Picture this: you wake up tomorrow morning, head into work, and discover six missed calls from potential clients looking for your agency to provide Medicaid services. At first, it feels like a win. But then a new thought hits: “Can my agency’s performance actually handle this growth?”
The best way to answer that question is by tracking the right metrics. Below are five essential agency performance metrics that help you measure service quality, operational readiness, and compliance—so you can grow with confidence.
1. Active Clients Over Time Period
Start by reviewing your agency’s client history over the past year. Track how many active clients you served each month and ask yourself:
- Did I have more active clients at the end of the year than at the beginning?
- Were clients consistently leaving the agency each month?
- Which month had the highest client volume?
This agency performance metric helps you understand whether:
- Your agency can absorb new clients without disruption
- Clients are satisfied with your level of service
- Certain times of the year bring higher demand
Knowing this allows you to plan staffing, scheduling, and growth more effectively.
2. Upcoming Expiring Authorizations
Each month, generate a list of active clients whose authorizations are expiring in the current and following months.
Monitoring expiring authorizations improves agency performance by helping you:
- Anticipate workload and revenue changes
- Reduce compliance risks
- Prevent denied claims and missed billing opportunities
- Avoid costly payouts and service gaps
Proactive authorization management is a major indicator of a high-quality, well-run agency.
3. Units Used Each Week
At the end of every week, agency administrators should compare:
- Scheduled units for each caregiver visit
- Actual units used during the visit
The difference between these numbers reveals whether caregivers are on track to exceed or underutilize a client’s authorized units for the month.
Tracking this agency performance metric helps you:
- Prevent recoupments
- Avoid leaving billable units unused
- Reduce manual visit corrections that could trigger audits
4. Unadjusted Visits Each Month
Before submitting claims, review how many visits:
- Checked in, completed, and checked out correctly
- Required manual adjustments after the visit ended
To calculate this:
- Divide the number of manually adjusted visits by total monthly visits
- Multiply by 100 to get the adjustment percentage
Monitoring this number month over month gives you insight into:
- Medicaid compliance
- Caregiver performance consistency
- Audit risk exposure
Fewer manual adjustments generally mean stronger agency performance.
5. Monthly EVV Adherence
Electronic Visit Verification (EVV) adherence reflects how closely your agency follows best practices required by Medicaid and EVV aggregators.
Monthly EVV adherence is calculated using:
- Percentage of adjusted visits
- Percentage of visits where billable units do not exceed scheduled units
- Percentage of schedules that remain within authorization limits
Tracking this agency performance indicator over time helps you determine whether:
- Compliance is improving
- Operational quality is increasing
- Audit risk is rising or falling
Improving EVV adherence is a clear signal of a high-performing agency.
Improve Your Agency’s Performance Without Adding More Work
Collecting and analyzing all of these agency performance metrics can be time-consuming—but it doesn’t have to be.
Chat with Aarron, our GEOH specialist, to learn exactly how GEOH can support your agency’s performance and growth!
