Patient Perceptions of Care From Hospital-Integrated Physicians

Hospital-physician vertical integration has become a defining feature of the health care landscape. While some evidence exists regarding integration's effect on clinical outcomes, little has examined patient-reported experience. We used the 2021 Medicare Current Beneficiary Survey, constructing psychometric scales of care coordination and quality, communication, and accessibility from survey responses. We analyzed how patient experience with each scale differed by the proportion of care received from integrated physicians, adjusting for patients' characteristics. Integrated care was significantly and positively associated with patients' perceptions of coordination and quality. This relationship was driven by patients with high clinical complexity, with effects twice as large as for patients with low clinical complexity. However, integrated care was not significantly associated with communication or accessibility. These findings suggest a nuanced relationship between integration and patient experience. Policymakers, who often discuss integration in terms of outcomes and affordability, should also consider ways in which it shapes patients' experiences.