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Hill Physicians Medical Group: Independent Physicians Working to Improve Quality and Reduce Costs

Hill Physicians Medical Group is the nation's largest independent practice association, with more than 2,200 physicians, 800 in primary care. Established in 1984 in Northern California, Hill serves 332,000 patients enrolled in seven HMOs, two Medicare Advantage plans, and Medi-Cal, California’s Medicaid Program. Hill member physicians have practices at 1,600 offices, and work in 30 hospitals and 15 urgent care centers. Hill demonstrates how an affiliated group of independent physicians can improve clinical outcomes, increase efficiency, and engender physician support for quality improvement and cost reduction activities. Working with health educators, member physicians have improved patient care: the number of diabetics in control of their blood sugar levels increased by 42 percent and patients in control of their cholesterol levels increased by 32 percent. Through the group, physicians are informed about and encouraged to participate in quality improvement initiatives and receive health information technology training and products.


This study was based on publicly available information and self-reported data provided by the case study institution(s). The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund’s case studies series is not an endorsement by the Fund for receipt of health care from the institution.

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T. Emswiler and L. Nichols, Hill Physicians Medical Group: Independent Physicians Working to Improve Quality and Reduce Costs, The Commonwealth Fund, March 2009.