# The Atlanta Long COVID Collaborative: A Multi-Health System Long COVID Coordinated Care Model Serving a Diverse Metropolitan Population

> **NIH AHRQ U18** · EMORY UNIVERSITY · 2023 · $1,000,000

## Abstract

Project Summary
Long COVID is a highly prevalent disease that can lead to significant impairments in quality of life and
function. Poor care coordination has been identified as a key barrier to optimizing health outcomes in Long
COVID, resulting in increased healthcare costs and delays in care delivery. These challenges have profound
impacts on underserved, minority populations that have a long-standing history of poor access to affordable,
quality healthcare. Limited acceptance of Long COVID among clinicians and members of the community
contributes to delays in diagnosis and impacts triage to appropriate services. High rates of anxiety,
depression, and PTSD are observed in this population and behavioral health services are often limited and
disjointed. The Atlanta Long COVID Collaborative leverages the city’s coordinated COVID-19 and Long
COVID response, and brings together major academic and healthcare institutions in the Atlanta metro area,
including Emory Healthcare System, Grady Healthcare System, and Morehouse School of Medicine (MSM).
Atlanta is rich in diversity and is home for key COVID-19 at-risk populations including African American and
Hispanic populations, underserved communities, and those with significant preexisting comorbidities. Our
site is uniquely suited to engage clinical and community stakeholders from our well-established Atlanta
RECOVER infrastructure, and from our Grady and Emory Long COVID clinical network. This project aims to
increase access to care, improve person-centered care coordination, and expand multidisciplinary networks
and behavioral health support. This will be achieved by 1.) increasing primary Long COVID care access
through expanded in-person and virtual visit capacity and increasing provider-based referrals through a
coordinated education series, 2.) adding dedicated care coordination, social services, and language
interpretive staff, 3.) expanding the existing Long COVID-specific subspecialty network and establishing
multidisciplinary case conferences to improve collaboration and expedited care of complex cases, 4.)
integrating dedicated behavioral health staff and implementing behavioral health and rehabilitation group
series, 5.) engaging community support systems including patient advocacy groups and community
alliances to improve access to and retention of care and to ensure Long COVID perspectives are integrated
into this comprehensive patient-centered medical home (PCMH) model. Clinic evaluation activities will be
iterative and include ongoing quantitative and qualitative evaluation of 4 key element domains, including
Long COVID care access, person-centered care, multidisciplinary and behavioral health network access,
and evidence-based medicine.

## Key facts

- **NIH application ID:** 10866097
- **Project number:** 1U18HS029944-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Jenny Elizabeth Han
- **Activity code:** U18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2023
- **Award amount:** $1,000,000
- **Award type:** 1
- **Project period:** 2023-09-30 → 2028-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10866097

## Citation

> US National Institutes of Health, RePORTER application 10866097, The Atlanta Long COVID Collaborative: A Multi-Health System Long COVID Coordinated Care Model Serving a Diverse Metropolitan Population (1U18HS029944-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10866097. Licensed CC0.

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