Changing the chronic care system to meet people's needs

Persons who are likely to be the heaviest users of medical and supportive c are services-those with chronic illnesses, disabilities, and functional lim itations-are often forced to navigate a system that requires them to perfor m most of the coordination functions themselves and is generally not organi zed around their needs. In 1996 an estimated 128 million Americans had at l east one of these three conditions, and 9.5 million had all three. This pap er examines the current programs designed to assist these persons and sugge sts changes in eligibility rules, coverage policies, and educational progra ms to provide a system more oriented to people's chronic care needs.