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Leveraging Technology to Manage the “80/20 Rule” for HCBS Providers

Published on May 13, 2024 by Sharon Morrisette

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In 2023, the Centers for Medicaid Services (CMS) suggested several regulatory changes aimed at enhancing the availability of home and community-based services (HCBS) for Medicaid recipients. A key proposal among these changes is a new rule mandating that HCBS agencies allocate at least 80% of their Medicaid payments for homemaker, home health aide, and personal care services directly to worker compensation, referred to as the “80/20 Rule”.

This new Medicaid regulation could create a seismic shift in the home care industry, will directly impact caregiver compensation, and play a pivotal role in shaping home care providers’ financial and operational strategies.

The enforcement of this rule will require states to begin collecting and tracking data on direct care worker compensation. This is why implementing the right technological solutions will become imperative in the short-to-medium term.

In this blog post, we’ll examine how technology can facilitate navigating the 80/20 rule while maintaining the delicate balance between regulatory compliance and operational efficiency.

Understanding the 80/20 Rule

Since its conception, the 80/20 rule has sought to ensure that the majority of Medicaid funds—precisely 80%—are allocated to direct patient care.

For home care providers, this means a careful balancing act between maintaining a robust workforce of caregivers and managing operational expenses. 

Compliance requires meticulous record-keeping and operational adjustments on the part of the providers; for caregivers, the rule introduces new changes to how their work is documented and compensated.

This dynamic underscores the critical need for efficient operational strategies, and where technology can play a pivotal role in simplifying compliance and focusing resources on client/patient care.

Cost Reduction through Efficient Operations

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Against the backdrop of the 80/20 rule, operational efficiency in home care is no longer just a goal — it’s a necessity.

Leveraging technology, especially a comprehensive suite of tools like Aaniie, is pivotal in achieving this efficiency.

These technological solutions offer a pathway to significant cost reductions by minimizing manual errors and administrative overhead. This, in turn, allows for a better allocation of resources towards caregiver wages, ensuring that the backbone of home care services is supported and valued.

Introducing such technology into daily operations streamlines processes, from scheduling to billing, reducing the time and effort required for tasks that once were cumbersome and error-prone.

As a result, agencies can focus more on delivering quality care rather than getting bogged down by paperwork and compliance checks.

Aaniie’s Time and Money-Saving Features

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Aaniie’s all-in-one software for managing Home-and-Community-Based Services, introduces a range of features designed to significantly improve efficiency and cash flow in your home care operations.

One of the standout features is the integrated Electronic Visit Verification (EVV) system, which is crucial for Medicaid compliance.

EVV ensures service delivery and ensures compliance with the new regulations by electronically capturing:

  • Date of the visit 
  • Clock in time and location
  • Clock-out time and location
  • A client who received the service
  • Caregiver who provided the services
  • Service that was delivered

By automating verification, Aaniie ensures accurate recording and easy validation of care provided, vital for reimbursement and adherence to regulations.

Beyond compliance, integrating EVV simplifies administrative tasks, allowing providers to focus on quality care. Eliminating the need for manual tracking reduces errors, streamlines billing, and promotes trust among stakeholders by maintaining transparent and accurate care records.

Furthermore, Aaniie offers a comprehensive scheduling, invoicing, and payroll platform to simplify caregiver management and significantly reduce the administrative burden. This allows for allocating more resources towards direct patient care and caregiver compensation, in line with the objectives of the 80/20 rule.

Strategic Planning with Technology

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Aaniie’s advanced analytics and reporting tools are crucial in home care providers’ strategic planning efforts.

By analyzing trends and patterns in caregiver activities and client/patient care hours in real time, providers can swiftly address discrepancies and anticipate potential compliance issues before they arise.

Furthermore, Aaniie’s technology helps identify areas for improved efficiency. Through detailed reports, providers gain insights into the effectiveness of their current strategies and can make more informed decisions on resource allocation.

This proactive approach enables providers to accurately forecast the financial impacts of the 80/20 rule, allowing adjustments to ensure ongoing compliance with Medicaid regulations and thereby reducing the risk of penalties.

Adapting to the 80/20 Rule: Technology is Your Greatest Ally

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Navigating the new landscape created by the 80/20 rule can be a delicate balancing act. Luckily, the transition can be smooth through the implementation and use of smart technology.

Aaniie, with its innovative features like Electronic Visit Verification and payroll management, is a powerful tool that streamlines adherence to Medicaid regulations, making it easier for you to navigate the 80/20 rule. This empowers providers to prioritize delivering quality care over cumbersome administrative tasks, aligning with the ethos of the 80/20 rule.

What’s more, Aaniie’s strategic planning tools offer a clear roadmap for providers to forecast and adapt to the financial impacts of the 80/20 rule, ensuring continued compliance.

Don’t Get Caught Out by the 80/20 Rule

With the 80/20 rule looming over the industry, home care providers are at a crucial crossroads. The time to embrace technology solutions like Aaniie is now, not just to meet regulatory demands but to transform your operations for the better.

Embracing technology solutions like Aaniie keeps pace with regulatory demands and will improve your operations, transforming your home care business.

Reach out today and ask for a free demo to discover how Aaniie can revolutionize your operations and ensure you’re prepared for these new regulations!