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Published in: Diabetes Therapy 3/2023

Open Access 21-01-2023 | Original Research

Project ECHO Diabetes Cost Modeling to Support the Replication and Expansion of Tele-mentoring Programs in Non-research Settings

Authors: Eugene M. Lewit, Lauren E. Figg, Ananta Addala, Stephanie L. Filipp, Rayhan Lal, Matthew J. Gurka, Jill Boylston Herndon, Michael J. Haller, David M. Maahs, Ashby F. Walker, for the Project ECHO Diabetes Research Team

Published in: Diabetes Therapy | Issue 3/2023

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Abstract

Introduction

Project ECHO Diabetes is a tele-education learning model for primary care providers (PCPs) seeking to improve care for patients with diabetes from marginalized communities. Project ECHO Diabetes utilized expert “hub” teams comprising endocrinologists, dieticians, nurses, psychologists, and social workers and “spokes” consisting of PCPs and their patients with diabetes. This Project ECHO Diabetes model provided diabetes support coaches to provide additional support to patients. We sought to estimate the costs of operating a Project ECHO Diabetes hub, inclusive of diabetes support coach costs.

Methods

Data from Project ECHO Diabetes from June 2021 to June 2022 and wages from national databases were used to estimate hub and diabetes support coach costs to operate a 6-month, 24-session Project ECHO Diabetes program at hubs (University of Florida and Stanford University) and spokes (PCP clinic sites in Florida and California).

Results

Hub costs for delivering a 6-month Project ECHO Diabetes program to five spoke clinics were $96,873. Personnel costs were the principal driver. Mean cost was $19,673 per spoke clinic and $11.37 per spoke clinic patient. Diabetes support coach costs were estimated per spoke clinic and considered scalable in that they would increase proportionately with the number of spoke clinics in a Project ECHO Diabetes cohort. Mean diabetes support coach costs were $6,506 per spoke clinic and $3.72 per patient. Total program costs per hub were $129,404. Mean cost per clinic was $25,881. Mean cost per patient was $15.03.

