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An Empirical Assessment of High-Performing Medical Groups: Results from a National Study
Stephen M. Shortell
University of California, Berkeley
Julie Schmittdiel
University of California, Berkeley
Margaret C. Wang
University of California, Berkeley
Rui Li
University of California, Berkeley
Robin R. Gillies
University of California, Berkeley
Lawrence P. Casalino
University of Chicago
Thomas Bodenheimer
University of California, San Francisco
Thomas G. Rundall
University of California, Berkeley
The performance of medical groups is receiving increased attention. Relatively little conceptual or empirical work exists that examines the various dimensions of medical group performance. Using a national database of 693 medical groups, this article develops a scorecard approach to assessing group performance and presents a theory-driven framework for differentiating between high-performing versus low-performingmedical groups. The clinical quality of care, financial performance, and organizational learning capability of medical groups are assessed in relation to environmental forces, resource acquisition and resource deployment factors, and a quality-centered culture. Findings support the utility of the performance scorecard approach and identification of a number of key factors differentiating high-performing from low-performing groups including, in particular, the importance of a quality-centered culture and the requirement of outside reporting from third party organizations. The findings hold a number of important implications for policy and practice, and the framework presented provides a foundation for future research.
Key Words: medical groups performance chronic care management quality of care quality culture
Medical Care Research and Review, Vol. 62, No. 4,
407-434 (2005)
DOI: 10.1177/1077558705277389

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