Patients and physicians at University of Pittsburgh Medical Center (UPMC) identified education as a barrier to the promotion of quality diabetes care.10 In an effort to provide education for physician practices and outlying hospitals, the UPMC Endocrine Division supported a certified diabetes educator (CDE). This provided an immediate solution, but a long-term strategy was needed for the UPMC system. In contrast to traditional methods, the chronic care model (CCM) provides a framework for a systematic approach and has been shown to improve processes and outcomes. The CCM is based on the premise that effective chronic disease programs are delivered in partnership with health systems and communities. Although the CCM has been used in diabetes improvement projects, it has never been tested in facilitating DSMT programs. The CCM identifies key elements that are critical to success: health system, to serve as the foundation by roviding structure and goals; community, to link with community resources; decision support, to ensure that providers have access to evidencebased guidelines; self-management support, to help patients acquire skills and confidence to self-manage; clinical information systems, to provide timely access to data about patients and patient populations using clinical information systems; and delivery system design, to restructure medical practices to facilitate team care. It was the objective of this study to evaluate the benefits of using all of the elements of the CCM to expand and support DSMT. The researchers hypothesized that introducing the components of the CCM would lead to increased administrative support along with improved reimbursement for services and A1C levels. By increasing the number of programs and providing DSMT in primary care, it was hoped that some of the barriers to DSMT could be curtailed, including access.