If you’re a primary care provider whose patients have chronic diseases like diabetes, hypertension, or chronic pain, you know the challenge. They need comprehensive education about nutrition, exercise, stress management, and self-care—but your 15-minute appointment slots simply don’t allow enough time to provide it.
Group medical visits offer a solution that benefits both patients and clinicians. But here’s what you might not know: These extended clinical encounters also address a powerful yet often overlooked driver of poor health outcomes and increased health care costs—loneliness.
The hidden health crisis
Jeffrey S. Geller, MD—often called the godfather of group visits—made a groundbreaking discovery back in 1999. His research, published in the Journal of Family Practice, revealed that loneliness independently predicts how often patients use the emergency department, even when you control for their chronic illness burden.1
Patients who scored above the mean on loneliness scales went to the ED 60% more frequently in a year than those with lower scores. This held true regardless of how sick they were with chronic conditions. In other words, loneliness itself was driving health care utilization—and costs.1
Dr. Geller concluded that loneliness represents a potentially expensive societal problem warranting resources for prevention, diagnosis, and treatment.1 This insight would fundamentally shape his development of group medical visits as a therapeutic intervention, one that could reduce social isolation while delivering high-quality integrative care.
What are group medical visits?
Group medical visits—also known as shared medical appointments or SMAs—bring together 10 to 16 patients with similar chronic conditions or similar health goals. The group meets for an extended session, typically one to two hours. The sessions include medical care, health education, peer support, and often integrative therapies like yoga, meditation, or tai chi.
Here’s the important part for practice economics: unlike traditional group education classes, group medical visits can be billed as regular medical appointments. Each patient receives individual attention from you during the session, and each patient’s participation is billed as an individual appointment using standard evaluation and management codes.2
The Centers for Medicare and Medicaid Services and the American Academy of Family Physicians all support this model. Leading institutions like Harvard Vanguard, Kaiser Permanente, Cleveland Clinic, and Yale Health have been using group visits since the mid-1990s.3
Meet the pioneer
Dr. Geller created the largest group medical visit program in the United States and currently operates 35 weekly group visits in his practice, which is dedicated to reducing health disparities in underserved populations.4 He is president and founder of the Integrated Center for Group Medical Visits (ICGMV), the leading group medical visit teaching center in the United States. His work has fundamentally shaped how group visits address both clinical outcomes and the social determinants of health.5
What makes Dr. Geller’s approach different? His empowerment-based model prioritizes patient agency over compliance, peer relationships over individual instruction, and participant-driven curricula over prescriptive protocols.6 Rather than telling patients what to do, the model creates space for them to learn from each other, try new approaches, and determine their own health priorities, much as our HOPE Note helps patients to do. The model uses open enrollment, allowing patients to join when ready and stay as long as beneficial. This has the added benefit of building community that can be sustained over time.
The evidence
Does this approach work? A 2015 study published in Global Advances in Health Medicine evaluated Dr. Geller’s empowerment model in 42 women with chronic pain over six months at the Greater Lawrence Family Health Center in Massachusetts. These women faced profound health burdens: only 32% could walk a block without limitation, more than 66% rated their health as fair to poor, and about 60% felt unable to work due to pain.6
Results showed statistically significant improvements across multiple quality-of-life domains, including bodily pain, general health, and social function. The most meaningful change occurred in social function—precisely the dimension you’d expect if the model successfully addresses loneliness and isolation.6
A randomized controlled trial published in PLOS One in 2019 examined integrative medical group visits for chronic pain in 159 low-income, racially diverse adults. The findings were striking. Although average pain intensity scores showed no significant differences between groups, participants in group visits made 68% fewer ED visits at nine weeks and had a 58% reduction in pain medication use at 21 weeks compared to controls receiving usual care.7
Think about what this means. Group visits didn’t necessarily make the pain go away, but they fundamentally altered how patients coped with it—reducing their reliance on emergency care and pain medications. That’s a powerful outcome.
