Project ECHO®, a unique model for expanding access to specialty health care services, can bolster state Medicaid program efforts to improve care in underserved areas. With a handful of states using Medicaid funds to support Project ECHO, more states are interested in pursuing ECHO models to enhance services for at-risk populations.

This brief outlines an array of financing options, including approaches currently in use as well as new options, and highlights how four states — California, Colorado, New Mexico, and Oregon — leveraged Medicaid support for ECHO. It outlines design considerations for specific delivery system environments as well as broad considerations for long-term sustainability of Project ECHO approaches. The brief was developed by the Center for Health Care Strategies as part of the Project ECHO Medicaid Learning Collaborative, a multi-state learning collaborative to promote long-term Medicaid policy and financing strategies for Project ECHO in states across the country.