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Medical Care Research and Review
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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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