As more individuals within the Medicaid population choose to receive home and community-based services (HCBS), the success of electronic visit verification (EVV) systems for self-direction programs hinges on the participant experience. 

The 21st Century Cures Act, signed in 2016, mandated the use of EVV for Medicaid-funded personal care services (PCS) in every state by 2020. By January 1, 2023, this mandate will extend to all home health care services. However, many states still find themselves in the early stages of EVV implementation for PCS.  

As states work to achieve Cures Act compliance, there is growing concern surrounding how EVV implementation could impact self-direction. Self-direction is wholly built on participants having control over their services, directing who provides the services and when, where, and how they are provided. An EVV system for self-direction programs should accommodate for mandated compliance requirements while preserving the greatest possible level of choice, control, and flexibility for participants.  

Key Elements to Consider When Choosing an EVV System in Self-Direction 

With more than 1.25 million people participating in self-direction programs nationally, states, providers, managed care organizations (MCOs), and EVV vendors must keep the relationship between participants and directly hired staff top-of-mind. State payer and MCO EVV programs should be designed and implemented to support self-direction, reinforcing the participant’s role to manage, direct, and schedule their staff.  

But with a growing market of EVV products, how can payers procure and implement the right system?  

As payers look to select an EVV system that supports, not hinders, self-direction, here are six key elements that a system should include: 

  1. Self-Scheduling (or no-scheduling) Options
  2. Participant Review and Approval Capability
  3. Flexibility 
  4. No Geo-fencing
  5. Variability
  6. Controls for Program Integrity

The Bottom Line  

As EVV continues to evolve, a one-size-fits-all approach creates challenges for providers and participants in self-direction programs. By prioritizing participant autonomy and following best practices, payers can ensure they implement an EVV system that delivers positive outcomes, compliance, reduced risk, and above all – an effective self-direction program that benefits all stakeholders. 

Download the full guide for more insights into the importance of these elements and discover the power of implementing the right EVV system in self-direction.