Mapping AHRQ's 30-Year Investment in Primary Care Research (1990-2020)

In 1990, ACHPR laid out an agenda for primary care research that envisaged safe, equitable, high-quality primary care for all Americans. Some investments in primary care research involved contract work and the commissioning of evaluations and reports, some came in the form of intramural projects, and most supported grants awarded to extramural research teams throughout the Nation.

Between 1990 and 2000, AHRQ’s primary care research portfolio has:

• Led to over 1000 publications on primary care research from grants funded between 2008 and 2019
• Supported the first demonstration of the ECHO model in 2009
• Cataloged dozens of tools and resources for primary care transformation
• Generated evidence for realistic steps to reduce clinician burnout 
• Supported development of the Six Building Blocks model for opioid management in primary care
• Invested $112 million to help over 1,500 small and medium-sized primary care practices across the country with using the latest evidence to improve the ABCS of heart disease prevention
• Released a 32 module Primary Care Practice Facilitation Curriculum and How to Guide for running a practice facilitation program 
• Produced EvidenceNOW's curated Tools for Change
• Led to creation of an interactive Playbook for the integration of behavioral health and primary care
• Increased access to Medication-Assisted Treatment to over 20,000 individuals struggling with opioid addiction in rural areas
• Advanced the latest methods to evaluate and refine new models of primary care delivery
• Developed models for workforce staffing configurations for primary care
• Disseminated white papers to policy- and decision-makers on team-based care, use of health IT for quality improvement, care coordination, engaging patients and families, and many more
• Supported the expansion of PBRN’s
• Initiated a more targeted focus on equity and priority populations
• Increased digital healthcare research to improve quality and safety 
• Developed and maintained the NCEPCR website to house research, funding opportunities, and practical tools and resources for primary care researchers.

Primary care has been described as the backbone of the healthcare system.³ In the United States, more than half of healthcare visits are primary care visits, and patients who have a primary care relationship have better health outcomes.¹⁷⁶ Primary care research is vital to advancing primary care. AHRQ has sustained a commitment to primary care research for 30 years, across three decades and four administrations, despite the absence of a dedicated budget for primary care research. The Agency has worked steadily to invest in research to revolutionize primary care organization, workforce, quality and safety, digital healthcare, financing and cost, and prevention. Significant contributions to building research infrastructure, developing research methods, and generating data for research have also been a constant for the past 30 years. These investments have resulted in impacts at the level of research, policy, programs, clinical practice, and health outcomes. Many projects were strategically designed to build upon and leverage previous Agency research, reflect collaborative and trans-agency initiatives, and laid the groundwork for wider exploration and implementation. The goals of primary care research have remained constant since the publication of AHCPR's 1990 research agenda and the research questions have remained largely unchanged—how can we provide safe, equitable, high-quality primary care for all Americans? Yet, the complexities involved with answering these questions have become so much greater. AHRQ stands ready to meet this dynamic, ever-evolving challenge.