It’s about outcomes, keeping severely sick patients out of the hospital and containing health care costs in New Mexico.
While 25,000 severely sick New Mexicans on Medicaid make up just 5 percent of the state’s 500,000 Medicaid patients, their bills make up more than half of the state’s $4 billion in Medicaid costs, according to UNM’s Dr. Sanjeev Arora.
Now, the University of New Mexico is launching a team approach to target 2,500 of these Medicaid patients who land in the hospital again and again, sending the public’s medical bill through the roof.
The new program, ECHO Care, will build on another innovative UNM program, Project ECHO, which uses teleconferencing to give primary care doctors access to UNM specialists for complex cases.
ECHO Care is funded by an $8.5 million federal grant and will start enrolling patients in the fall. The 2,500 ultimately will be cared for by 10 five-member teams across the state that will have responsibility for 250 patients each. UNM specialists will supervise each team, which will consist of a nurse practitioner or a physician assistant, a registered nurse, a counselor and two community health workers. Their salaries will be paid by Medicaid managed care organizations in New Mexico.
The teams will work out of Las Cruces, Farmington, Santa Fe, Albuquerque, Española, Las Vegas and other locations around the state.
Implementation of the Affordable Care Act is expected to put new pressures on an already burdened health care system – and 170,000 more New Mexicans are expected to enroll in Medicaid.
This is definitely the time to try innovative ideas to handle the tide of newly insured patients. But ECHO Care shouldn’t be just another program that sounds good. UNM needs to track and report on how well these patients progress, whether the program really is keeping them out of the hospital and whether it really saves money. And how much.
This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.