From 1992 through 2002, the Robert Wood Johnson Foundation (RWJF) funded Building Health Systems for People With Chronic Illnesses, a national program that encompassed a broad range of initiatives covering the full spectrum of medical, mental health and supportive service needs of people with disabilities and chronic health conditions.
RWJF designed Building Health Systems to address deficiencies in the nation's system to treat and serve individuals with chronic physical or mental impairment—some 99 million Americans at the time. These deficiencies—administrative, institutional, professional and financial—resulted in a system of care that was often fragmented, unresponsive, inappropriate, lacking in consumer choice and based in institutions, rather than occurring at home or in the community.
These barriers contributed significantly to the high cost of care for chronically ill people—estimated when the program began at $470 billion annually—representing an enormous part of the nation's total health care expenditure.
In general, the program director believed that by supporting projects that strove to integrate care delivery and financing, Building Health Systems advanced the movement away from an acute-care focus within the health care system and toward a social health model of care for people with chronic conditions.