The Expanding Capacity for Health Outcomes (ECHO) Act (S. 2873)

Introduced by Senators Hatch and Schatz

Rural Health Challenges

Only about 10 percent of physicians practice in rural areas of the United States despite nearly one-fourth of the population living in these areas. 

Rural areas have higher rates of some chronic diseases and face many challenges, including transportation, connectivity, and isolation. 

It is difficult to recruit health care providers to work in rural and underserved areas, and opportunities for professional development and support in such areas can be difficult.

Project ECHO Model 

Project Extension for Community Health Outcomes (ECHO) is an innovative continuing medical education model that uses interactive videoconferencing to link specialist teams ("hubs") with primary care providers ("spokes") in rural and underserved areas. Together, they participate in weekly teleECHO clinics that combine didactic teaching with mentoring and case-based learning. 

Demonstrated uses of Project ECHO have been numerous and include:

Addressing disease conditions and topic areas, including hepatitis C, integrated addictions and psychiatry, chronic pain/headache management, and diabetes; 

A complex care program offering support to multidisciplinary teams providing primary and behavioral health care to high-need, high-cost patients; and 

Public health interventions, including addressing H1N1, HIV, and tuberculosis as well as improving health and wellness within Native American populations.

Benefits of Project ECHO model for: 

Patients: Improved access to quality and accessible care, with high patient satisfaction 

Providers: Increased knowledge for providers in rural/underserved areas, with ability to serve as a local resource; improved provider network; enhanced professional satisfaction and reduced isolation; more access to specialists. 

Health care system: Higher retention of providers in rural/underserved areas; better care delivered in the right place at the right time by the right person; decreased costs (less travel for specialty visits, less hospitalizations and ER visits, better quality of care close to home, and treatment of chronic diseases earlier before complications arise). 

Current health care challenges: Project ECHO has successfully been used to increase the number of physicians able to prescribe buprenorphine for opioid abuse, to quickly educate health providers on public health crises such as H1N1, and to train providers to address complex mental health disorders.

2873, the Expanding Connectivity for Health Outcomes (ECHO) Act

The ECHO Act aims to better integrate the Project ECHO model—referred to as a “technology-enabled collaborative learning and capacity-building model”—into health systems across the country. The bill does the following:

Requires the Secretary of the U.S. Department of Health and Human Services (HHS), in collaboration with the Health Resources & Services Administration (HRSA), to prioritize analysis of the model, its impacts on provider capacity and workforce issues, and evidence of its effects on quality of patient care. 

Requests a GAO report regarding opportunities for increased adoption of such models, efficiencies and potential cost savings from such models, ways to improve health care through such models, and field recommendations to advance the use of such models. 

Requires the HHS Secretary to submit a report to Congress on the findings of the GAO report and the HHS report, including ways such models have been funded by HHS and how to integrate these models into current funding streams and innovative grant proposals.


American Academy of Neurology
American Medical Association (AMA)
Association for Behavioral Health and Wellness
Healthcare Information and Management Systems Society (HIMMS)
Healthcare Leadership Council
National Association of ACOs
National Association of Community Health Centers
National Rural Health Association
Project ECHO, University of New Mexico School of Medicine
University of Utah Health Care, University of Utah
University of Hawaii John A. Burns School of Medicine