Purpose: The existence and form of interaction effects between service quality and satisfaction are still uncertain. The main purpose of this study is to examine whether satisfaction moderates the relationship between service quality and behavioral intentions. Design/methodology/approach: A structured questionnaire was distributed to the out-patients of 12 regional hospitals (the middle level) in Taiwan. Findings: The findings show that the forms of moderators played by satisfaction are not always the same under different dimensions of service quality (i.e. reliability, responsiveness, assurance, and empathy). Satisfaction positively moderates the influence of reliability/empathy on behavioral intentions, but negatively moderates the relationships between responsiveness/assurance and behavioral intentions. Originality/value: This study reveals the moderating role of satisfaction in the translation from service quality to behavioral intentions in health care services. Moreover, the natures of the moderating effects are not the same for different service quality dimensions. Emerald Group Publishing Limited.