January 2020 | Journal Article


ECHO Care, a complex care intervention pilot tested in New Mexico, was designed to improve care management and reduce unnecessary utilization for Medicaid beneficiaries with complex health and social needs. This Journal of General Internal Medicine article describes a study of the ECHO Care pilot, which involved 770 patients between September 2013 and June 2016. Nearly all patients enrolled had a chronic mental illness, and over three-quarters had a chronic substance use disorder.

Under the pilot, multidisciplinary outpatient intensivist teams (OITs) — typically including a nurse practitioner, registered nurse, licensed mental health provider, and at least one community health worker — provided care to high-need, high-cost Medicaid patients. Participating multidisciplinary care teams were supported using the Project ECHO model, which uses videoconferencing to connect specialists with primary care providers for case-based mentoring to address complex needs.

The study found that 12 months after enrolling in ECHO Care, patients were 50 percent less likely to have an inpatient admission or emergency department visit compared to pre-enrollment. In addition, patient use of outpatient care increased by 23 percent and prescriptions increased by eight percent.

The Center for Health Care Strategies (CHCS) helped to provide technical assistance for the innovation challenge award from the Center for Medicare and Medicaid Innovation that supported the ECHO Care pilot. Allison Hamblin, MSPH, CHCS president and CEO, is one of the authors of the study.