Electronic Visit Verification (EVV) has become a constant presence in the lives of people who provide or receive in-home care services funded by Medicaid. The app, which tracks workers’ locations and activities, requires workers to verify their work several times a day. Technologies like EVV have been promoted as a tool for modernising and improving service delivery, to prevent fraud, waste, and abuse, and to more fairly and efficiently manage a labor force that is one of the fastest growing occupations in the country. Though the federal legislation that mandated EVV for all Medicaid-funded personal health services required the system to be 'minimally' burdensome, the reality is that it has been anything but. State-level policies and technology design encoded far more invasive features into EVV systems than were required.

Drawing on interviews with workers and service recipients across the country, this report provides evidence about the impacts of EVV implementation on workers and care recipients. Technologies that monitor workers also affect the lives of the people they provide services to, their families, and their social networks. In this respect, EVV has had far-reaching effects on people’s lives; many found themselves moving through invisible walls and re-organising their daily lives around proving that they were not cheating the system.

Related Information

EVV: a guide to intersecting harms and policy consequences

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