Increased Organizational Stress in Primary Care: Understanding the Impact of the COVID-19 Pandemic, Medicaid Expansion, and Practice Ownership

From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Richmond, VA (NMC).

From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Richmond, VA (NMC).

From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Richmond, VA (NMC).

From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Richmond, VA (NMC).

From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Richmond, VA (NMC).

From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Richmond, VA (NMC).

From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Richmond, VA (NMC).

From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Richmond, VA (NMC).