skip to content
Primary navigation

Evaluation of Opioid-Focused ECHO Programs in Minnesota

In recent years, Minnesota has invested in meeting the pressing need for services to prevent opioid use disorder (OUD) and to treat and assist in recovery for individuals who experience it. One investment was in Project ECHO, a tele-mentoring program that, in Minnesota, has focused on expanding capacity for treating OUD in primary care settings. Each ECHO program consists of a “hub” where specialists work in an interdisciplinary team and “spokes” (typically providers in rural or underserved areas, or primary care providers who do not have specialized training in treating a particular illness) who connect to the hub through regular videoconferences for didactic and case-based learning. 

This study assesses the causal impact of the two largest and longest-persisting ECHOs in Minnesota, Hennepin Healthcare and Catholic Health Initiatives (CHI) – St. Gabriel’s, on primary care provider prescribing behaviors and patient outcomes. The primary goal of these ECHOs was to teach providers to appropriately provide medications for opioid use disorder (MOUD), especially buprenorphine. MOUD are evidence-based treatments for substance use disorders that, when paired with counseling, are the most effective way to treat OUD and reduce overdoses (SAMHSA, 2021). 

This novel analysis used Medicaid data to compare, over the course of 18 months, providers who participated in ECHO with like providers who did not participate. We also examined the outcomes of these providers’ patients. Overall, the impact of the two Minnesota ECHO hubs on MOUD prescribing was very promising. We find:

  • Providers who attended one or more ECHO sessions were more likely to provide buprenorphine to their patients with OUD than comparison providers at 6, 12, and 18 months after ECHO. For every 100 OUD patients that providers saw per month, ECHO providers prescribed buprenorphine for 6.5 more patients than comparison providers.
    • Providers who attended six or more ECHO sessions had the greatest growth in prescribing MOUD, suggesting that strong participation is important for seeing benefits from ECHO.
  • Patients with a history of OUD who saw an ECHO-trained provider were more likely to receive buprenorphine prescriptions 6, 12 and 18 months after their initial visit with that provider (a 4.2 percentage point net increase at 18 months), relative to patients who saw a comparison provider.
  • Both ECHO and comparison providers substantially decreased the amount of opioid analgesics they prescribed during the study period. The decreases were similar in scale for both groups.
  • There was no difference in OUD patients’ overall risk of receiving medical care for a nonfatal opioid overdose because of seeing an ECHO-trained provider. 

The positive impacts on MOUD prescribing are meaningful because ECHOs are currently reliant on non-permanent federal and state funding. Given this evidence and other prior research, we believe ECHOs can be part of a robust continuum of care—prevention, early intervention, treatment, and recovery services —that mitigates the harm of opioid addiction. 

Legislative Report

Peer-Reviewed Article – JAMA Health Forum

Project Registration Date:  

March 24, 2021

Project Status:  


Project Lead:  

Dr. Anna Solmeyer

Evaluation Priority Area:  

Opioid Epidemic Response

Project Pre-Registration

Project OSF Page

back to top