AHRQ’s Investments in Primary Care Research for 2023 and 2024

AHRQ invested a total of $204.3 million for the primary care research projects with active funding in 2023 and 2024, spanning the multiple fiscal years (FYs) of funding from 2019-2029. This investment included $173.4 million for 104 grants and $30.9 million for 12 contracts. In FYs 2023 and 2024, AHRQ actively provided funding for a total of 547 unique grants. Of these, 104 were primary care research focused, meaning that primary care research represented 19% of the full AHRQ grant portfolio during this period. 

In 2023 and 2024 alone, AHRQ committed $84.1 million to new primary care research projects that will continue into 2029 (including $78.2 million for 58 grants and $5.9 million for 3 contracts). This funding came from the following sources: 

• $43.6 million from the General Health Services Research appropriation, which includes the NCEPCR earmark.
• $17.2 million from the Patient Safety appropriation.
• $14.9 million from the Patient-Centered Outcomes Research Trust Fund (PCORTF).
• $6.9 million from the Digital Healthcare Research appropriation.
• $1.5 million from the COVID-19 appropriation.

Most of this funding was awarded through grants; two categories, the General Health Services Research appropriation and PCORTF, also included contract awards ($1.2M and $4.7M respectively).

NCEPCR received $2 million in earmarked funds each year for 2023 and 2024; about half of that amount went towards funding nine continuing investigator-initiated grants and the other half funded two contracts that were active during this timeframe. In 2023 and 2024, NCEPCR awarded eight new primary care grants totaling $3.3M (spanning 2023-2028), and one new contract totaling $1.2M. The NCEPCR-funded grants and contracts are indicated throughout this report with a star icon:

AHRQ’s investment in primary care research supports a large body of work that is leading to significant impacts on primary care on behalf of the American public. To better understand this body of work and AHRQ’s investment in primary care research, we provide analysis across AHRQ’s primary care research grants and contracts with active funding in FYs 2023 and 2024 (not just those newly funded during this period) in this report. Go to Appendix A. Approach and Methods for details about how we identified the grants and contracts included in this report. 

Primary Care Research Grants and Cooperative Agreements

Of the 104 unique grants and cooperative agreements described in this report (collectively referred to as “grants” from here on), 24 (23%) were initially funded in FY 2024, 34 (33%) were initially funded in FY 2023, and 46 (44%) received their initial funding in previous FYs.

Below we describe the distribution of grants by funding mechanism, geographic distribution, awardee organization types, topic areas, and other attributes. 

Funding Mechanisms

Of AHRQ’s 104 unique primary care research grants, 87 (84%) were Research Projects and Cooperative Agreements, including two Dissertation Grants; 13 (13%) were Research Career Development Program grants (also known as K-awards); 2 (2%) were Research Program Projects and Centers (P30 awards); and 2 (2%) were Conference Grants. The specific funding mechanism and the number and percentage of each type are shown in Exhibit 1.^a 

Percentages by funding mechanisms were mostly similar between this set of grants and those that were active in FYs 2021 and 2022 (as described in our previous report). Two exceptions are that the number of active Research Demonstration and Dissemination Projects (R18s) declined by 10% from the previous period (from 31% to 21%); and Small Research Project Grants (R03s) doubled (from 6% to 13%), likely due to a new primary care R03 opportunity AHRQ released in early 2023. 

Exhibit 1. Number and Percentage of Primary Care Grants, by Funding Mechanism (n=104) 

*The total sum of the percentages shown in the table is greater than 100% due to rounding. 

The proportion of grants by funding mechanism type among the 87 Research Projects and Cooperative Agreements only (i.e., not including career development grants, research center grants, and conference grants) is depicted in Exhibit 2. The largest proportion of these grants was made up of R01s (n=36, 42%), followed by R18s (n=22, 25%), and R03s (n=14, 16%). 

