The Chronic Care Model (CCM) is a widely adopted approach to improving ambulatory care, aiming to transform the daily care for patients with chronic illnesses from acute and reactive to proactive, planned, and population-based. The CCM consists of six interrelated system changes: self-management support, decision support, delivery system design, clinical information systems, health care organization, and community resources. Over the past decade, numerous studies have evaluated the effectiveness of CCM-based interventions, showing that they can improve patient care and health outcomes. However, cost-effectiveness remains a key area for further research. The CCM is particularly effective in large, well-resourced practices, and external financial incentives and quality improvement support may be essential for widespread implementation, especially in smaller practices. More research is needed to understand the practicality, effectiveness, and cost implications of implementing the CCM, as well as to develop better tools and dissemination models to help practices improve their systems.The Chronic Care Model (CCM) is a widely adopted approach to improving ambulatory care, aiming to transform the daily care for patients with chronic illnesses from acute and reactive to proactive, planned, and population-based. The CCM consists of six interrelated system changes: self-management support, decision support, delivery system design, clinical information systems, health care organization, and community resources. Over the past decade, numerous studies have evaluated the effectiveness of CCM-based interventions, showing that they can improve patient care and health outcomes. However, cost-effectiveness remains a key area for further research. The CCM is particularly effective in large, well-resourced practices, and external financial incentives and quality improvement support may be essential for widespread implementation, especially in smaller practices. More research is needed to understand the practicality, effectiveness, and cost implications of implementing the CCM, as well as to develop better tools and dissemination models to help practices improve their systems.