Original ArticlesThe Contribution of Physician-System Integrating Structure to Select Health System OutcomesNguyen, Ann M. PhD, MPH; Johnson, Christopher E. PhD; Wood, Suzanne J. PhD, MS, FACHE; Dowling, William L. PhD, MA, MBAAuthor Information Department of Population Health, School of Medicine, New York University, New York (Dr Nguyen); Department of Health Management & Systems Science, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky (Dr Johnson); and Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Wood and Dowling). Correspondence: Ann M. Nguyen, PhD, MPH, Department of Population Health, School of Medicine, New York University, 180 Madison Ave, 2nd Floor, New York, NY 10016 (firstname.lastname@example.org). This project was supported by grant no. R36HS024895 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Journal of Ambulatory Care Management: July/September 2020 - Volume 43 - Issue 3 - p 237-256 doi: 10.1097/JAC.0000000000000331 Buy Metrics Abstract Physician groups are increasingly being vertically integrated with hospitals and health systems; yet, the evidence on the impact of physician-system integration on health system outcomes is mixed. The objective of this study was to examine the impact of increased physician-system integration on select health system outcomes. We used a mixed-methods approach: (1) a fixed-effects multivariate mediation analysis; and (2) a qualitative analysis of interviews with health executives (n = 25). Our findings showed that hospitals spent $633 375.22 to $827 110.24 for each “level” increase in integration. This relationship was attenuated, however, by the presence of care coordination mechanisms. © 2020 Wolters Kluwer Health, Inc. All rights reserved.