Health plans are committed to the advancement of disease management (DM). They believe DM is crucial to the successful management of care, and actively promote a variety of DM initiatives. However, the political climate in the US in recent years has not been conducive to the advancement of managed care, and thus threatens the advancement of DM as well. On the other hand, voters have recently demonstrated a lack of sympathy with critics of managed care, and despite a contentious debate over patients' rights, there is growing awareness of the benefits of evidence-based care, particularly in managing chronic conditions to improve quality of life and productivity. This awareness, although perhaps overshadowed by the current political scene, creates important opportunities for DM advocates.