Overview

Home and Community-Based Services (HCBS) allow Medicaid beneficiaries to receive services in their home or community rather than institutions or other isolated settings. These programs serve a variety of targeted population groups, such as people with intellectual or developmental disabilities, physical disabilities, or mental illnesses. Over 3 million individuals receive HCBS through various Medicaid Waiver programs. These services sometimes are known as Private Duty Non-Medical or Personal Care services.

To meet the needs of individuals who prefer long-term care services in their home or community, states have the ability to create Medicaid Waiver programs tailored to their specific requirements. However, this flexibility has resulted in varying regulatory frameworks for authorizing and managing services. Home Care Agencies that provide HCBS services must manage a high volume of schedules, deal with frequent employee turnover, and navigate constant schedule changes. Effective scheduling is crucial for HCBS Home Care Agencies to optimize staff utilization, reduce scheduling errors and non-billable services, lower payroll costs, increase patient and employee satisfaction, and improve the agency's overall performance.

HCBS and Private Duty Non-Medical Home Care Agencies should leverage technology and intelligent automation to improve scheduling efficiency. Improving scheduling efficiency will positively impact many aspects of agency operations. A Home Care Software platform with efficient scheduling tools will improve the operational efficiency of HCBS and Non-Medical Home Care Agencies.

This blog will discuss some of the vital scheduling features required in the software to improve the scheduling efficiency of HCBS and Non-Medical Home Care Agencies.

Improve the scheduling efficiency of HCBS and Non-Medical Home Care Agencies

Key Features to Improve Scheduling Efficiency

HCBS and Private Duty Non-Medical Home Care Agencies face unique challenges in managing constantly changing schedules with various authorization requirements. The following are key scheduling software features that will help HCBS Home Care Agencies.

Authorization Integration

Medicaid Waiver programs authorize services in various formats, such as authorized hours, units, and amounts. Some authorizations may have limits per day, week, month, or authorization period. Creating and managing schedules directly from the authorization will be essential for home care agencies to minimize revenue leakage in the form of unbillable services and paying for those services. Scheduling tools should proactively notify schedulers when there are not enough hours, units, or amounts to cover the services or when the schedule is outside the authorization period. Minimizing revenue leakage will improve the agency's bottom line.

Consumer Directed Services

Many HCBS Home Care Agencies serve as fiscal agents for Consumer Directed Services or Self-Directed Services, where patients can hire caregivers. At the same time, the agencies manage billing and payroll for the caregivers. Not having control over the caregivers’ schedules poses a unique challenge for the agencies. The scheduling software should allow caregivers to create and link their schedules to the authorization.

Ease of use

Ease of use is critical for HCBS and Non-Medical Home Care Agencies to manage schedules with constant changes and high employee turnover. Different scheduling views for employees, patients, and schedulers and the ability to switch between views will improve the productivity of schedulers. Schedulers’ ability to view all open shifts in one screen, match available employees with patients and schedule the employee on the same screen will improve scheduling efficiency.

Intelligent Matching

One of the challenges HCBS and Non-Medical Home Care Agencies faces is quickly identifying a group of available matching employees for a patient with an open shift. Scheduling software should match patient preferences with the employee profile and provide a list of matching employees to assist the schedulers.

Publish Shift Offers and Available Shifts

Publishing available shifts and offering an open shift to employees will minimize the need to contact employees to determine their availability. Having a pool of available employees for a shift will improve schedulers' efficiency, improving employee productivity and revenue.

Split Shifts

Sometimes, Medicaid Waiver programs will authorize different levels of care for a patient to be provided simultaneously during a shift. The ability to accommodate multiple service levels under one shift will significantly improve the efficiency of schedulers and employees.

Configurable Validations

Proactive alerts and validations, such as duplicate schedules, overtime, missing authorizations, etc., will alert the schedulers about potential issues at the point of scheduling. Home Care Scheduling software should allow the agencies to configure the validations based on their needs. Proactively detecting and resolving problems will improve employee satisfaction and productivity and reduce unnecessary payroll costs.

EVV Integration

Electronic Visit Verification (EVV) is mandatory for all HCBS and Personal Care Services under Medicaid or Waiver programs. Home Care Scheduling Software should have standard and efficient interfaces to all state and managed care EVV Aggregators.

Billing Integration

Effective schedule management is critical in improving revenue cycle management efficiency. Proactively detecting potential billing issues at the point of scheduling will help the billing team to send out clean claims and improve the reimbursement timeline and cash flow. Scheduling functions should minimize manual efforts by attaching correct authorizations based on the level of care.

Payroll

Home Health Care Agencies usually spend about 60% of their revenue on employee wages. Timely and accurate payroll is very critical for employee satisfaction. If not managed effectively, overtime and shift differential costs can quickly add up and cut into the agency's bottom line. Considering the complexity of the scheduling requirements for HCBS and Non-Medical Home Care Agencies, Home Care Software should have the tools to minimize manual interventions and improve the accuracy and timeliness of payroll.

Communication

Communication plays a crucial role in effectively filling open shifts for patients with matching employees. Schedulers usually spend a lot of time texting or talking with employees before scheduling one or more open shifts. Employee Portals, Family Portals, and integrated messaging applications will help schedulers to communicate effectively with patients and employees. The ability to schedule reminders for employees and patients will significantly reduce missed shifts for patients and employees.

Conclusion

HCBS and Non-Medical Home Care Agencies should look for a software platform with functions and features to meet the unique scheduling requirements for providing care under many Medicaid Waiver programs. CareVoyant understands the demanding need to manage services provided under waiver programs while supporting other services like Private Duty Nursing and Home Health. CareVoyant Home Care software platform offers the right technology and tools to help an HCBS and Non-Medical Home Care Agency effectively manage the agency and improve operational efficiency and the agency's bottom line.

About CareVoyant:

CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.

CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.

For more information, please visit CareVoyant.com or call us at 1-888-463-6797.