Dataset Information

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

ABSTRACT:

Background

A 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.

Objective

To 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.

Design

Using an interrupted time series analysis of Medicaid claims data, we measured healthcare utilization and expenditures before and after ECHO Care.

Participants

ECHO 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.

Intervention

ECHO 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 results

ECHO 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.

Conclusions

ECHO 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.

SUBMITTER: Komaromy M

PROVIDER: S-EPMC6957626 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

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

Komaromy Miriam M Bartlett Judy J Gonzales-van Horn Sarah R SR Zurawski Andrea A Kalishman Summers G SG Zhu Yiliang Y Davis Herbert T HT Ceballos Venice V Sun Xi X Jurado Martin M Page Kimberly K Hamblin Allison A Arora Sanjeev S

Journal of general internal medicine 20191030 1

<h4>Background</h4>A 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.<h4>Objective</h4>To 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 educa ...[more]

PMID: 31667743

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Dataset Information

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

Background

Objective

Design

Participants

Intervention

Main measures

Key results

Conclusions

Publications

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

Similar Datasets

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