This Webinar is hosted by the Center for Multi-stakeholder Demonstration and feature Dr Jennifer Lail from Chapel Hill Pediatrics and Adolescents, P.A. Dr Lail will present some of the steps they took on their journey to becoming a patient-centered medical home with special emphasis on how they coordinate care for their patients with special health care needs. Dr Lail will discuss the critical factors related to coordinating care which include Relationships, Ready Access, Registry/Records, Resources (including Care Coordination services) , Reimbursement and Recruitment. She will identify several approaches they took to enhance communication and co-management to improve chronic condition management for patients in their practice.