Although there are no formal public patient-centered medical home (PCMH) programs in the state, the Nevada Division of Health Care Financing and Policy (DHCFP) has identified the most pervasive high cost and chronic conditions for persons served through the fee-for-service (FFS) system. Because the care enrollees received in Nevada’s FFS program have historically been unmanaged, the DHCFP estimates that costs for providing care to persons with chronic illness will only escalate. To curtail the costs and provide appropriate care navigation assistance to persons with chronic illness, the state has identified a distinct need for a comprehensive care management program, namely, the Nevada Comprehensive Care Waiver (NCCW) program. The DHCFP as well as its sister agencies and counties are partnering with the Centers for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Administration (SAMHSA) to develop both the NCCW program and a model for Health Homes and Care Management and Coordination.