Enthusiasm for the patient-centered medical home model is growing, yet initial research is scant, showing that true transformation is challenging and that meaningful improvements in care delivery, efficiency, and health outcomes take time and sustained investment. This brief surveys safety-net health centers to determine their potential to become medical homes. Safety-net health centers that provide vulnerable and low-income populations with comprehensive primary care have unique opportunities for successful transformation, but also face challenges. For example, nearly half of the health centers surveyed do not have a process for scheduling patients with a personal provider or have an existing process that needs improvement; two-thirds do not have a process for same-day scheduling or have a process that needs improvement. Survey data also show that health centers that employed team-based care were more likely to have instituted patient access and communications processes, relative to those without team-based care.