When Getting Bigger is too Big—Challenges of Growing Healthcare Systems

*Atlanta VA Health Care System, Surgery and Perioperative Care, Decatur, GA †Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, GA ‡Department of Surgery, Morehouse School of Medicine, Atlanta, GA §Department of Surgery, University of Michigan, Ann Arbor, MI ∥Institute for Healthcare Policy & Innovation, Center for Healthcare Outcomes & Policy, University of Michigan, Ann Arbor, MI Funding/Support: This work was supported by the US Department of Veterans Affairs Health Services Research and Development Service of the VA Office of Research and Development Merit Review (701 HX003127, NNM), the National Institutes of Health (R01 HL157323, NNM) and the Agency for Healthcare Research and Quality (R01 HSO28606, AMI). Conflict of Interest Disclosures: None of the authors has any conflicts of interest to report. [email protected]