The following study examines practice leaders’ perceptions and experiences of how patient-centered medical home (PCMH) transformation improves patient experience. Lead physicians, site clinic administrators, and nurse supervisors completed semi-structured interviews to identify critical patient experience domains and mechanisms of change. The study identified 28 patient experience domains improved by PCMH transformation and 24 mechanisms of change. Specifically, practices would benefit from collecting specific information on staff behaviors related to teamwork, team-based communication, scheduling, emergency and inpatient follow-up, and referrals.