Primary care physicians are supposed to play a central role in care coordination. This chapter finds no strong evidence that they have been able to improve care, a possible reason for relative low incomes for this specialty and small numbers. Evidence does show a need for care coordination, but health system managerial strategies to make gains by use of financial incentives (pay for performance) or organizational changes (patient-centered medical homes) have so far not been demonstrated. Prospects for the use of other sources of coordination (advanced practice providers and hospitalists) are discussed and opportunities outlined. Bundled payment or capitation might help support coordinated services, and competition among health systems to offer different models may eventually lead to success.