The majority of state Medicaid programs are testing models of coordinated medical care to improve quality and reduce costs, particularly for patients with multiple chronic illnesses.  Patient-centered medical homes are similar to managed care approaches and health maintenance organizations, but ask providers to focus on improving care rather than managing costs. Such medical homes focus on improving the relationship between doctors and patients, aim to put the patient at the center of the care system, and provide coordinated and integrated care over time and across care settings. Descriptions of eleven states’ pilot programs or authorizing legislation are included.