Catalyst for Payment Reform

Project ECHO is creating waves, employers should take notice

Project ECHO is creating waves, employers should take notice

What started as a localized solution for improving access to care in New Mexico has quickly spread through the country. By utilizing technology and embracing a knowledge-sharing culture, Project ECHO, or the Project Extension for Community Healthcare Outcomes, is seeing positive uptake as a method for expanding access to health care and reinventing the care delivery wheel within our current system. And as the largest collective body of health care purchasers, employers should have Project ECHO on their radar.

At its conception Project ECHO addressed a local need for hepatitis C care by linking local primary care physicians with the knowledge and support of specialist providers through telemedicine at the University of New Mexico in 2003. Project ECHO utilizes a hub and spoke tele-mentoring model. This approach focuses on the movement of knowledge, education, and mentorship to compensate for shortages in people, such as specialists in certain geographies. The so-called “hub” is an academic medical center with readily available specialist teams, like the University of New Mexico. The “spokes” are primary care clinicians that rely on the hub’s leadership and specialist knowledge to guide their care delivery on the ground.  The relationship between these academic medical centers and local primary care practices is intended to be an evolving, learning opportunity for both partners, through weekly virtual clinics, patient case studies, and treatment discussions, and to aid in delivering high-value health care locally, optimizing already existing community resources and personnel.

From Chicago to Albany, New York, and all the way to Oakland and Palo Alto, California, there are 175 ECHO hubs reaching thousands of communities in 46 states, so far. In addition to treating hepatitis C, providers are now using the ECHO model for cardiology care, bone health, chronic pain, opioid management, and other substance abuse, dementia, mental health, and HIV and AIDs treatment. While there is little evidence to date on the model’s cost and quality performance, the federal government embarked on a national study on the model with the goal to ultimately make Project ECHO a federally-funded service.

Overall, Project ECHO model of “moving knowledge, not people” pairs really nicely with the growing trend of employer-purchasers investing in primary care access and utilization. CPR sees a big opportunity for employer-purchasers to engage with Project ECHO, especially those with on-site or near-site clinics. Are you an employer-purchaser who has incorporated Project ECHO into the care delivery for your covered population? Let us know by emailing

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