Sandata vs. HHAeXchange: The Ultimate EVV Showdown (2026)
If you bill Medicaid for home care or personal care services, it is mathematically impossible to avoid them. Sandata and HHAeXchange are the undisputed giants of the Electronic Visit Verification (EVV) industry.
Together, they hold the contracts to act as the official “State Aggregator” for dozens of state Medicaid programs. But they aren’t just aggregators—they also sell enterprise-grade agency management software directly to providers.
So, if your state mandates one of these systems, should you use their software? And if you have a choice, which one is actually better? In this showdown, we break down the pros, the cons, and the secret third option most agencies ignore.
At a Glance: Sandata vs. HHAeXchange
| Feature | Sandata | HHAeXchange | Winner |
|---|---|---|---|
| Best For | Extreme Compliance | MCO Network Integrations | HHAeXchange |
| UI/UX (Ease of Use) | Outdated / Clunky | Dense, but functional | HHAeXchange |
| Caregiver App | Average | Above Average | HHAeXchange |
| Customer Support | Historically Slow | Slow | Tie (Both struggle here) |
| Open Vendor API | Excellent | Very Good | Sandata |
Understanding the “State Aggregator” Monopoly
Before we compare the software, you must understand how these companies operate. When the federal government passed the 21st Century Cures Act, states had to find a way to collect GPS clock-in data from thousands of agencies. States like Ohio and Texas hired Sandata to build a massive database. States like New York and New Jersey hired HHAeXchange.
Because they hold the state contracts, they offer a “Free” basic version of their software to agencies in those states to log EVV.
Expert Advice: Never use the free state-provided software. It lacks scheduling algorithms, payroll engines, and advanced billing modules. You cannot run a scalable business on the free version.
1. Sandata: The Compliance Behemoth
Sandata has been in the home care space for over 40 years. They are deeply entrenched in the Medicaid compliance ecosystem.
Why Agencies Use Sandata
- Audit-Proof: If you use Sandata Agency Management, your EVV data is perfectly formatted for the state (because Sandata is the state).
- Open Vendor API: Sandata has spent years perfecting their API. If you want to use a third-party software (like CareSoftPro or AxisCare), Sandata makes it incredibly easy for that software to push EVV data into the state database.
The Drawbacks
- The Interface: The administrative dashboard feels like it was built in 1998. It requires dozens of clicks to complete simple scheduling tasks.
- Customer Support: When an agency has hundreds of denied claims stuck in the Sandata aggregator, getting a human on the phone to resolve the API error can take days.
2. HHAeXchange: The MCO Powerhouse
HHAeXchange dominates the Northeast (particularly New York and New Jersey) and has rapidly expanded nationwide. They positioned themselves as the ultimate bridge between the agency and the Managed Care Organization (MCO).
Why Agencies Use HHAeXchange
- Direct MCO Routing: HHAeXchange integrates directly with the massive MCOs that manage Medicaid (e.g., Centene, Fidelis). It routes the EVV data directly into an 837P claim and shoots it straight to the payer.
- The “Linked” Ecosystem: In many states, MCOs broadcast available patient cases directly into the HHAeXchange portal. Agencies can accept new patients with a single click.
The Drawbacks
- Rigidity: The software is designed for enterprise-level compliance, making it feel incredibly rigid for a smaller agency trying to adjust a schedule on the fly.
- The Caregiver App: While slightly better than Sandata’s, caregivers frequently report issues with the app freezing during clock-outs in low-connectivity areas.
The Secret Third Option: The “Bring Your Own Software” Model
Here is the secret that neither Sandata nor HHAeXchange wants you to know: In most states, you do not have to use their software.
If you live in an “Open Vendor” state, the law states that you must send your EVV data to the aggregator (Sandata or HHAeXchange), but it does not dictate how you collect it.
You can purchase a much faster, cheaper, and modern software platform (like CareSoftPro or AxisCare), and they will automatically push the EVV data to the state aggregator in the background via API.
This allows you to enjoy modern scheduling algorithms, beautiful family portals, and bulletproof offline mobile apps, while remaining 100% compliant with the state mandate.
Final Recommendation: Which Should You Choose?
If you are a massive, multi-state enterprise agency that relies heavily on MCO referrals, HHAeXchange is the clear winner. Its ability to ingest patient broadcasts directly from the payer is a massive operational advantage.
If you are a mid-sized or small agency, do not buy either of them.
Take advantage of the Open Vendor model. Purchase a modern, agile home care software platform that integrates with your state’s aggregator. You will get better customer support, a better mobile app for your caregivers, and a platform that actually helps you grow.