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“Disease management” is the latest catch phrase in the ever-evolving American health care spectacle. What does it mean? Who is promoting it and why? What does it portend for the future of health care? Disease management has two forms — a contracted “carve-out” model and a primary care–based model — and I argue here that the carve-out model may have negative consequences for American health care.What is Disease Management?One hundred million Americans live with chronic illnesses.1 Yet physicians are not adequately caring for this population. According to Dr. Edward Wagner, a leading scholar on the subject, “Surveys and . . .
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Thomas Bodenheimer (1999) studied this question.
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