The author talks about the state of U.S. healthcare and its problems such as rising rates of preventable chronic conditions, the increasing cost of care, and poor application of evidence-based prevention and management strategies. Topics include the concept of high-need, high-cost (HNHC) patients, or those with three or more chronic conditions coupled with a functional limitation to daily activities, care management models for HNHC patients, and the misalignment of U.S. health care resources.