Technology Steps Up in Home Healthcare: Using Innovation to Help Fraud Prevention

John Olajide

Guest post by John Olajide, president and CEO, Axxess.

The home health delivery model has become more prevalent in recent years as a cost-effective, patient-preferred alternative to traditional hospital and skilled nursing settings. Approximately 12 million U.S. individuals receive care from more than 33,000 agencies for acute illness, long-term health conditions, permanent disability, or terminal illness — according to a survey by the National Association for Home Care & Hospice (NAHCH).

Demand for home health services is seeing an increase as more baby boomers turn 65 daily and choose to receive their health care services at home. Recent surveys of older adults are showing a preference to receive healthcare in the dignity and comfort of their homes. As an example, surveys by the American Association of Retired Persons (AARP) consistently show that over 80 percent of older adults want to remain in their homes and communities throughout their lives. Several surveys show the same trend in the wider patient populations; and technology innovations are making it possible to deliver quality healthcare services to patients at home.

While the increased awareness in and recent growth of the home healthcare sector is promising for home health agencies, critical to their success is the adoption and integration of the right cloud-based technology to increase operational efficiency, ensure compliance with stringent regulatory requirements and improve patient outcomes.

Technology can also assist in preventing home healthcare fraud. While fraud can occur in all sectors of healthcare, home health is unique in that the caregiver visits the patient in the home. A common example of fraud in home health is when a caregiver submits documentation for visits that were not made and the home health organization, in turn, submits claims to insurance providers for such services without obtaining proof that such service was actually rendered. Home health agencies would be wise to protect themselves from the possibility of this type of fraudulent activity by a disreputable employee.

Agencies can help clinicians prove that the visit took place in the patient’s home by equipping them with electronic visit verification (EVV) technology. EVV technology allows the electronic verification that a service visit occurs and documents the precise date, time and location the service is provided. While there are telephone and computer-based EVV systems, more sophisticated and secure systems use advanced encryption, GPS, cellular and Wi-Fi technology to record the date, time and location of home care visits using mobile apps on phones, tablets or other mobile devices. In addition patient signatures are collected on such mobile devices as additional proof that the care was provided at the point of care.  Several states — Florida, Illinois, New York, Ohio, Tennessee, Texas and Washington — have already enacted regulations requiring Medicaid providers to prove that care was received in the patient’s home. More states are expected to follow.

The more comprehensive, sophisticated home health apps offer more than proof-of-care at the point-of-care. They put patient care in the palm of a caregiver’s hand. For instance, a caregiver is able to manage their schedules in real time, communicate and collaborate with a multi-disciplinary team of caregivers, have secure and real-time access patient records and document visits. The tools provided empower the caregivers to focus on patient care, not paperwork; and the home health agency benefits from the improved operational efficiency.

The future of home health agencies will depend on integrated health IT systems that enable mobility, fraud prevention, compliance with regulations, automated processes, electronic billing and more. The technology, in turn, will allow agency professionals to spend less time on administrative functions and more time on patient-centered care.

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