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y's health systems can enhance future efforts to study systems as complex organizations, to assess their performance, and to better understand the effects of payment innovation, care redesign, and other reforms. To understand how health systems are facilitating primary care redesign (PCR), examine the PCR initiatives taking place within systems, and identify barriers to this work. A purposive sample of 24 health systems in 4 states. Data were systematically reviewed to identify how system leaders define and implement initiatives to rede