’s providing the best care possible to the patients we serve.

All Metro’s Top Tips for Successful EVV Adoption:

  1. Ensure your internal processes are documented before diving into implementation.

  2. Approach implementation from a change management perspective; break the project up into manageable pieces.

  3. Communicate to your employees how EVV can help them do their jobs better.

  4. Consider rolling out EVV to a small subset of your staff first. Take their feedback, make improvements where possible, and then roll it out at large.

  5. Choose an EVV vendor that will be a true partner to your business and is invested in your success.

  6. Make EVV about improving your business, not just complying with a mandate.