Exhibit 2. Research Projects and Cooperative Agreements by Funding Mechanism (n=87) 

Geographic Distribution

The 104 primary care research grants were distributed across 67 organizations located in 30 states. Exhibit 3 depicts the distribution of awards across the U.S., with the size of the dots indicating the number of grants received in a particular geographic area (i.e., larger dots indicate a greater number of grants). This geographic distribution is similar to that of the primary care research grants in FYs 2021 and 2022, where the 124 grants were distributed across 66 organizations in 30 states.

Exhibit 3. Map of Grant Awardee Organizations (n=104)

Awardee Organization Type

Among the 67 organizations that received AHRQ primary care research grants (Exhibit 4, below), the majority were academic institutions (n=46, 69%), followed by healthcare institutions (n=12, 18%). Among the 46 academic institutions represented in the list, 65% were public and 35% were private. These proportions are similar to those for primary care research grants in FYs 2021 and 2022.

Exhibit 4. Awardee Types (n=67) 

About one third (n=23, 34%) of the 67 organizations held more than one AHRQ-funded primary care research grant during FYs 2023 and 2024. Of these, 9 (13%) held more than two grants. Exhibit 5 lists the organizations with more than one primary care research grant, along with the number of grants they had during this period. As described in the previous report, 29 of the 66 organizations (44%) held more than one active grant during FYs 2021 and 2022, and 12 (18%) held more than 2 grants. 

Exhibit 5. Organizations With Multiple Grants 

*Names of organizations are as shown in grant applications

Across the 71 total grants that went to academic institutions, the majority went to schools of medicine (n=45, 63%) distantly followed by schools of nursing (n=5, 7%), public health (n=4, 6%), engineering (n=3, 4%), and arts and sciences (n=2, 3%). In addition, one grant award each went to a school of social welfare/social work, a school of pharmacy, and a research unit. Another nine grants were labeled as “university wide” or “unspecified”. 

Among the 45 grants awarded to schools of medicine, the largest proportion went to Internal Medicine departments (n=17, 38%), followed by Pediatrics (n=8, 15%) and Family Medicine (n=7, 15%). Other departments that were represented with just one or two grants each included Emergency Medicine, Neurology, Obstetrics & Gynecology, and Urology. 

Topic Areas

Main Topic Area Across Grants

To further understand AHRQ’s primary care grants, we categorized each grant across key topic areas of interest to AHRQ. When we look at the single topic area that best describes each grant we find that the largest proportion of grants focused on Patient Safety (n=18, 17%), followed by Practice and Quality Improvement (n=17, 16%), Healthcare Systems and Infrastructure (n=15, 14%), and Health Disparities (n=15, 14%) – and almost two thirds of all the grants had one of these four as their main topic area. A smaller proportion of grants aligned with Behavioral Health and Substance Use Disorders, Digital Healthcare, Person-Centered Care, Primary Care Workforce, or Public Health and Community Integration. The full distribution of the main topic area for each grant is shown in Exhibit 6. 

Patient safety was added as a new main topic area for this report, making comparisons with the previous period difficult. For this reason, discussion about changes in topic focus over time is included under Multiple Topic Areas Across Grants, below.

Exhibit 6. Main Topic Area Across Grants (n=104)

Multiple Topic Areas Across Grants

Most of the AHRQ primary care research grants align with multiple topic areas rather than just one. When we look at the top three topic areas of focus for each grant instead of the single top topic, we see a slightly different picture. For example, looking at the total number of grants that align with each topic area when accounting for the top three topics for each grant, we see that the largest proportion of grants had a focus on Practice and Quality Improvement (45%, n=47), followed by Health Disparities (44%, n=46), and Digital Healthcare (36%, n=37). A smaller number of grants looked at Primary Care Workforce, Behavioral Health, and Public Health and Community Integration. The total number of grants that align with each topic area is shown in Exhibit 7.

Notable changes from the previous analysis of grants from FYs 2021 and 2022 include an 18% increase in Health Disparities (from 26% to 44%), an 11% increase in Primary Care Workforce (from 4% to 15%), and a 12% decrease in Digital Healthcare (from 48% to 36%). 

