Models for collaboration: how system dynamics helped a community organize cost‐effective care for chronic illness

Abstract Chronic illness is a large and growing problem throughout the world. Experts agree that the U.S. health care system is poorly organized to care for chronic illnesses and, as a result, is wasteful and unresponsive to the needs of patients. This article describes a program to improve chronic care in a county of Washington State, and how system dynamics models focusing on diabetes and heart failure supported the planning of that program. The models project the program's costs and benefits over 20 years and have given its leadership the ability to do resource planning, set realistic expectations, determine critical success factors, and evaluate the differential impacts on affected parties. Relying upon model projections, the leadership is seeking ways to address concerns about financial “winners” and “losers” so that all parties are willing to participate in and support the program. Copyright © 2004 John Wiley & Sons, Ltd.