The rising prevalence of chronic disease requires a concerted focus to better integrate care and to achieve better health outcomes and greater system efficiencies. Achieving and evaluating these improved patient outcomes and system efficiencies will take both time and investment, and will challenge existing models of care. This paper examines the Health Care Home program being developed by the Australian Government Department of Health. It proposes that the model should be patient-centred, flexible and delivered according to local needs and local system capacity, but must also be built on shared principles and values, and must acknowledge the need to address both the business model and the care model. Without shared principles, the capacity to achieve substantial system change and acceptance from funders, providers and patients will be compromised. 

To achieve change organised around these principles, the following enablers must be part of the Health Care Home model:

• institutional and professional leadership from all levels of the healthcare system
• a mutually shared understanding of principles and objectives
• collaborative, sector-led planning and change management, appropriate funding and incentives broad workforce engagement
• patient-centred, co-designed care
• outcomes-focused data and technology to support innovation
• models of coordinated care adapted to local circumstances
• operational and equity considerations, balanced with risk stratification

The opportunity for reform and the associated potential for failure are significant. Public and expert debate must be fostered to ensure that the model to be more broadly implemented is accepted by funders, providers and consumers. Shared principles are proposed to inform this debate, and to contribute to the change management required for successful implementation of Health Care Homes in Australia.