Methods Study site: primary care clinics at VA Palo Alto. Study Design: staircase design with 2 steps of design/implementation/formative-evaluation/redesign with increasing numbers of participants, followed by a 3rd step evaluating the final model. Participants: primary care providers (MDs and RNPs) and their patients with hypertension. Participating primary care providers (PCPs) are randomly allocated 2:1 Group Visits (GV)intervention:control; patients of intervention PCPs are also randomly allocated 2:1, yielding 3 study arms (patients of GV-PCPs enrolled in GVs; patients of GV-PCPs not in GVs, and patients of non-GV-PCPs). This design allows for comparison between control patients of primary care providers conducting group visits with primary care providers who do not participate in the group medical appointment intervention. Intervention: group medical visits of patients with their own PCP. Group visits include both education and medical care components. Organizational component: tracking of organizational issues in establishing the program of group visits; interviews with key stakeholders to identify barriers and facilitators to implementing the new model of care. Outcome measures: patients' blood pressures (BPs), medication adherence, satisfaction, and health-related quality of life; PCP satisfaction; qualitative analysis of themes from interviews for patient, physician, and medical center factors involved in making organizational changes to encompass group visits.