Advisor(s)
Larry Hearld
Committee Member(s)
Christy Harris Lemak
Nancy Borkowski
Sue Feldman
School
School of Health Professions
Document Type
Dissertation
Department (new version)
Health Professions
Date of Award
9-9-2024
Degree Name by School
Executive Doctor of Science (DSc) School of Health Professions
Abstract
Since the 1990s, hospitals and health systems have built primary care networks to establish market share and ensure sustainability. At this same time, the under?performance of the U.S. primary care system in terms of quality, service, and access has been widely documented. Value-based payment models have emerged. These trends created opportunities for new primary care market entrants. These market entrants may erode the primary care base of established health systems. This study examined how health systems may be adapting to a subset of new, disruptive primary care market entrants or disruptive primary care models. This study included disruptive primary care models that met the following criteria – they: (1) established a continuous relationship with a specific segment of patients, (2) had a physical location, (3) leveraged multi-disciplinary care teams, and (4) possessed some type of unique proprietary technology. It examined one structural (a medical home model) and two technological (virtual visits and remote patient monitoring) services health systems may be offering to compete with disruptive primary care models. It also explored the question of whether hospitals and health systems were collaborating with disruptive primary care models. Primary data collection was used to identify the locations of disruptive primary care models. All general, medical surgical hospitals located within the same core based iv statistical areas (CBSAs) as these disruptors were identified through use of the 2022 AHA Survey. Binary logistic regression was used to estimate the relationship between concentrations of (primary care disruptors) and health systems’ structural (a medical home) and technical offerings (virtual visits and remote patient monitoring). Six semi?structured interviews explored whether health systems were collaborating with disruptive primary care models. With one exception, (the provision of virtual visits), the number of disruptors in a market was not associated with the provision of a medical home model or remote patient monitoring. That said, other market and hospital characteristics were associated with these offerings including the percentage of people living in poverty, hospital ownership type, and hospital size. Qualitative interviews revealed that most health system strategy leaders were taking a cautious wait-and-see approach before partnering with disruptive primary care models.
ProQuest ID
Prior version
Recommended Citation
Suko, Jolynn R., "Health Systems' Adaptations To "Disruptive Primary Care Models"" (2024). All ETDs from UAB. 7588.
https://digitalcommons.library.uab.edu/etd-collection/7588
