# The Role of Virtual Care in Improving Primary Care Access and Continuity for At-Risk Multimorbid Older Adults

> **NIH NIH K23** · BRIGHAM AND WOMEN'S HOSPITAL · 2021 · $168,204

## Abstract

Project Summary/Abstract
This K23 award will establish Ishani Ganguli MD, MPH as a clinician-investigator focused on
how care delivery and payment innovation can advance high-value outpatient care and better
outcomes for older adults. Dr. Ganguli is an Assistant Professor of Medicine and primary care
physician at Harvard Medical School and Brigham and Women’s Hospital. Building on her
clinical training, methods coursework, and experiences studying care innovation and leading it
at an Accountable Care Organization (ACO), this award will allow her to develop expertise in (1)
how aging needs, especially for those with multimorbidity and Alzheimer’s Disease (AD) and
AD-related dementias (AD/ADRD), can be met through outpatient care innovation, (2) advanced
quantitative methods, and (3) claims-linked electronic health record (EHR) data analysis. To
achieve these goals, Dr. Ganguli has assembled a team with expertise in health services
research on care innovation (Drs. Ateev Mehrotra, Thomas Sequist), geriatrics (Dr. Christine
Ritchie), primary care (Drs. Meredith Rosenthal, Joshua Metlay), quantitative methods (Drs. E.
John Orav, J. Michael McWilliams, Craig Pollack), and EHR data analysis (Dr. Christine Vogeli).
Primary care access and continuity of care improve outcomes for multimorbid older adults, so a
recent decline in primary care office visit rates – likely due in part to barriers attending these
visits – raises concerns. Virtual care may enable access and continuity. But we do not know
which groups faced office visit barriers pre-dating the Covid-19 pandemic nor how post-
pandemic expansion of virtual care will affect primary care access or continuity for these groups.
To address these critical questions, Dr. Ganguli will first use the claims-linked Medicare Current
Beneficiary Survey to describe visit use and visit continuity of care (COC) associated with
reported trouble getting to the doctor’s office and whether adults with AD/ADRD or social risk
factors were at greater risk of this barrier (Aim 1). In Aim 2, using difference-in-differences
analysis of claims-linked EHR data in a large Medicare ACO, she will assess how post-
pandemic expansion of virtual care affects primary care use in these populations. In Aim 3, she
will use these claims-linked EHR data to develop a novel application of the COC measure
(“touch continuity,” which includes virtual care) and determine if it is associated with risk of
preventable hospitalizations. This work and training will provide the basis for a future R01
proposal of a quasi-experimental, multi-health system study of virtual primary care for
multimorbid older adults. This K23 award and future R01 will inform how to pay for and deliver
virtual care to promote high-value outpatient care and better outcomes for older adults.

## Key facts

- **NIH application ID:** 10215112
- **Project number:** 1K23AG068240-01A1
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Ishani Ganguli
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $168,204
- **Award type:** 1
- **Project period:** 2021-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10215112

## Citation

> US National Institutes of Health, RePORTER application 10215112, The Role of Virtual Care in Improving Primary Care Access and Continuity for At-Risk Multimorbid Older Adults (1K23AG068240-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10215112. Licensed CC0.

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