Over the past six years, Medicaid agencies in 25 states have pursued initiatives to support the efforts of physician practices to become patient-centered medical homes. A Commonwealth Fund–supported article published in Health Affairs reviews the variety of reforms taking shape, including new fee structures that enable physician practices to be reimbursed for the care management services they provide; support for smaller practices to share the services of registered nurses, behavioral health specialists, and other health professionals; and the alignment of payment with quality-of-care standards.