Advances in managing chronic disease

Managed care organisations that consistently monitor and report on quality have shown significant improvements in quality. 5 The Health Plan Employer Data and Information Set (HEDIS)-the principal tool used for evaluating managed care in the United States-has several measures relating to the treatment of cardiovascular disease, mental illness, and diabetes. 12 Two other papers describe the sharing of responsibility for chronic illness care between primary care and commercial disease management vendors in the US and the United Kingdom; the authors conclude that for-profit disease management shows promise in improving care but may have adverse consequences including fragmentation of care, diversion of funding from care giving, and improper use of patient data (pp 563, 566).