Voices: Praba Manivasager, President, Cashé Software

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This article is sponsored by Cashé Software. In this Voices interview, Home Health Care News sits down with Cashé (pronounced: Cash-ay) President Praba Manivasager to learn about the company’s new person-centered agency management tool, Pavillio. Manivasager describes why Cashé is going all in on this new platform, the impact Pavillio is having on personal care providers and how the system is designed to accommodate the surge of in-home care brought on by COVID-19.

HHCN: You have spent your career in cutting edge technology, including your position as president of Cashé since 2017. Tell us about your journey.

Manivasager: I’ve been the president for almost four years. When I jumped in and looked at the software business itself, it was intriguing. My path has been in technology all along, but the health care business was an area that I was not familiar with.

I
quickly realized the work I would be doing at Cashé would be pertinent to
personal experiences. There are three
people in my life who’ve been affected or are related to the industry. My best
friend had a stroke and is requiring services. My niece has cerebral palsy. And
my child, she’s beautiful and everything is fine with her, but she was also
very close to receiving services, because she was premature by three months.
All of that changed my perspective.

I
very quickly realized that my expertise in technology and what I’ve learned
throughout my career could be applied toward something that could help a lot of
people. Now, the technology part of my life is just a backdrop. The passion is,
“Go build something and touch two million lives in the fastest possible
way.” We believe that Cashé can do that.

Cashé has a robust billing
service. Was that in place when you arrived? If not, what was?

Cashé’s
DNA is billing. When the company was started more than 15 years ago, it was to
serve a very specific population and a set of companies in Minnesota that
served the PCA (personal care assistance) population. Over the years, our platform
has become better and more sophisticated to a point where we not only provide
software, but we also provide billing services.

Yet
the technology sophistication required work. We set out to improve the platform
and the technology to automate and streamline billing. We still, over the last
three years or so, did a number of things to improve how billing was done, how
validations for billing were done, how we connected with the payors, and how we
give the end user information about how billing through Medicaid was actually
being handled better than if they chose any other avenue.

You developed a new tool,
Pavillio. What does it deliver that Cashé could not previously do?

Honestly,
when we bought the company, we recognized that the shelf life of the current
platform was limited. It had a few years left — maybe four or five. We
recognized that we needed to have a platform that did a few things. One, it had
to be easy, for both technical reasons and business reasons.

The
technical reasons were that the legacy platform was outdated and had
limitations. Think of it as multiple coats of paint on a wall over the years.
It meant that improving that platform was starting to be difficult, because we
couldn’t maintain it as well. The first business reason was the platform was
not capable of traveling across states. We have our business in the Midwest,
and we wanted to be national. For us to be national the platform would require
a lot of configurability, and the legacy platform didn’t have that capability.

The
second business reason was the platform was very billing-focused and not care
delivery-focused. Given these limitations, we said, “Look, we knew we were
going to build the platform. If we are to build it, it must be different from
the legacy platform.”

Pavillio
was built on the premise that everything starts with the person being served.
They’re at the center of the universe and we build the technology around them.
Pavillio is more human. It is a person-centered platform that has all the
capabilities of billing, but we built it to serve the person.

What did you see when you
came to Cashé that led you to push the company down this path toward Pavillio,
and how did you develop it?

The
company has an objective — a set of core values. The purpose of the organization
is to make a difference in the lives of people in need. That’s our mission. We
do that through data-driven technology for smaller care.

We
had to make this transformation from being a de facto billing company in the
state of Minnesota, to being a company on a mission to make a difference in the
lives of people in need nationwide. That changed fundamentally how the whole
organization thought and behaved, because now we wake up and we talk about,
“How many lives are we touching?” We wake up and we talk about,
“How did we help an agency grow?” We wake up and talk about,
“How did we work towards our goal of two million lives?”

Writing
a new platform for a small company like ours is a make-or-break decision. We
weren’t willing to simply put a new coat of paint on the old system. We said,
“we’re starting from scratch and we are betting the farm, so to speak, on
Pavillio.”

