title: Self-care: the new principal care.
abstract: We predict self-care will become the new principal source of care. People living with diverse chronic conditions spend more time on self-management than with their providers. The increasing burden of chronic disease and costs coupled with value-based payments and innovative care models will generate a shift away from expensive specialized care toward high-value self-care facilitated by information technology, social support, and clinical expertise. This predicted shift in the value stream carries with it risks and uncertainties but will likely prevail as society seeks to confer "agency" by enabling people to make decisions and engage effectively in care coproduction.
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice and Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (Drs Nelson and Meyer); Harvard Business School, Cambridge, Massachusetts and The Kings Fund, London, United Kingdom (Dr Bohmer).
authors.forename: Eugene C
authors.initials: EC
authors.lastname: Nelson
authors.forename: Gregg
authors.initials: G
authors.lastname: Meyer
authors.forename: Richard
authors.initials: R
authors.lastname: Bohmer
mesh_terms: D002908:Chronic Disease / Q000191:economics / Q000628:therapy*; D005102:Health Expenditures / Q000639:trends; D006801:Humans; D061214:Patient Safety; D011320:Primary Health Care / Q000191:economics / Q000592:standards* / Q000639:trends; D012648:Self Care / Q000191:economics / Q000592:standards* / Q000639:trends; D012944:Social Support; D013997:Time Factors; D062505:Value-Based Purchasing / Q000592:standards / Q000639:trends