Abstract:The adoption of telehealth in primary care was accelerated by the COVID-19 pandemic, particularly within the Veterans Health Administration (VA), which has been a national leader in providing telehealth services. This dissertation examines how hybrid (in-person and telehealth) primary care utilization influences downstream healthcare utilization and health outcomes among U.S. Veterans with type 2 diabetes (T2D), a population with high chronic disease burden and unique barriers to care. Using a mixed-methods approach, the three papers in this dissertation provide complementary perspectives on the role of hybrid care in primary care and T2Dmanagement.The first paper investigates the association between the frequency of hybrid primary care visits and meeting Healthcare Effectiveness Data and Information Set (HEDIS) diabetes care quality metrics. The second paper examines the relationship between hybrid primary care utilization and emergency department visits for acute preventable diabetes complications. Both papers’ quantitative analyses draw on electronic health records from over two years of national VA administrative data. The third paper qualitatively explores both Veterans’ and primary care providers’ perspectives on video telehealth, identifying barriers and facilitators to its sustained use and comparing how high and low video telehealth-using sites differed in their implementation of the technology. Together, these papers highlight the potential of hybrid care versus solely in-person care to enhance chronic disease management and reduce acute care utilization for chronic disease patients such as Veterans with T2D, while also identifying challenges to equitable and effectiveimplementation. The findings may be used to inform future policy and practice for integrating telehealth into routine primary care for vulnerable populations.