The overall goal in today’s healthcare is to obtain better care and lower the cost of receiving healthcare. As the healthcare system is comprised of employers, physicians, healthcare professionals, consumer and patient advocacy groups, patients quality organizations, health plans, hospitals and unions, they all must join together to establish an effective and efficient system. The PCMH’s do just this as they improve health outcomes, heighten the patient and provider experience of care. Also they reduce expensive, unnecessary hospital and emergency department utilization. On the opposing side, the healthcare systems that focus more on volume rather than value are constantly facing inefficiencies, having inconsistent health outcomes, and unstable financials. For these reasons there has been growing support for the PCMH across the vast majority of the United States. One of the most influencial benefits of the PCMH is the patient and family engagement. The PCMH’s initiatives are conveying the expectation for authentic patient and family engagements. This type of engagement happens at a few different levels within its system. As a patient one of the most important engagements is at the clinical encounter. This is where the patient and family engage in the care, the planning, and most importantly the decision-making. One of the hardest and most difficult process’ in your health is making decisions. PCMH’s give the patient and family a sense of trust and comfort. Engagements also occur at the practice or organizational level, where the patient and family engage in quality improvement and health care redesign. Times have changed as healthcare used to be controlled primarily by physicians, where now authority has trickled down to patients and their loved ones. Thirdly, engagements in PCMH’s occur at the community level. PCMH’s bring together community resources with