The medical landscape is changing due to technological advancements and ever-changing policies. While technology adoption is easily manageable, policy adherence is often complicated, confusing, and disrupts workflow. Back in 2016, the 21st Century Cures Act (2016 Cures Act) was signed into action. This act served as a dedication to effective patient care, specifically applying to Personal Care Services (PCS) and Home Healthcare Services (HHCS). In accordance with the Cures Act, agencies were required to implement an Electronic Visit Verification (EVV) for all state Medicaid-funded in-home services including attendant care, home-making, daily function assistance, and even skilled nursing services.
Under the Cures Act, states mandated the use of EVV and thus agencies were required to select a model from the provided list, and select the preferred method of data gathering (software system, phone/landline, or EVV device). After the model and method were selected, the providers of a given agency were to input data for each client visit including the electronic verification of six elements: type of service, name of the care receiver, name of the provider, date of service, location, and timestamp of clock-ins and clock-outs.
While PCS agencies nationwide were required to adopt EVV systems by January 1, 2020, that was not the case.
The Current State of Electronic Visit Verification
As states began institutionalizing their approaches, it soon became apparent that the 2020 goal would not be reached by the majority of states. The first state to file for a Good Faith Effort (GFE) exemption from federal fines was Wisconsin. One by one, other states followed suit, each State Department of Human Services filing GFEs and awaiting the Center for Medicare and Medicaid Services (CMS) approval. As of December 2019, 49 of the 50 states received approval for GFE exemptions. Tennessee was the only state who reached the 2020 goal.
Going forward, the Cures Act will expand to apply to HHCS and its adoption deadline is set for January 1, 2023.
Adapting to a Changing Medical Care Landscape
Whether you’re a PCS provider catching up on mandated EVV adoption or an HHCS agency preparing for the 2023 adoption deadline, adapting to the new medical landscape is inevitable. The first step is adapting to the state-decided EVV model.
The model options include:
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Open Vendor:
- Self-selected vendors which integrate with a state’s data aggregator.
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State-Mandated External Vendor:
- State-sponsored/funded vendors.
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State-Mandated In-House System:
- Self-built EVV system which all state providers must use.
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Provider Choice:
- Vendor at personal expense.
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Managed Care Organization Choice
- MCOs select and pay vendors at their own expense.
The second part of adapting to new requirements is to implement a state-wide EVV system reporting method. The options include:
- A mobile app with GPS technology
- Phone/landline which providers use to call a toll-free number to verbally input data
- A Fixed Verification Visit involves agencies providing or lending EVV devices which cost an estimated $85 per unit.
While policy changes are often complicated and confusing, they don’t have to be. Agencies can streamline the policy adoption process by integrating a third-party EMR solution. Implementing home health software allows agencies to seamlessly integrate EVV systems with other operational management systems, creating one ecosystem for all records, scheduling, documentation, and more. These robust EMR systems can help your agency increase productivity and efficiency while helping you seize opportunities for growth.
Your Solution for Tackling Electronic Visit Verification
KanTime is a reputable EMR software that offers an EVV feature to assist in recording patient care. Investing in a digital ecosystem for agency operations can help ease the process of understanding, transitioning, and rolling out required EVV initiatives. For agencies that operate across state lines, KanTime ensures EVV data transmission, assists in clinical guideline compliance, and optimizes operational workflow.
By investing in advanced integrative software, your agency can effectively minimize fraudulent care claims, reduce human entry error, and enhance scheduling. To learn more about how KanTime can help you adapt to the changing medical landscape, visit our website to request a demo.
