New Mexico's nationally recognized Health Extension Rural Offices enable independent primary care practices in the state to share clinical resources and receive technical assistance in becoming patient-centered medical homes. These extension centers provide onsite coaching on quality improvement, connect practices with specialists to co-manage complex patients, link patients to off-hours nurse triage services, and provide other resources smaller practices lack. This grant will enable a University of New Mexico team to provide technical assistance to three states—Kansas, Kentucky, and Oregon—that are interested in replicating New Mexico's program. The project team will also create an online resource to help state and local policymakers, provider organizations, health plans, and academic health centers across the country adapt the New Mexico model.