Propoint Technology Inc. Case Study: Statewide Electronic Visit Verification

 

Project Overview

Propoint Technology, Inc. (Propoint) was contracted to provide project management, analysis, testing, and communication services for the implementation of the Electronic Visit Verification (EVV) system. These services supported the implementation of a minimum viable product from start to deployment in four months. Propoint subsequently supported a full-feature implementation and several post-implementation activities.

Medicaid is a critical government resource for individuals and families seeking subsidized medical services. The growth of the Medicaid program has led to increased oversight and regulation. The 21st Century CURES Act mandated that states were required to implement an Electronic Visit Verification (EVV) System to comply with this federal mandate. An EVV System verifies that all Medicaid-funded Personal Care Services (PCS) and Home Health Care Services (HHCS) are provided to the client at the date and time recorded.  

Propoint provided a consulting team to assist the Office of Technology and Solutions Integration (OTSI) in implementing an EVV System for the State of California through the EVV Phase II Project (CalEVV). The CalEVV implementation required collaboration among five California Sponsor Departments with differing needs, as well as the OTSI and external vendors.

OTSI served as the contract administrator and provided project management oversight.

Vendors partners that were involved in the CalEVV implementation included:

  • Sandata Technologies, LLC – EVV Solution provider
  • Propoint Technology, Inc. – Project management and implementation support
  • Other consultants provided PMO administration and technical consulting

 

Customer Pain Points

The Federal implementation mandate required the CalEVV solution to be implemented and usable by a specific deadline. Due to unexpected delays experienced during the software solution procurement and contracting process, California had just four months to complete the initial implementation to avoid federal penalties. In addition, the five sponsor departments needed to reach agreement on the functional requirements. This required focused collaboration and critical project scheduling. It was a large lift in a short period of time, but the joint effort succeeded.

CalEVV needed to implement visit verification for all Medicaid PCS and HHCS client visits. The system requires the capture of client visit data in real-time using either a smartphone app or a landline in the client’s home. To prevent fraud and confirm the service, the Provider employee logs the service when arriving at the client’s home, and then again when the visit is concluded. Thus, the system can electronically store when, for how long, and where (using GPS) a visit occurs. The solution was also designed to verify additional visit information:

  • Client receiving the service
  • Date of service
  • Applicable service code
  • Location of service
  • Employee providing the service
  • Service timeframe

To be successful and meet federal requirements, the EVV solution needed to incorporate an “open vendor” model and support a self-directed/individual provider or agency provider model.

Overall project management and direction were the responsibility of the OTSI. They recognized that additional resources were needed to complete the project in such a short period.

Read the entire case study here

Published On: July 8, 2024
About the Author: Propoint Technology
Founded in 2005, Propoint has established a proud tradition of delivering a full suite of information technology (IT) and management consulting services. Their team of seasoned IT consulting professionals carry extensive experience that can be measured in decades, holding industry certifications recognized by some of the most respected IT industry organizations. Propoint currently has a combination of delivery staff, comprising employees and full-time contract consulting personnel.