Why use this guide

Better care experiences, better population health, lower cost, and happier staff.

Primary care practices are achieving this quadruple aim by creating more effective practice teams and becoming certified as Patient-Centered Medical Homes. The Primary Care Team Guide provides step-by-step direction on how to establish these high-functioning teams and implement new functions essential to team-based care. Numerous tools and resources from 31 exemplary practices nationwide are made available to support you.

Featured Resources and Modules

Physicians share their experience with team-based care.

Creating a culture of trust and shared responsibility is the foundation, say physicians.

The result is grateful patients and staff, and better care. Team-Base Care: The Physician Experience Video

Engage lay health workers as part of the care team.

Lay health workers, like patient advocates, can take over administrative tasks that weigh down clinical staff and reduce time with patients. Neighborhood Family practice in Ohio used a variety of tools to engage patient advocates effectively.

The Lay Person module

Health coaches can be a patient’s guide through the healthcare experience.

Incorporating health coaches and nurse practitioners into care teams helped High Plains Community Health Center significantly improve patient experience and give physicians more time with patients. Watch this video about the Center’s transformation.

The Medical Assistant module