As the Center for Medicare Service (CMS) considers using the models described for Accountable Care Organizations (ACOs), the health system is seeing that the PCMH model is increasingly widely implemented. . In order for the PCMH model to improve patient quality, physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, social workers, educators, pastors, and care coordinators remember that quality is the result of sincere effort which, along with skillful execution is not an accident and represents a cascade of wise choices. “PCMH is a conceptually sound approach to organizing patient care and shows promise, particularly for improving the experience of patients and staff involved in the healthcare system” (Jackson et al..,