Although it may seem odd to medical professionals to state that disease management is a new concept, it represents a sea change in medical care delivery. Because of the dramatic increases in technologies that do not cure diseases, but improve them, and the costs we pay for using these technologies, we are finding that medical delivery models based on cure are no longer viable. Evidence for better strategies that coordinate care across populations of persons with similar diseases is at hand. As financial pressures mount, organised approaches to disease management will become more widespread. Along the way, the existing roles of key players, such as hospitals, physicians and pharmaceutical companies, will change.