After 1 year, patients with care guides had achieved more goals than those who received usual care. Care guide patients reduced unmet goals more than usual care patients (30.1% vs. 12.6%). In particular, care guide patients improved more than usual care patients in meeting several individual clinical goals, including not using tobacco and, for those with diabetes, getting retinal eye examinations and urine tests for protein. In surveys conducted after the study was completed, the care guide patients reported more positive perceptions of their care than the usual care patients in terms of social support, individualized care, help, reinforcement, and understanding of how to improve their health. The estimated cost of the care guide intervention was $286 per patient per year.