Insights from managed care in the United States will help the NHS

Two papers in this issue of BMJ examine developments in the management of chronic illness in the United States and explore their potential relevance to recent NHS initiatives and policies.1 2 A new King's Fund study of the care of chronically ill people in five leading US managed care organisations, summarised in the paper by Dixon et al (p 220), provides several observations and insights of relevance to new NHS initiatives targeting care of chronic illness.1 The authors conclude that the success of these organisations relates to five factors, which serve as the basis for their recommendations for NHS action. With some minor exceptions, I believe that their observations and recommendations are on target and worthy of serious consideration by policy makers in the United Kingdom.