June 17, 2021

Dr. Ryan Kandrack

Dr. Ryan Kandrack

Ryan Kandrack, PhD, recent doctoral graduate from the UNC Gillings School of Global Public Health’s Department of Health Policy and Management, will present an abstract of his research today as part of AcademyHealth’s Annual Research Meeting (ARM) “Best of ARM” session.

The study, titled “The Effect of Primary Care Practice Vertical Integration on Spending and Utilization for Medicare Fee-for-Service Beneficiaries,” represents some of the highest quality research presented at ARM. It was chosen as one of eight publications from among hundreds of submissions from faculty, researchers and students across the country, and it will be presented along with three other papers which highlight the theme of “Evaluating Policy Changes and Evidence-based Interventions in Varied Settings.”

It is based on Kandrack’s dissertation research, which he defended in April in pursuit of a doctoral degree he received in May.

The study investigates how vertical integration – the practice of hospitals acquiring primary care practices – has the tendency to increase Medicare spending. The surges were driven by increased spending and use of hospital and emergency department care, as well as increased spending on evaluation and management services despite a decrease in service use after vertical integration. This sort of outcome runs counter to the ostensible goal of most efforts related to payment and service delivery reform.

“Our team found that the vertical integration of primary care practices with health systems leads to increased health care spending,” Kandrack explained. “Continued consolidation in the health care industry poses a serious threat to the affordability of health care services and our ability to bend the cost curve. This is especially true in the wake of the coronavirus pandemic, as health care providers may increasingly look to vertical integration with large systems to get much-needed financial and administrative support.”

Kandrack collaborated with Associate Professor Valerie Lewis, PhD, Adjunct Associate Professor Erin Fraher, PhD, MPP, and Professor Mark Holmes, PhD from the Department of Health Policy and Management, as well as Distinguished Professor Darren DeWalt, MD, MPH, from the UNC School of Medicine.

Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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