A Novel Intervention for High-Need, High-Cost Patients: A Study of ECHO Care

Miriam Komaromy
Judy Bartlett
Sarah R. Gonzales-van Horn
Andrea Zurawski
Summers G. Kalishman
Yiliang Zhu
Herbert T. Davis
Venice Ceballos
Xi Sun
Martin Jurado
Kimberly Page
Allison Hamblin
Sanjeev Arora
Journal Article
January 2020

ECHO Care is a complex care intervention pilot that integrated the Project ECHO model, which links primary care practitioners virtually with specialists, with outpatient intensivist teams (OITs) in New Mexico. Under the ECHO Care pilot, 770 high-need, high-cost Medicaid patients received medical, behavioral, and social care from six OITs comprised of nurse practitioners or physician assistants, registered nurses, licensed mental health providers, and community health workers. During weekly videoconferences, the OITs received expert advice from specialists on complex topics using case-based mentoring.

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. Conversely, patient use of outpatient care increased by 23 percent and prescriptions increased by eight percent. This improvement in health care utilization indicates access to more effective care and higher levels of communication and trust between patients and their care teams.

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Population Addressed
Adults Under 65 with Disabilities
People with Advanced Illness
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
  • How can outpatient intensivist teams be used to reduce inpatient and emergency department utilization?
  • What supports can help increase the effectiveness of outpatient intensivist teams in improving care for patients with complex medical, behavioral health, and social needs?
Level of Evidence
What does this mean?