Many U.S. policymakers believe that increased integration between hospitals and physicians may foster better care and potentially decrease health care spendind. The logic behind this notion is straightforward: When physicians are employed or otherwise more substantially influenced by the hospitals in which the work, they are less likely to focus on generating revenue to maintain an independent practice and more likely to focus on patient care. The objetive of this article was to examine changes in United States acute care hospitals that reported employment relationships with their physicians and to determine whether quality of care improved after the hospitals switched to this integration model.