Risk adjustment models can establish appropriate payments and incentives for delivering superior primary care, particularly to people with chronic conditions, through health-based capitation and performance assessment in a patient-centered medical home (PCMH). The practical issues and administrative structures for implementing bundled PCMH payment that we discuss are relevant for single-payer Scandinavian countries as well as the US. Feasibility is supported by the “virtual all-payer” PCMH pilot of one US health plan.