Chronic Care Programs

RWJF Retrospective Series: Chronic Care Programs

Almost half of all Americans live with a chronic condition or disability. Since its establishment in 1972, the Robert Wood Johnson Foundation (RWJF) has devoted more than $1 billion to programs to improve the lives of people with chronic illnesses and disabilities.

In early 1991, RWJF’s Board of Trustees established chronic illness as a major Foundation priority, “To improve the way services are organized and provided to people with chronic health conditions.”
This retrospective, the third installment in the RWJF Retrospective Series, provides a broad overview of RWJF’s chronic illness-related programs--their outcomes and their impact on the systems of care for persons with chronic illnesses and disabilities. It also discusses the impact of the 1991 priority on RWJF’s grantmaking.
The authors of this Retrospective found that many of the programs had important positive effects on the care and services that  people with chronic conditions received, and several of the programs greatly influenced the field of chronic illness care. Few of the programs, however, produced outcomes beyond the boundaries of the particular program or lasting fundamental changes in the health care system. The report suggests that the lack of strategic coordination of program identification, development, and implementation resulted in a low degree of synergy among programs. Perhaps most importantly, even the substantial resources committed to this priority were dwarfed by the enormous size of the issues being addressed.


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of Americans have a chronic condition or disability. Read the latest installment in the RWJF Retrospective Series on chronic illness.