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Senate to vote on rural health access bill

  • Legislation introduced by Sens. Hatch and Schatz.
  • Bill helps primary care physicians learn about complex diseases from specialists.

The Senate will vote today on legislation requiring the government to study increasing access to specialty care in rural areas, and the legislation is expected to pass the chamber, a Senate Democratic spokesman told The Hill Extra.

Expanding Capacity for Health Outcomes Act — ECHO — (S. 2873) aims to interweave a model of continuing medical education into more areas of the country, as accessing specialist care can be particularly difficult in rural areas.

The Senate Democratic spokesman wrote in an email that there hadn’t previously been objections to the measure, and thus, expects it to pass.

Started in 2003, Project ECHO (Extension for Community Healthcare Outcomes) links primary care physicians in underserved areas to those who specialize in complex diseases, such as hepatitis C, chronic pain, behavioral health. Both participate in video conferences, where the primary care physicians are able to learn from the specialists to better care for patients in remote areas.

Currently, there are more than 100 hubs that help primary care physicians, Sanjeev Arora, Project ECHO director, told The Hill Extra.

The ECHO Act requires the Department of Health and Human Services to analyze the model’s effect on provider capacity and workforce issues and how it impacts patient care.

Additionally, it requests a report from the Government Accountability Office on increasing the use of this model, potential cost savings and more. It also requires the HHS secretary to submit a report to Congress on its and GAO’s findings.

The American Medical Association and the National Association of Community Health Centers lauded the bill in a press release announcing its introduction in April. The bill (H.R. 5395) was also introduced in the House in June, and a House Republican spokeswoman expressed confidence the Senate would support the measure and hope that it will be brought up on the House floor.

ECHO’s inception.
In the early 2000s, Arora — who is a distinguished professor of medicine at the University of New Mexico — had an eight-month waitlist for patients diagnosed with hepatitis C to see him in his clinic. Patients were driving from hundreds of miles away to receive treatment, he told The Hill Extra, because there weren’t specialists in rural areas available to treat them.

Thus, the concept of ECHO was born, using technology to help primary care physicians learn how to treat patients with hepatitis C. In less than two years, Arora’s waitlist whittled from eight months to two weeks, he said.

“We developed ECHO to bring access to care to everyone with hepatitis C in
New Mexico,” Arora said. “We knew if we could do that … we could have a model to treat complex diseases in rural locations and developing countries.”

Sen. Brian Schatz (D-Hawaii) and Sen. Orrin Hatch (R-Utah) introduced the measure, and Arora said he was “really, really surprised that they were interested, and just very grateful.”

“Having the Senate give its approval of the model and for it to be studied by the government can be a big game changer for us,” he said.

Community Health Center, Inc., in Connecticut, runs its own ECHO sessions, where specialists help teach providers in rural areas. Its president and CEO, Mark Masselli, told The Hill Extra that ECHO is a good tool to help manage complex diseases. He said he’s “excited about the legislation” and that it could help further the understanding of the method’s effectiveness.