Disease management (DM) programs have become common in health systems, espe
cially in managed care organizations and hospitals. These programs are desi
gned to improve both the quality of care and the efficiency of health care
delivery. However, there may be controversy about the most important outcom
es to consider. Furthermore, the effectiveness of DM initiatives is largely
undocumented in the literature. The purpose of this paper is to review the
issues, methods, and outcomes involved in creating and instituting DM prog
rams. To improve DM efforts within health systems, constructive relationshi
ps with practitioners need to be built by involving important individuals e
arly in the process. It is hoped that evidence-based guidelines will furthe
r enhance DM efforts. Beneficial DM initiatives require a multidisciplinary
focus of cooperation and willingness to share data between distinct profes
sional groups. More thorough analysis of DM programs is needed in many heal
th systems.