The patient-centered medical home is a model of primary care in which patients receive well-coordinated services and enhanced access to a clinical team, and clinicians use decision support tools, measure their performance, and conduct quality improvement activities to meet patients' needs. The model holds promise not only for improving clinical quality and patients' experiences, but also for reducing health system costs. Fund research demonstrates, moreover, that most racial disparities in health care vanish when patients have a medical home. The Commonwealth Fund is launching a new, five-year demonstration to help 50 safety-net primary care clinics become patient-centered medical homes that achieve benchmark levels of quality, efficiency, and patient experience. In the initiative's first year, project staff will develop the curriculum for improvement, engage national stakeholders, develop a request for proposals, and select the regions and clinics that will participate.