Putting Constituents First with Intentional Change

Using our people-centric Organizational Change Management (OCM) approach, we successfully supported a state agency in implementing a federally mandated technology solution that streamlines its business processes and consolidates data collection. Our approach enabled a solution that protects state and federal healthcare funds while improving the health and well-being of Medicaid beneficiaries.

Client Situation                                                                                                      

In December 2016, the 114th U.S. Congress enacted the 21st Century Cures Act, which requires states to implement Electronic Visit Verification (EVV) for Medicaid-financed Personal Care Services and Home Health Care Services. EVV is designed to help states identify, prevent, and reduce fraud and abuse within their Medicaid programs by ensuring services are delivered as billed.

Stakeholders impacted by EVV adoption include a vast number of Medicaid members and providers, as well as state Medicaid agencies and their business partners—all of whose input, engagement, and ultimate adoption of EVV are vital to its success. Recognizing the high stakes surrounding EVV, the state Medicaid agency engaged North Highland to support the implementation of its EVV solution. In partnership with the agency, we provided OCM services anchored in our people-centric approach.

Our Approach

North Highland crafted a tailored OCM approach alongside the agency, with the goal of ensuring seamless adoption of the EVV solution and importantly, compliance with the federal mandate.

At the time of implementation, change of any kind was a daunting proposition for our client. Like most organizations, it had been significantly impacted by COVID-19. The pandemic expanded Medicaid coverage, and in turn, its services, to a much broader group. It also shifted communications to virtual platforms only, which upended existing ways of working.

Adding to the complexity of implementation, EVV required buy-in and alignment both in and outside of the agency. Since the EVV solution relies on a global positioning system (GPS), some stakeholders resisted the change, citing data-privacy concerns. Successfully implementing EVV also called for additional time and effort from Medicaid provider workforces. Specifically, agency employees were expected to embrace new skillsets, behaviors, and ways of working quickly to maximize the technology’s potential. Finally, for EVV to succeed, it meant that Medicaid members would need to play an active role by signing and validating services provided for each visit.

Faced with these challenges, it became clear that change management needed to be at the core of the project to support stakeholders along the change journey. We took an approach that married accountability with grace, introducing change in three intentional phases:

  • Phase One: Define the Change: We focused on understanding the EVV’s impacted stakeholders, their needs, and their perspectives to develop a strategy and tactics. In collaboration with agency leaders, we conducted interviews, designed and fielded surveys, and held visioning sessions to collect data and insights that helped inform our strategy by revealing what it would take to successfully enact change.
  • Phase Two: Manage the Change: With an OCM strategy in place, it was time to execute. North Highland utilized an agile mindset within a Prosci® framework to anticipate and address stakeholder needs. The team established feedback loops between the agency and Medicaid members and providers to frequently collect and leverage insights. These data points informed stakeholder outreach and enabled the team to determine if and when to adapt their strategy.
  • Phase Three: Anchor the Change: During this phase, North Highland helped institutionalize and sustain the adoption of EVV through ongoing stakeholder engagement activities. In that effort, we utilized data to measure and keep a pulse on the level of change happening throughout the organization.

Value Delivered

Implementing EVV is a persistent challenge for states nationwide, and our client’s story was no exception—especially amid the pandemic. But alongside the agency sponsor and team, we laid the groundwork for a successful system adoption. By leveraging communication channels, change networks, and direct outreach tactics, the agency effectively communicated the change to all key stakeholders. As a result, nearly 80 percent of providers had registered for EVV just five months after the solution became available. Additionally, over 90 percent of impacted Medicaid providers surveyed in October 2020 reported awareness of EVV.

These are just the initial results we’re seeing. North Highland continues to partner with the agency to mitigate stakeholder privacy concerns and increase solution adoption through a combination of communications and outreach in EVV planning and implementation for additional Medicaid services in 2022.