Exhibit 7. Total Number of Grants by Topic Area (n=104)

Health Conditions

Almost half (n=49, 47%) of the 104 primary care research grants focused on one or more chronic condition. The range of chronic conditions and the number of grants studying each condition is included in Exhibit 8. 

Exhibit 8. Chronic Conditions Studied Across Grants

In addition, some grants focused on non-chronic conditions. The non-chronic conditions included acute respiratory tract infections, COVID-19, human papilloma virus (HPV), iron deficiency anemia in pregnancy, pediatric eating disorders, urinary tract infections (UTIs), renal injury from febrile urinary tract infection, vascular anomalies, and venous thromboembolism. 

Patient Populations

AHRQ’s primary care research grants also focused on improving care for a wide range of patient populations, including children and adolescents, older adults, Black and Hispanic populations, people with limited English proficiency, low income or medically underserved patients, Medicare and Medicaid beneficiaries, rural populations, Veterans, and women. These patient populations are similar to those observed across AHRQ’s primary care research grants from FYs 2021 and 2022. Appendix B includes tables of grants focused on some of these populations, including children and adolescents, rural populations, women, and older adults.

Grantee Publications 

Through searches using the National Institutes of Health’s (NIH’s) Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) website, our team identified 228 published papers acknowledging 56 of the 104 AHRQ primary care grants from FYs 2023 and 2024 as of July 2025. The number of publications per grant ranged from zero to 19. Exhibit 9 shows the journals with the most publications across these grants. 

Exhibit 9. Most Common Journals for Publications from AHRQ Primary Care Grants

Our previous report found a greater number of publications (516 from 82 grants) for the FY 2021 and 2022 grants. However, there were a greater number of total grants for that previous analysis (124 compared to the current 104), and a longer period had elapsed between the funding period and the review of publications (17 months then compared to 10 months for the current analysis). 

Primary Care Research-Related Contracts 

A total of 12 AHRQ contracts with a focus on primary care research-related topics were active in FYs 2023 and 2024. These 12 contracts were led by nine organizations, including seven research and consulting firms (Abt Global, Econometrica, Mathematica Policy Research, National Opinion Research Center [NORC], RAND Corporation, Research Triangle Institute International [RTI], and Westat), one university (Oregon Health & Science University), and one member association (Association for Prevention Teaching and Research). Information about each of these contracts is included in Exhibit 10. Eight of the 12 contracts were awarded prior to FY 2023 and are also included in the previous report on AHRQ’s primary care investments. Many of the resources released by AHRQ to support primary care research and primary care clinician practice (described in the following sections of this report) were developed through these contracts. 