Conclusion

Herein, we document real-world costs to operate a Project ECHO Diabetes hub and diabetes support coaches. Future analysis of Project ECHO Diabetes will include estimates of spoke participation costs and changes in health care costs and savings. As state agencies, insurers, and philanthropies consider the replication of Project ECHO Diabetes, this analysis provides important initial information regarding primary operating costs.
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Literature
1.
go back to reference Walker AF, Cuttriss N, Haller MJ, Hood KK, Gurka MJ, Filipp SL, et al. Democratizing type 1 diabetes specialty care in the primary care setting to reduce health disparities: project extension for community healthcare outcomes (ECHO) T1D. BMJ Open Diab Res Care. 2021;9(1): e002262.CrossRefPubMedPubMedCentral Walker AF, Cuttriss N, Haller MJ, Hood KK, Gurka MJ, Filipp SL, et al. Democratizing type 1 diabetes specialty care in the primary care setting to reduce health disparities: project extension for community healthcare outcomes (ECHO) T1D. BMJ Open Diab Res Care. 2021;9(1): e002262.CrossRefPubMedPubMedCentral
2.
go back to reference Cuttriss N, Bouchonville MF, Maahs DM, Walker AF. Tele-rounds and case-based training. Pediatr Clin North Am. 2020;67(4):759–72.CrossRefPubMed Cuttriss N, Bouchonville MF, Maahs DM, Walker AF. Tele-rounds and case-based training. Pediatr Clin North Am. 2020;67(4):759–72.CrossRefPubMed
3.
go back to reference Walker AF, Hood KK, Gurka MJ, Filipp SL, Anez-Zabala C, Cuttriss N, et al. Barriers to technology use and endocrinology care for underserved communities with type 1 diabetes. Diabetes Care. 2021;44(7):1480–90.CrossRefPubMedPubMedCentral Walker AF, Hood KK, Gurka MJ, Filipp SL, Anez-Zabala C, Cuttriss N, et al. Barriers to technology use and endocrinology care for underserved communities with type 1 diabetes. Diabetes Care. 2021;44(7):1480–90.CrossRefPubMedPubMedCentral
4.
go back to reference Walker AF, Hu H, Cuttriss N, Anez-Zabala C, Yabut K, Haller MJ, et al. The neighborhood deprivation index and provider geocoding identify critical catchment areas for diabetes outreach. J Clin Endocrinol Metab. 2020;105(9):3069–75.CrossRefPubMedPubMedCentral Walker AF, Hu H, Cuttriss N, Anez-Zabala C, Yabut K, Haller MJ, et al. The neighborhood deprivation index and provider geocoding identify critical catchment areas for diabetes outreach. J Clin Endocrinol Metab. 2020;105(9):3069–75.CrossRefPubMedPubMedCentral
5.
go back to reference Walker AF, Addala A, Sheehan E, Lal R, Haller M, Cuttriss N, et al. Using peer power to reduce health disparities: implementation of a diabetes support coach program in federally qualified health centers. Diabetes Spectrum. 2022;35(3):295–303.CrossRefPubMed Walker AF, Addala A, Sheehan E, Lal R, Haller M, Cuttriss N, et al. Using peer power to reduce health disparities: implementation of a diabetes support coach program in federally qualified health centers. Diabetes Spectrum. 2022;35(3):295–303.CrossRefPubMed
6.
go back to reference Lal RA, Cuttriss N, Haller MJ, Yabut K, Anez-Zabala C, Hood KK, et al. Primary care providers in California and Florida report low confidence in providing type 1 diabetes care. Clin Diabetes. 2020;38(2):159–65. Lal RA, Cuttriss N, Haller MJ, Yabut K, Anez-Zabala C, Hood KK, et al. Primary care providers in California and Florida report low confidence in providing type 1 diabetes care. Clin Diabetes. 2020;38(2):159–65.
7.
go back to reference Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, et al. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011;364(23):2199–207. Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, et al. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011;364(23):2199–207.
11.
go back to reference Rattay T, Dumont IP, Heinzow HS, Hutton DW. Cost-effectiveness of access expansion to treatment of hepatitis C virus infection through primary care providers. Gastroenterology. 2017;153(6):1531-1543.e2. Rattay T, Dumont IP, Heinzow HS, Hutton DW. Cost-effectiveness of access expansion to treatment of hepatitis C virus infection through primary care providers. Gastroenterology. 2017;153(6):1531-1543.e2.
12.
go back to reference Cantor JC, Chakravarty S, Farnham J, Nova J, Ahmad S, Flory JH. Impact of a provider tele-mentoring learning model on the care of Medicaid-enrolled patients with diabetes. Med Care. 2022;60(7):481–7. Cantor JC, Chakravarty S, Farnham J, Nova J, Ahmad S, Flory JH. Impact of a provider tele-mentoring learning model on the care of Medicaid-enrolled patients with diabetes. Med Care. 2022;60(7):481–7.
13.
go back to reference Blecker S, Paul MM, Jones S, Billings J, Bouchonville MF, Hager B, et al. A Project ECHO and community health worker intervention for patients with diabetes. Am J Med. 2022;135(5):e95-103.CrossRefPubMed Blecker S, Paul MM, Jones S, Billings J, Bouchonville MF, Hager B, et al. A Project ECHO and community health worker intervention for patients with diabetes. Am J Med. 2022;135(5):e95-103.CrossRefPubMed
Metadata
Title
Project ECHO Diabetes Cost Modeling to Support the Replication and Expansion of Tele-mentoring Programs in Non-research Settings
Authors
Eugene M. Lewit
Lauren E. Figg
Ananta Addala
Stephanie L. Filipp
Rayhan Lal
Matthew J. Gurka
Jill Boylston Herndon
Michael J. Haller
David M. Maahs
Ashby F. Walker
for the Project ECHO Diabetes Research Team
Publication date
21-01-2023
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 3/2023
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-022-01364-3

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