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Medical Group Structural Integration May Not Ensure That Care Is Integrated, from the Patient’s Perspective

Group care integration may not work for patients


The consolidation of medical practices into larger groups may lead to enhancements in care coordination and communication. This is particularly the case for patients with multiple chronic conditions, who often see many different providers in multiple settings. To determine whether this kind of consolidation has led to improvements for patients, Commonwealth Fund–supported researchers surveyed Medicare beneficiaries in practices that had and had not consolidated.

What the Study Found

The authors surveyed patients about six domains of integration: provider and staff knowledge of the patient (including medical history, needs, and values); provider support for self-directed care, medication adherence, and home health management; and communications regarding test results.

There were no consistent patterns between medical group size and the domains of integration. Patients in practices with greater technology capability were no more likely than patients in other practices to perceive care as more integrated. There were some exceptions: patients in multispecialty group practices had strong favorable perceptions of staff knowledge of patients’ medical histories compared with patients in primary care practices.

Survey responses were most favorable for test result communication and least favorable for provider support for medication and home health management.


Health care practitioners and policymakers should not assume that structural integration of provider practices will yield care improvements.

Publication Details



Mary Mahon, Former Vice President, Public Information, The Commonwealth Fund

[email protected]


M. J. Kerrissey, J. R. Clark, M. W. Friedberg et al., “Medical Group Structural Integration May Not Ensure That Care Is Integrated, from the Patient’s Perspective,” Health Affairs, May 2017 36(5):885–92.