OBJECTIVE: To explore how healthcare management has evolved from managing separate components to disease management. DATA SOURCES: Recent published atricles and the authors' experiences. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: Disease state management integrates services from all areas of healthcare. To evaluate whether a disease is being treated effectively, clinical, physical, and quality of life, indicators need to be measured. Protocols and intervention strategies need to be developed at minimal cost without compromising patient care. Patient and physician satisfaction need to be evaluated to measure the success of the disease management process. CONCLUSION: The old paradigm of component management of medical care is losing ground and being replaced by systems focused on patient outcomes as the best way to deal with the issues of access, quality, and cost. KEY WORDS: Disease state management, Outcomes, Costs.