A nurse-managed primary care community health center, Abbottsford Community Health Center (ACHC), provides highly accessible, quality, cost-effective care to the residents of the Abbottsford Community. Data revealed that, in comparison to the aggregate family practices in an HMO, ACHC has achieved better outcomes in areas such as emergency department visits, inpatient days and client care costs. The nurse manager's roles and responsibility are critical in achieving this success.