The new health reform legislation ensures that up to 20 million low-income Americans will gain insurance coverage through Medicaid by 2019. To serve these beneficiaries, it will be essential for Medicaid to purchase high-value primary care that drives better outcomes, greater patient satisfaction, and more efficient use of resources. A new Commonwealth Fund report explores how a system of shared supports can help ensure that smaller independent physician practices serving Medicaid patients are able to deliver a full range of services.