The U.S. health care system provides acute care tools to deal with the problems of chronic disease, and strategies are needed to engage hospitals in chronic care innovations. Acute care-based models that improve chronic care have been developed, but their diffusion is limited by the absence of a business case for adoption. Yet a financial case for improving chronic care is possible by aggregating previously tested models into a service line that can be customized to local circumstances. Beyond benefits to hospitals, patients and payers could benefit from improved patient outcomes and costs; society could benefit from more appropriate deployment of resources.