Beyond the conceptual and data challenges, a well-defined operational infrastructure in which financing is aligned with this approach is a prerequisite for its successful implementation. Community-based performance improvement requires a well-defined team structure such as that of a patient-centered medical home, where nurse practitioners and physician assistants or population managers can intervene using innovative, non–visit-based approaches. Payment structures that reward value-driven care models that seek to improve health outcomes and limit waste, rather than focusing solely on office-visit volume, will provide the foundation for sustaining our approach. Many delivery systems and payers have put these core components in place, and we expect that trend to continue.