Read About the ECHO® Survey

The Experience of Care and Health Outcomes (ECHO) Survey asks about the experiences of adults and children who have received mental health or substance abuse services through a health plan in the previous 12 months. It is appropriate for patients with a range of service needs, including those with severe mental illness, but does not include questions about inpatient stays or self-help groups. The National Quality Forum endorsed this survey in July 2007.

The current version of the ECHO Survey is 3.0. The survey can be used for two types of organizations that are responsible for delivering behavioral health services:

  • Managed care organizations (MCOs). The MCO Survey asks enrollees about treatment, counseling, and administrative services, such as experiences filling out paperwork or finding information in written materials.
  • Managed behavioral healthcare organizations (MBHOs). The MBHO Survey asks enrollees primarily about treatment and services; only a few questions focus on administrative services.

To download these versions of the ECHO Survey and associated documentation, go to Get ECHO Survey and Instructions. Both the MCO and MBHO Surveys are available for adult and child populations. Supplemental items that can be used to customize the questionnaire are available for adults only.

Updating the survey: The CAHPS team is in the process of developing and testing updated items for the ECHO Survey. The updates will make the ECHO Survey more consistent with the 5.0 version of the CAHPS Health Plan Survey and other advances in consumer experience surveys. Consequently, the documentation available for this survey does not yet reflect recent changes (e.g., changes in administrative codes) or refinements in the instructions provided for newer CAHPS surveys.

Quality Measures from the ECHO Survey

The ECHO Survey for adults produce the following measures of patient experience:

  • Getting treatment quickly
  • How well clinicians communicate
  • Getting treatment and information from the plan (or MBHO)
  • Perceived improvement
  • Information about treatment options
  • Overall rating of counseling and treatment (MCO and MBHO)
  • Overall rating of the health plan (MCO only)

The first three composite measures are similar to measures in the CAHPS Health Plan Survey. The other two composite measures are unique to the ECHO Survey.

Ten questions that do not group well with other items can be reported as single-item measures:

  • Having to wait in the office.
  • Being told about medication side effects.
  • Including family and friends in treatment.
  • Getting enough information to manage the condition.
  • Getting information about patient rights.
  • Whether the patient feels that he or she can refuse treatment.
  • Privacy of information.
  • Cultural competency.
  • Helpfulness of counseling or treatment.
  • Getting treatment after benefits are used up.

Review measures from the ECHO Survey 3.0.

Measures for children. A set of measures from the child version of the surveys for children is not available. To develop your own measures, you can start with the reporting measures for adults and substitute comparable items from the instruments for children.

Brief History

The ECHO Survey is the result of a collaborative effort to evaluate and merge the original Consumer Assessment of Behavioral Health Survey (CAHBS) and the Mental Health Statistics Improvement Program (MHSIP) survey. The survey has been tested with a wide range of behavioral health consumers to ensure that the items are easily understood.

Learn about the development of the ECHO Survey.

Use of the ECHO Survey

Like the CAHPS Health Plan Survey, the ECHO Survey can be used for multiple purposes:

  • To improve the quality of mental health and substance abuse services;
  • To evaluate and monitor the quality of behavioral health care organizations; and
  • To hold providers accountable through public reporting.

Organizations interested in the ECHO Survey have included State Medicaid agencies, State mental health agencies, managed behavioral health organizations (MBHOs), and managed care organizations (MCOs).

Page last reviewed May 2016
Page originally created January 2012
Internet Citation: Read About the ECHO® Survey. Content last reviewed May 2016. Agency for Healthcare Research and Quality, Rockville, MD.