A patient-centered medical home (PCMH) program for diabetes care. Last year's health care reform package focused in part on changing from "reactive" health care to preventive strategies, including the management of chronic conditions, such as diabetes, one of the most expensive chronic illnesses. The United States spends $174 billion on diabetes annually, and the cost of care for patients with diabetes averages 2.3 times that for patients without diabetes. In response, Pennsylvania is implementing a statewide PCMH program. Combining methods from the "chronic care model" to attempt to improve diabetes care, the 25 participating facilities are showing results. After the first year, the percentage of people who lowered their glycated hemoglobin, blood pressure, and low-density lipoprotein levels increased, as did the percentages of patients who received foot examinations, eye examinations, and pneumonia vaccines or had stopped smoking. The report appears in the June issue of the Joint Commission Journal on Quality and Patient Safety.