PROJECT SUMMARY Dr. Brady Post’s long-term goal is to explain how system-level integration affects quality and equity, specifically for rural residents. The American health care system has moved quickly toward greater integration between hospitals and physicians. As a way to organize healthcare services, hospital-physician integration has generated much controversy within the health policy community. Advocates hope for more efficiency and care coordination while skeptics raise concerns over costs and quality. This pressing policy issue, poised to be a defining issue in health care for decades to come, requires dedicated scholars. Dr. Brady Post has focused his scholarship on this topic since his doctoral studies at the University of Michigan and he continues to build the evidence base as an Assistant Professor at Northeastern University. A natural next step in his career is to advance the science on hospital-physician integration using a more sophisticated set of methodological approaches that will round out his skillset and, simultaneously, help to fill persistent gaps in the literature. Through a comprehensive training plan that includes formal coursework and mentored, project-based learning, this project will equip Dr. Post with (1) deep knowledge of rural health needs, policy, and service delivery (2) qualitative and mixed-methods techniques, and (3) survey design and measurement theory needed for survey research. This unique combination will position Dr. Post to direct innovative studies of how hospital-physician integration reshapes health care in rural communities. This training will build his skills as an independent researcher and prepare him to successfully compete for R01-level grants. This project will examine the effects of hospital-physician integration on care coordination, patient access to care, and disparities in health outcomes across rural and urban areas. It will leverage rich survey data to highlight patients’ perspectives and use in-depth interviews to highlight physicians’ and mangers’ perspectives. With this award, Dr. Post will bring new concepts and new approaches to the literature on hospital-physician integration at a time when the Centers for Medicare and Medicaid Services, the Federal Trade Commission, and other policymakers are actively weighing the benefits and drawbacks of increased integration. This proposal directly answers AHRQ’s request for health services research to advance health equity (NOT-HS-21-014) and focuses on the AHRQ priority population of rural residents. This award will support Dr. Post’s transition to independence, establishing him as a leading scholar on the quality and equity implications of increasingly integrated health care systems.