For diabetes management, a meta-analysis found HbA1c reductions of 0.46% with group visits, with duration of treatment mattering more than frequency. For every additional year of participation, HbA1c decreased by an additional 0.25%. Given that a 1.0% HbA1c reduction is associated with a 37% decrease in microvascular complications, these are clinically meaningful effects.8
The cost data is equally compelling. Multiple studies document 32-68% fewer ED visits, 33% decreased heart failure-related rehospitalizations, and 24% fewer specialty visits per year.9 One analysis showed that while diabetes group visits had implementation costs of $1,770 per patient, they generated savings of $1,855 at 12 months through reduced hospitalizations.9
Can group visits be virtual?
Dr. Geller has been running virtual group visits since the COVID-19 pandemic began. He anticipates a future where only a small percentage of visits occur in person.4 Virtual delivery can extend whole person care to people who face transportation barriers, mobility limitations, or geographic isolation—populations particularly vulnerable to loneliness.
A mindfulness-based group visit series for cancer patients during the pandemic achieved 90% attendance, with 87% rating it excellent. Patients emphasized feeling empowered, connected, and appreciative of virtual participation’s flexibility.11 Policy changes now allow virtual group visits to be billed like in-person visits when conducted through HIPAA-compliant platforms.
What patients say
Studies show 85-90% of patients who attend one group visit schedule subsequent appointments as group visits, with satisfaction rates reaching 96% in some programs.6 That kind of retention tells you something important about the patient experience.
As Dr. Geller notes, “A patient may listen to another patient going through the same problem, more so than a provider. Knowing that you’re not alone is part of healing.” Peer support, shared experiences, and extended time create a therapeutic environment that addresses both medical and psychosocial needs in ways that short, individual appointments simply can’t.
How do group visits benefit you?
Group visits aren’t simply good for patients. They may help address one of health care’s most pressing problems: clinician burnout.
“Physicians get fulfillment from actually talking with their patients. Group visits reduce burnout,” notes Shilpa Saxena, MD, a nationally recognized expert on lifestyle-based group visits.12 The extended patient contact time, enhanced team collaboration, and ability to address social determinants of health through group visits may prevent or reduce burnout in ways that individual appointments can’t.13
Providers report greater job satisfaction from meaningful patient relationships, schedule flexibility, and the sense that they’re finally able to practice medicine the way they were trained to—with time to listen, educate, and connect.13
Health equity factors
Group medical visits hold promise for reducing health disparities. Research examining group visits in community health centers found that the format can shift traditional patient-provider power dynamics and potentially interrupt the reproduction of health care inequalities.14
How does this work? In group settings, patients take active roles in each other’s care through peer advocacy and support. Experience is respected alongside professional clinical expertise. Extended appointments allow thorough discussion of the social context of health problems. For patients experiencing trauma or social isolation or simply feeling pushed to society’s margins, group visits can help people move from suffering toward individual healing and community participation.14
Dr. Geller’s original loneliness research found that Spanish-speaking patients demonstrated significantly higher loneliness scores than others, pointing to cultural and linguistic isolation as critical factors.1 Many group visit programs serving underserved populations intentionally normalize inclusion of people with physical disabilities, mental illness, and diverse racial and ethnic backgrounds.
Getting started with group visits
If you’re considering implementing group medical visits in your practice, here’s some practical advice from those who’ve done it successfully.
“Do the first one and get over the fear. Once you do one, it’s not so bad,” advises Dr. Saxena. “Patients will be understanding as you learn if you’re humble. Let them know that they’re helping you better serve all your patients.”12
Group visits can focus on many topics: nutrition, exercise, weight management, stress management, sleep optimization, pain management.12 Each format can be repeated many times. You can include ready-made videos or create your own and create handouts, interactive documents and multimedia education. Just two group visits a month can make a meaningful difference for your patients and your practice.
ICGMV offers comprehensive support: educational materials, consultation services, in-person training, and an annual conference.5 ICGMV can help with program design, staff training, billing strategies, quality improvement, and integration of integrative medicine modalities.
A different way forward
As health care continues evolving toward population health management and value-based care, group medical visits represent something important—a model that addresses loneliness and chronic disease simultaneously, reduces costs while improving satisfaction, and transforms both patient experience and clinician fulfillment.
