The views expressed in the evidence brief are the views of the authors and should not be taken to represent the views of the Ontario Ministry of Health and Long-Term Care, the AHSC AFP Innovation Fund, CPD-O or its member organizations. [...] In Ontario, the issue can be understood at a number of levels: 1) the nature and burden of chronic diseases that the healthcare system must manage; 2) the cost- effective programs, services, and drugs that the healthcare system must provide to meet the needs of those living with chronic disease; 3) the health system arrangements that determine access to and use of cost- effective CDM programs, ser [...] In Ontario, the prevalence of arthritis remains consistently high, with 17.2% of people over 12 years of age living with arthritis in 2005, 16.3% in 2007, and 16.9% in 2008.(12) The prevalence of asthma has increased slightly, from 8.0% in 2005 to 8.3% in 2008.(12) The proportion of Ontarians known to be living with diabetes has increased more significantly, from 4.8% in 2005 to 6.2% in 2008, and [...] Within the category of delivery arrangements, there is a lack of self-management supports targeted at patients with chronic disease, a lack of decision supports for teams that focus on the processes of care (not just the content of care), and a lack of clinical information systems that permit the monitoring and engagement of patients with chronic disease, among other challenges. [...] A recently published report of four Canadian case studies of effective CDM using primary healthcare teams found that none of the cases embraced all features of the model.(37) However, the case-selection process did not involve developing an inventory of Canadian primary healthcare practices that had adopted select features of the model and the case studies did not include an explicit assessment of