There
is no company in this industry in 2020 writing a new platform, except us. We
built it with ideas and tools and technologies that are current today and will
grow with us, so that we can get the platform across the country and touch two
million lives.

Pavillio launched in the
personal care space, which I think speaks to the company’s person-centered,
agency-focused approach to technology that we’ve discussed. What results have
you seen so far?

Great
results. We launched in the personal care space because, while the first part
of our DNA was billing, the second part was serving the personal care industry
in the state of Minnesota. When we launched Pavillio, the first thing we wanted
to do was support a large customer base of PCA agencies. But the intent of the
platform was not just to do PCA services, but to have service packs.

So
far, the platform has been a great success. The ease of usability of the
platform is off the charts. It is very user-friendly, intuitive and
comprehensive, and has taken everything that we’ve known from legacy and built
it into Pavillio. The billing capabilities and the ideas that we want to
implement in legacy, but couldn’t, were all done in Pavillio.

One
of our biggest successes so far has to do with submitting claims for
reimbursement. The industry average denial rate for first-time submissions is
around 18%. In Pavillio, we are already seeing that rate drop as low as 2%.
That makes the biggest difference for our customers. because the system is
preventing bad claims from going out in the first place.

The
other early win is how accessible we’ve made the system. Every person who is
part of the care team can have access to the system, because it’s one system,
one platform, and person-centered.

What is Pavillio’s key
differentiator, and what is the most important way it helps users and enhances
the home health industry?

I
would say the number one capability of the platform is portability of the
health record. Somehow we’ve gotten ourselves, as an industry, into believing
in having to talk about portability of the health record because these large
EHR systems have been so closed in managing data. We, on the other hand, built
the platform with portability in mind, so that a person receiving Medicaid
services has the ability to take their records with them as they travel.

Number
two, we are truly person-centered. We’re not just saying those words; we’re
constantly thinking about them, and that thinking alters what features go in,
how the features are built, and how the patient is using those features.

Number
three, if you look at the continuum of starting on the left side with the
person, and moving to the right side where you get paid for the services
delivered, most existing platforms are focused on the care delivery
documentation, which is in the middle. But with Pavillio, we focused on the
whole continuum. We do all the things
necessary for person-centered care and to operationally run the
business. That includes a focus on managing billing so that operators maximize
their reimbursements.

Ultimately,
these agencies are a business and businesses run on a fuel called cash. Getting
cash flow and managing cash flow is a huge part of running an agency. What
we’ve done with Pavillio is give agencies a better Swiss Army knife to run
their business.

Well said. What are Cashé’s
plans for expansion with Pavillio?

We
continue to add service packs, which means service capability within the
platform. We are specifically built for home and community-based services. To
grow, we want to make this platform available nationwide, and we have to go
state by state, since every state has a different definition of what their set
of services are for HCBS (home and community-based services). To make that
effective, we have to have a platform
that we can quickly add service lines to as we move into each state. The plan
is that in four to five years, we’ll be in every state in the U.S.

Lastly, how has COVID-19
changed the equation for Pavillio?

What
we saw with COVID was that there is an even greater need for services in the
home versus in institutional settings. Within about a month of COVID, it was
evident that institutional settings were being hit hard. Our mission and our
purpose is even more important today than it was six months ago, because there
are going to be more people receiving services in the home, which is the
preferred method of service delivery.

We
feel like we’re positioned really well to support that. In fact, the next
release has a built-in capability for remote service delivery, and a video
capability built right into the platform. We’ve recognized our mission is even
more important today. We recognize that the industry is changing, and we
facilitate success in the changing industry by being nimble, and by building in
those capabilities, so that the person receiving care ultimately gets better
quality of care quicker because they’re with an agency that’s on Pavillio.

Editor’s note: This interview
has been edited for length and clarity.

Cashé Software is Minnesota’s leading provider of agency management
software for home and community-based services agencies. To learn more about
Pavillio, visit pavillio.com

The Voices Series is a
sponsored content program featuring leading executives discussing trends,
topics and more shaping their industry in a question-and-answer format. For
more information on Voices, please contact sales@agingmedia.com.

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