Dr. Geller’s work over more than 12 years demonstrates that group visits function not merely as efficient care delivery mechanisms but as therapeutic interventions addressing the psychosocial determinants of health. What emerges consistently is that group visits alter the process and experience of care: They provide time, build relationships, validate patient knowledge, offer peer support, and create communities of healing.
Success requires more than adopting a protocol. Dr. Geller’s empowerment model emphasizes facilitator skill over curricula, patient agency over adherence, and community building over efficiency metrics. These principles enable sustainability and impact that extend far beyond what time-limited interventions can capture.
If you’ve been feeling frustrated by the constraints of traditional appointment structures, if you sense your patients need more than you can provide in 15 minutes, or if you’re looking for ways to practice medicine that feel more meaningful—group medical visits may be worth exploring.
Resources
The Integrated Center for Group Medical Visits: https://icgmv.org/
Annual ICGMV conference: September 18, 2026 (register by March 6, 2026)
Training platform, icgmv.thinkific.com, offers more than 11 hours of asynchronous CME training and 150+ hours of recordings from ICGMV annual conferences.
ICGMV consulting services for program design, staff training, billing strategies, and quality improvement
Healing Works Foundation resources on whole person primary care and integrative medicine
References
- Geller J, Janson P, McGovern E, Valdini A. Loneliness as a predictor of hospital emergency department use. J Fam Pract. 1999;48(10):801-804.
- Blue Cross Blue Shield of North Carolina. Group visit (shared medical appointment) guidelines. Reimbursement Policy. Last review 12/22. Accessed January 29, 2026.
- Jaber R, Braksmajer A, Trilling JS. Group visits: a qualitative review of current research. J Am Board Fam Med. 2006;19(3):276-290. doi:10.3122/jabfm.19.3.276
- ICGMV Newsroom. The Catalyst Podcast with Dr. Lara Salyer Episode 99: Unpacking Group Visits with ICGMV Founder Dr. Jeff Geller, MD. February 2, 2024. Available at https://icgmv.org/news-room. Accessed January 13, 2026.
- Integrated Center for Group Medical Visits. Consulting Services. Available at https://icgmv.org/consulting-services. Accessed January 29, 2026.
- Geller JS, Kulla J, Shoemaker A. Group medical visits using an empowerment-based model as treatment for women with chronic pain in an underserved community. Glob Adv Health Med. 2015;4(6):27-30. doi: 10.7453/gahmj.2015.057
- Gardiner P, Luo M, D’Amico S, et al. Effectiveness of integrative medicine group visits in chronic pain and depressive symptoms: a randomized controlled trial. PLOS One. 2019;14(12):e0225540. https://doi.org/10.1371/journal.pone.0225540
- Housden L, Wong ST, Dawes M. Effectiveness of group medical visits for improving diabetes care: a systematic review and meta-analysis. CMAJ. 2013;185(13):E635-E644. doi:10.1503/cmaj.130053
- Wan W, Staab EM, Li J, et al. Costs and health care utilization analysis of medical group visits for adults with type 2 diabetes in community health centers. Med Care. 2023;61(12):866-871. doi:10.1097/MLR.0000000000001937
- Mishra KK, Leung IC, Chao MT, et al. Mindfulness-based group medical visits: strategies to improve equitable access and inclusion for diverse patients in cancer treatment. Glob Adv Integr Med Health. 2024;13:27536130241263486. doi:10.1177/27536130241263486
- Healing Works Foundation. Chronic disease management with group visits. Case Study. 2018. Available at https://healingworksfoundation.org/wp-content/uploads/2018/09/CS_Group-Visits_FINAL.pdf. Accessed January 29, 2026.
- Thompson-Lastad A, Gardiner P. Group medical visits and clinician wellbeing. Glob Adv Health Med. 2020;9:2164956120973979. doi:10.1177/2164956120973979
- Thompson-Lastad A. Group medical visits as participatory care in community health centers. Qual Health Res. 2018;28(7):1065-1076. doi:10.1177/104973231
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