Cantwell Highlights Huge Coverage Benefits from Medicaid Expansion and Growing Need for Telemedicine to Boost Rural Healthcare

Cantwell-cosponsored ECHO Act is advancing innovative telemedicine program

WASHINGTON, D.C. – As rural communities across the country continue to face significant challenges in accessing high-quality, affordable healthcare, U.S. Senator Maria Cantwell (D-WA) today emphasized the importance of Medicaid expansion and innovative healthcare solutions, like telemedicine, in providing care to rural communities across Washington state.

“Access to healthcare through the Medicaid expansion was big in rural communities in my state. At large, 600,000 people in our state got expanded coverage,” Senator Cantwell said in a Senate Finance Committee hearing on rural healthcare. “Counties like Douglas and Chelan… have seen an uninsured rate drop by more than 60 percent thanks to that.”

In the hearing, Senator Cantwell also highlighted Project ECHO, a program being led in Washington state by the University of Washington’s (UW) health system. Project ECHO facilitates connections between doctors and other healthcare providers around the state to provide care, consultation, and ongoing professional development opportunities.

“Telemedicine… is another delivery system that… allow[s] medical professionals from Seattle to consult with people over in the Yakima Basin to talk about the decisions for highly complex patients,” Senator Cantwell said.

In her questions, Senator Cantwell highlighted ongoing medical provider shortages in rural communities. The Expanding Capacity for Health Outcomes (ECHO) Act, legislation she cosponsored to increase access to high-quality healthcare in rural America, was signed into law in December 2016 after being unanimously approved by the Senate.

“The doctor shortage for our rural communities continues, and we just need to fight that,” said Senator Cantwell. “We have counties in our state that have 4,000 people and no [healthcare] access. So we’ve got to do better.”

The ECHO Act is based on an innovative telemedicine healthcare delivery model, Project ECHO. One of the first states to implement the Project ECHO model in 2008, Washington has so far connected more than 1,000 rural hepatitis C patients with the expert specialty care they need but have difficulty accessing. UW Medicine’s Harborview Medical Center in Seattle has been a national leader in implementing Project ECHO.

Project ECHO uses interactive videoconferencing to link specialist teams in academic medical centers (“hubs”) with primary care providers (“spokes”) in rural and underserved areas. Together, they participate in weekly teleECHO clinics that combine teaching with mentoring and case-based learning. Through Project ECHO, physicians are able to share knowledge and coordinate the care of medically-complex patients.

After its introduction to Washington state, the ECHO model was expanded to address a range of conditions including chronic pain and heart failure, as well as diseases like tuberculosis, multiple sclerosis, and substance abuse disorders. Project ECHO has made especially significant progress in the fight against HIV/AIDS in rural and tribal communities.

Senator Cantwell’s commitment to improving rural healthcare stretches back almost seventeen years.  She cosponsored the Rural Health Innovation Act of 2001, which sought to erase inequities in the Medicare system for rural providers and standardize reimbursement amounts for all providers, whether urban or rural. More recently, in December 2016, Cantwell helped pass legislation ensuring that rural Medicare beneficiaries can continue to access services like blood draws and blood transfusions at their local hospitals, and legislation to promote Medicare Accountable Care Organizations (ACOs) in rural areas.