Exhibit 10. AHRQ’s Primary Care–Focused Contracts

Contract Title	Contractor	Brief Description of Project Scope
Update AHRQ's Playbook for Assisting Clinicians in Delivering Medication for Opioid Use Disorder (MOUD) in Primary Care Settings	Westat, Inc.	Updates the content and nomenclature of AHRQ's existing playbook for delivering medication for opioid use disorder (MOUD). Then evaluates the utility of the revised and updated MOUD Playbook to primary care clinicians that provide care to underserved populations and/or under-resourced communities in order to improve its value and usability.
Person-Centered Care Planning for Persons with Multiple Chronic Conditions (MCC)	Oregon Health & Science University	Conducts foundational information gathering about promoting person-centered care planning as standard practice for people with MCC. Includes a review of current practices and barriers; identification of potential models and digital solutions for implementation and scaling; and development of research priorities, strategies, and recommendations to advance dissemination and implementation.
Identifying and Supporting the Needs of Primary Care Practice-Based Research Networks (PBRNs)	Econometrica	Convenes a technical expert panel of PBRN members and stakeholders to assess the needs of the PBRN community. Develops effective tools and assistance to support PBRNs in their efforts to conduct rigorous primary care research, produce new evidence on primary care delivery, and improve understanding of methods to disseminate and implement evidence into practice. Read more about PBRNs and the learning materials developed under this contract here.
Dissemination and Implementation of PCOR Evidence in the U.S. Healthcare System During and Post Pandemic Recovery	Mathematica Policy Research, Inc.	Enhances AHRQ’s Compendium of U.S. Health Systems to include variables on the use of patient-centered outcomes research evidence in long-term care facilities, post-acute care settings, primary care practices, and rural and urban community health centers (including federally qualified health centers). Read more about updates to the Compendium of U.S. Health Systems here.
Dissemination and Stakeholder Engagement Support for AHRQ’s National Center for Excellence in Primary Care Research (NCEPCR)	Abt Global	Supports AHRQ’s NCEPCR by (1) producing reports to summarize and synthesize AHRQ’s recent investments in primary care research; (2) developing and executing a dissemination plan to increase awareness of AHRQ’s primary care research; and (3) engaging primary care stakeholders to inform the Center’s efforts.  This report and the Strengthening Primary Care Research webinars series were developed under this contract.
Patient-Centered Preventive Healthcare: Gathering Stakeholder Input on Evidence and Implementation	Research Triangle Institute	Updates the list of high-priority clinical preventive services for adults age 35+ through expert consensus and gathers expert input on strategies for the patient-centered implementation of these services as recommended by the U.S. Preventive Services Task Force and the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
Strategies for Integrating Behavioral Health and Primary Care	Oregon Health & Science University	One large topic refinement with pre-award key question posting, and an optional task of one large systematic review with simultaneous peer review and public comment.
Preventive Medicine and Primary Care Residency Rotation Program	Association for Prevention Teaching and Research	Administers and coordinates a preventive medicine and primary care residency rotation program providing scientific and dissemination support to the U.S. Preventive Services Task Force.  Read more about the U.S. Preventive Services Task Force and this residency rotation program here.
The Academy for Integrating Behavioral Health and Primary Care	Westat, Inc.	Maintains the Academy portal to serve as a national resource hub to support the integration of behavioral health and substance abuse with primary care.  Read more about the Academy and its materials here.
EvidenceNOW Contracts
Supporting and Evaluating the Dissemination and Implementation of PCOR to Increase Screening and Management of Unhealthy Alcohol Use in Primary Care	National Opinion Research Center	Supports the EvidenceNOW: Managing Unhealthy Alcohol Use program through technical assistance and evaluation. Develops a resource center, convenes a technical expert panel, conducts an environmental scan, facilitates a learning community among the grantees, and conducts an evaluation to assess the performance and impact of the grants.  Read more about EvidenceNOW and the materials developed for this contract here and here.
Technical Assistance to and Evaluation of Grant Initiative to Develop State-Level Capacity for Dissemination and Implementation of Patient-Centered Outcomes Research Into Primary Care	Abt Global	Supports the EvidenceNOW: Building State Capacity program through technical assistance and evaluation. Provides technical assistance to grantees, develops and curates materials to support grantees and healthcare extension services broadly, and conducts an overarching evaluation of the program.   Read more  about EvidenceNOW and the materials developed for this contract here and here.
Improving Nonsurgical Treatment of Urinary Incontinence Among Women in Primary Care (INTUIT-PC) Evaluation and Technical Support	RAND Corporation	Supports the EvidenceNOW: Managing Urinary Incontinence program through technical assistance and evaluation. Develops resources to support grantees’ success, creates a learning community to support peer-to-peer sharing of resources and lessons learned, and evaluates the program’s impact.  Read more about EvidenceNOW and the materials developed for this contract here.

 Key: MCC=multiple chronic conditions; PBRN=practice-based research network; PCOR=patient-centered outcomes research; NCEPCR=National Center for Excellence in Primary Care Research. 

^a. Grant mechanism names and descriptions used in this report come from AHRQ https://www.ahrq.gov/funding/process/mechanisms/index.html