Watch for Electronic Visit Verification Rules in Your State
Posted On: July 5th, 2017
Vice President of Product Management, Change Healthcare
After fits and starts in as many as 17 states, the 21st Century Cures Act was signed into law during the waning days of the Obama administration. Under the new law, electronic visit verification (EVV) is expected in all states by 2023 for Medicaid home health providers.
If your organization wants to have input into what technology is adopted for compliance in your state, you should closely follow the law’s implementation. If you don’t, your organization may not have a choice of what vendor to use, which could increase your compliance burden and hurt your bottom line.
EVV plusses and minuses
The Affordable Care Act first brought EVV to the forefront. On one hand, a robust EVV system can help ensure that home health organizations and their employees are providing care and charging Medicaid appropriately. Home care comprises just 3% of total healthcare spending, according to the Kaiser Family Foundation, but, as an industry, we should applaud efforts to curb fraud and help ensure that healthcare dollars are spent wisely.
On the other hand, more than one-half the jurisdictions that already have EVV for some services are mandating the use of specific equipment to document visits. If the verification system you are required to use does not integrate with your agency management system, this creates another layer of bureaucracy that brings more documentation headaches. How does that benefit patients?
Choices for states
We are firm believers in the value of electronic visit verification, which is why we have mature verification products that use a patient’s phone or an aide/clinician mobile device and integrate seamlessly with McKesson home health software. We also can create an interface between a third-party EVV system vendor to McKesson Homecare™ because we do not believe that specific technology should be mandated for compliance.
Seventeen states have some form of EVV for home health. Those states are Connecticut, Florida, Illinois, Iowa, Kansas, Mississippi, Missouri, New Mexico, New York, Ohio, Oklahoma, Oregon, Rhode Island, Texas, South Carolina, Tennessee and Washington.
The best option, from our viewpoint, is an open model system. States specify what information will be required for EVV compliance, and home health organizations use whatever technology they want to provide it. Application program interfaces (APIs) can connect the EVV system to the state collection technology. Some states have multiple EVV vendors from which to choose, while others have a single vendor. Ultimately, we believe all EMR vendors that provide services in the homecare space should offer this service within their products. With this approach, states would not need to fund one vendor specifically; rather, it simply would be a standard.
It remains unclear how states will implement EVV, but the federal government is expected to fund 90% of the costs associated with the development of an EVV system, as well as 75% of operational and maintenance costs.
To avoid being locked into a single system that may not be compatible with your home care organization’s software, closely watch EVV developments in your state and make your voice heard.