# Telemedicine Utilization and Impacts on Access Among Rural Medicare Beneficiaries

> **NIH NIH K08** · UNIVERSITY OF PENNSYLVANIA · 2021 · $169,884

## Abstract

PROJECT SUMMARY / ABSTRACT
Candidate: Krisda H. Chaiyachati, MD, MPH, MSHP is a general internist and early-stage health services
investigator passionate about improving access to health care and health outcomes for vulnerable, older, rural
adults. He seeks content expertise in aging research and training in health economics to transition him towards
independence and catalyze his career path towards improving health care access for older adults.
Research Context: Rural, older Americans are facing an acute access crisis as fewer primary care providers
and specialists work in rural areas to care for an increasingly older, poorer, sicker population. Telemedicine
has been proposed as one solution to help overcome access barriers, but whether it is achieving this wanted
outcome is unknown. Within fee-for-service Medicare plans—the most common insurance for rural, older
Americans—telemedicine has been growing 128% per year since 2004. Understanding whether rural, older
Americans with limited access have used telemedicine, how these visits have altered access, and whether
telemedicine use reduces emergency department visits or hospitalizations remain fundamental questions for
policymakers and providers if telemedicine is going to be promoted as a valuable way to deliver health care.
Specific Aims: (1) Measure the association between telemedicine use and barriers to in-person care: residing
in a county with fewer providers, having geriatric conditions, or living below the federal poverty level; (2)
measure whether initial specialty telemedicine visits were follow-up visits or first-time visits and the association
between barriers to in-person care and the frequency of follow-up or first-time telemedicine visits; and (3)
measure the association between telemedicine use and subsequent acute care visits (emergency departments
or hospitalizations), particularly among patients with geriatric conditions.
Research Plan: To accomplish these aims, Dr. Chaiyachati will learn and develop quasi-experimental,
econometric techniques to empirically analyze a large administrative datafile containing 2010-2018 fee-for-
service Medicare Part B enrollees combined with provider supply measures, patient sociodemographics, and
geographic indicators (e.g., rurality, broadband access, and transportation).
Career Development Plan: Dr. Chaiyachati will (1) concentrate his passion and perspective on the needs of
older adults; (2) develop expertise in analytic methods used by health economists to study large administrative
datafiles; and (3) develop expertise in how telemedicine is being used and its impact in real-world settings. Dr.
Chaiyachati's career development will be supported by close mentorship from international experts in
geriatrics, health economics, telemedicine, and health policy.
Environment: The University of Pennsylvania offers the ideal environment for him to pursue this training, with
well-established mentors dedicated to his success and it is a well-resourced, ...

## Key facts

- **NIH application ID:** 10126471
- **Project number:** 1K08AG065444-01A1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Krisda H Chaiyachati
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $169,884
- **Award type:** 1
- **Project period:** 2021-01-15 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10126471

## Citation

> US National Institutes of Health, RePORTER application 10126471, Telemedicine Utilization and Impacts on Access Among Rural Medicare Beneficiaries (1K08AG065444-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10126471. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*