This study describes how 4 primary care practices deliver components of the patient-centered medical home (PCMH) model. Interviews with administrators and clinicians were conducted and analyzed. All practices had achieved National Committee for Quality Assurance Level 3 Medical Home Accreditation. Yet, the manner in which some of the core PCMH components were delivered varied across sites. For example, information technology is used in different ways and to different degrees although the same electronic medical record is employed in all settings. Evaluations of the PCMH model must account for differences in approach to truly assess its effectiveness.