Clinical Compliance

How Caregiver Behavioral Change Software Boosts EVV Compliance in Homecare

08/07/2025

A Brief History of Electronic Visit Verification (EVV)

Electronic Visit Verification (EVV) was created to help cut down on fraud and ensure that patients receive the care they need. It was designed to help verify that services billed for homecare are for actual visits made. The passing of the ACA (signed into law in 2010) required provisions be instituted to reduce fraud and over-payments, requiring states to stop Medicaid payments to providers when there is credible evidence of fraud.

Optimizing Electronic Visit Verification through Innovative Approaches

EVV is mandatory and is often a significant challenge for many agencies. Although EVV is essential to the homecare industry, many agencies face ongoing challenges in maintaining consistent compliance. Traditional methods like periodic training and manual reminders often fail to achieve lasting behavioral change. To address these challenges, innovative solutions like caregiver behavioral change software, exemplified by platforms such as Caribou, offer a promising route to greater compliance and improved care outcomes.

The Challenges of EVV Compliance in Homecare

Digital visit verification aims to cut fraud, improve care delivery, and simplify billing. However, the implementation of EVV has brought its own set of hurdles for homecare agencies and caregivers alike. Common obstacles include technological literacy and language gaps among caregivers, resistance to change from established routines, connectivity issues in rural or underserved areas, and the additional administrative workload that EVV may entail. These factors can result in missed or incomplete visit logs (the dreaded red screens), delayed billing, and even audit risks for agencies. Moreover, non-compliance with EVV regulations can lead to financial penalties, termination of established contracts, and, most importantly, disrupt patient care continuity.

The Case for Behavioral Change in Caregiver Practices

Improving EVV compliance requires more than just technical solutions; it demands a shift in daily caregiver behaviors and attitudes toward documentation and accountability. Behavioral science teaches us that sustainable change arises from supportive environments, timely feedback, and intrinsic motivation—not from top-down mandates alone. In the context of homecare, caregivers are more likely to consistently use EVV systems when they understand the “why” behind compliance, receive real-time support, and are recognized for positive behaviors (through financial incentives). Simply put, fostering a culture where compliance is seen as integral to quality care—rather than as a burdensome obligation—can dramatically improve adherence rates.

Introducing Caregiver Behavioral Change Systems: The Example of Caribou Care

Caregiver behavioral change software, like Caribou, represents a new generation of platforms designed specifically to bridge the gap between policy and practice in homecare. These systems leverage behavior modification techniques, data analytics, and user-centric design to drive positive, sustainable habits among caregivers. For example, Caribou uses features such as digital nudges - timely reminders tailored to each caregiver’s workflow - to prompt accurate and timely EVV entries.

These platforms also include gamification elements, where caregivers earn badges or monetary rewards (e.g., receiving an electronic “lottery ticket” for every EVV clock-in/out, which enters them in monthly or weekly prize draw). The lottery ticket idea is extremely popular with caregivers and greatly improved EVV compliance at my previous agency, raising it to over 90% on a consistent basis.

These systems can also be set-up to allow Schedulers/Care Coordinators to monetarily reward caregivers if, for example, they accept a last-minute shift, travel to a difficult-to-staff area or receive a patient compliment. In addition, these systems have robust dashboards that provide supervisors with actionable insights, highlighting trends, flagging potential issues early, and enabling targeted coaching for those who need extra support. For more information on Caribou, visit their website at www.caribou.care.

Real-World Impact: Increased Compliance and Enhanced Care Quality

The implementation of a caregiver behavioral change software can have a transformative impact on both EVV compliance rates and the overall quality of homecare services. Agencies using these systems have seen faster and more accurate visit verification. By reinforcing desired behaviors and removing pain points, these platforms create an atmosphere where compliance becomes second nature. Notably, caregivers who feel supported and empowered—not micromanaged—tend to exhibit higher job satisfaction, lower turnover rates, and a stronger commitment to delivering quality care. For agencies, this translates into more robust audit trails, fewer compliance violations, and improved relationships with both payers and patients. Agencies must maintain sustainable EVV compliance, as many states will soon enforce accountability.

The Future of EVV Compliance Lies in Empowering Caregivers

As the homecare industry continues to evolve, so too, the strategies for ensuring regulatory compliance and high-quality care delivery. EVV systems are here to stay, but their effectiveness hinges on the willingness and ability of caregivers to integrate them seamlessly into their daily practices. By embracing caregiver behavioral change software, agencies can move beyond punitive enforcement and toward a model that values education, support, and positive reinforcement.

If you find that sustaining acceptable EVV compliance is a challenge at your agency, we can help you assess your needs, develop an improvement plan and implement strategies and tools (including behavioral change software) to maximize your performance in this critical area. Please reach out to us at 203.691.1319, or email us here. We will be happy to set up an introductory conversation to discuss your situation.

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