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Purpose: While COVID-19 has upended lives, it has also catalyzed innovation with potential to advance health delivery. Yet, we know little about how the delivery system, and primary care in particular, has responded and how this has impacted vulnerable patients. We aimed to understand the impact of COVID-19 on primary care practice sites and their vulnerable patients and to identify explanations for variation. Approach: We developed and administered a survey to practice managers and physician leaders from 173 primary care practice sites, October-November 2020. We report and graphically depict results from univariate analysis and examine potential explanations for variation in practices' process innovations in response to COVID-19 by assessing bivariate relationships between seven dependent variables and four independent variables. Findings: Among 96 (55.5%) respondents, primary care practice sites on average took more safety (8.5 of 12) than financial (2.5 of 17) precautions in response to COVID-19. Practice sites varied in their efforts to protect patients with vulnerabilities, providing care initially postponed, and experience with virtual visits. Financial risk, practice size, practitioner age, and emergency preparedness explained variation in primary care practices' process innovations. Many practice sites plan to sustain virtual visits, dependent mostly on patient and provider preference and continued reimbursement. Value: While findings indicate rapid and substantial innovation, conditions must enable primary care practice sites to build on and sustain innovations, to support care for vulnerable populations, including those with multiple chronic conditions and socio-economic barriers to health, and to prepare primary care for future emergencies.

This paper aims to examine corporate governance and consequences of the Sarbanes‐Oxley Act (SOX) in the US from a socio‐political perspective.

The author employs neo‐liberalism and its related mentality of governmentality to develop an analysis of how corporate governance and reforms such as SOX are socially constructed through autonomous agents, including managers and accountants, and various power relationships that comprise government.

This paper theorizes that legislative reform, such as SOX, represents pervasive mechanisms of disclosure, surveillance and power, and an insurance rationality designed to manage the new and significant risks of corporate governance. A framework is established which conceptualizes SOX as the intersection of neo‐liberalism, political rationalities and governmental techniques, and accounting practices which lead to the elements of security, quantification and shareholder value. Through this framework a model of risk as governance is developed that examines SOX through technologies of the self, calculation and insurance, designed to act upon managers using knowledge about control or financial statement weaknesses. Such mechanisms identify corporate governance risks, which can be acted upon by outside experts, such as accountants.

The major inference from this paper is that corporate governance research in accounting should pursue new lines of inquiry, which will permit the more profitable extension of existing research. Such inquiry should focus less on empirical corporate governance factors and more on the relationships, and power constructs of corporate governance, as well as how legislative reforms employ tactics to normalize the behaviour of not only managers, but also accountants.