ArticleJournal of general internal medicine2020
A Novel Intervention for High-Need, High-Cost Medicaid Patients: a Study of ECHO Care.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Project ECHO Occupational and Environmental Medicine: A Qualitative Study of HealthCare Providers Supporting Workers with Work-Related Injuries and Illnesses.Journal of occupational rehabilitation · 2026Article
- Higher suicidality among primary care patients who have opioid use disorder and co-occurring depression and/or PTSD.BMC primary care · 2026Article
- Predicting high-need high-cost pediatric hospitalized patients in China based on machine learning methods.Scientific reports · 2025Article
- Project Extension for Community Healthcare Outcomes Intervention Evaluations: A Scoping Review of Research Methods.The Journal of continuing education in the health professions · 2025Article
- Implementation, intervention, and downstream costs for implementation of a multidisciplinary complex pain clinic in the Veterans Health Administration.Health services research · 2024Article
- Interprofessional collaboration between social workers and community health workers to address health and mental health in the United States: A systematised review.Health & social care in the community · 2022Review
- Substance Use-related Emergency Department Visits and Resource Utilization.The western journal of emergency medicine · 2022Article
- High-cost high-need patients in Medicaid: segmenting the population eligible for a national complex case management program.BMC health services research · 2021Article
- Emerging models of care for individuals with multiple chronic conditions.Health services research · 2021Article
- Comparative Effectiveness of a Complex Care Program for High-Cost/High-Need Patients: a Retrospective Cohort Study.Journal of general internal medicine · 2021Article
- Design of CLARO (Collaboration Leading to Addiction Treatment and Recovery from other Stresses): A randomized trial of collaborative care for opioid use disorder and co-occurring depression and/or posttraumatic stress disorder.Contemporary clinical trials · 2021Article
- The Promise of Virtual Complex Care Management.Journal of general internal medicine · 2020Article
- ECHO Care: Providing Multidisciplinary Specialty Expertise to Support the Care of Complex Patients.Journal of general internal medicine · 2020Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA small number of high-need patients account for a disproportionate amount of Medicaid spending, yet typically engage little in outpatient care and have poor outcomes.
objectiveTo address this issue, we developed ECHO (Extension for Community Health Outcomes) Care™, a complex care intervention in which outpatient intensivist teams (OITs) provided care to high-need high-cost (HNHC) Medicaid patients. Teams were supported using the ECHO model™, a continuing medical education approach that connects specialists with primary care providers for case-based mentoring to treat complex diseases.
designUsing an interrupted time series analysis of Medicaid claims data, we measured healthcare utilization and expenditures before and after ECHO Care.
participantsECHO Care served 770 patients in New Mexico between September 2013 and June 2016. Nearly all had a chronic mental illness, and over three-quarters had a chronic substance use disorder.
interventionECHO Care patients received care from an OIT, which typically included a nurse practitioner or physician assistant, a registered nurse, a licensed mental health provider, and at least one community health worker. Teams focused on addressing patients' physical, behavioral, and social issues. MAIN MEASURES: We assessed the effect of ECHO Care on Medicaid costs and utilization (inpatient admissions, emergency department (ED) visits, other outpatient visits, and dispensed prescriptions. KEY
resultsECHO Care was associated with significant changes in patients' use of the healthcare system. At 12 months post-enrollment, the odds of a patient having an inpatient admission and an ED visit were each reduced by approximately 50%, while outpatient visits and prescriptions increased by 23% and 8%, respectively. We found no significant change in overall Medicaid costs associated with ECHO Care.
conclusionsECHO Care shifts healthcare utilization from inpatient to outpatient settings, which suggests decreased patient suffering and greater access to care, including more effective prevention and early intervention for chronic conditions.
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