Created in 1965, Medicaid is the single largest source of funding for medical and health-related services for people with limited income in the U.S. In 2011, Federal Medicaid outlays totaled more than $260 billion. Incredibly, 57% of outlay dollars went to 5% of Medicaid patients. That's a lot of money to care for a very small percentage of patients.
To better equalize this "imbalance," UNM Health Sciences Center's Project ECHO (Extension for Community Healthcare Outcomes) was awarded nearly $8.5 million over the next three years from the U.S. Department of Health and Human Services (HHS) as part of its Health Care Innovation awards.
The award is administered through HHS's Center for Medicare and Medicaid Innovation, and estimated to save more than $11 million in health care costs over the same time period. The department says Innovation awardees were selected for offering creative solutions to health care challenges facing their communities and a focus on creating a well-trained health care workforce.
Under the grant, UNM will identify 5,000 high-cost, high-utilization, high-severity patients in New Mexico and Washington State, and use a team of outpatient "intensivists" trained to care for complex patients with multiple chronic diseases, working with area managed care organizations and care providers.
"The federal government is looking for new ideas to reform health care; to improve our health, while reducing costs," relates Sanjeev Arora, MD, professor of Internal Medicine at UNM, and creator and director of Project ECHO. "This small group of very complex patients, who often combine diabetes and cardiovascular disease with mental health and substance abuse issues, needs more than a single physician. We will develop and train outpatient medical teams comprised of nurse practitioners, case managers, counselors and community health workers to integrate their care, thus improving their quality of care while reducing emergency room visits and hospitalizations."
Project ECHO will train as many as 120 workers to help increase primary care capacity to treat and manage complex patients. "Clinics and medical groups throughout New Mexico and Washington State will develop their own teams of medical intensivists and link through Project ECHO," Arora adds. "These hyper-trained specialists will be developed, for example, within First Choice, Presbyterian, El Centro and other providers in New Mexico. There's tremendous potential to improve health outcomes for this small patient population, while significantly lessening their burden on the system."
The Centers for Medicare and Medicaid Services received approximately 3,000 applications for the Health Care Innovation Awards from across the U.S. HHS has awarded 107 projects that are estimated to save the health care system nearly $2 billion over the next three years.
Project ECHO is an internationally acclaimed program developed within the School of Medicine in 2003 to improve rural and frontier access to specialty care for New Mexico patients. The program has experienced great success in improving patient access and health outcomes, and in training community health care providers. ECHO is evolving into an equally powerful model for conducting biomedical participatory research.