Growing evidence suggests that health care is more efficient and effective when patients are actively engaged in their treatment.  Engaged, or activated, patients collaborate with their providers, are treated with respect and dignity, receive information related to their care, and are involved in decision-making.  Two separate reviews commissioned by the Institute of Medicine and Robert Wood Johnson Foundation found that chronic disease self-management and promotion of patient engagement are essential to successful care management programs targeting patients with high needs and high costs and are associated with improved quality of life, functional autonomy, and decreased hospital use.