TO RESOLVE THE NATION’S HEALTH CARE DILEMMA AND tackle exploding costs, the current sporadic and reactive focus on treating episodes of disease must be transformed into one that is coordinated to improve health and minimize the consequences of chronic diseases. Because care is more effective when services are coordinated, there are mounting efforts to spur greater integration of delivery systems. What is missing is an approach that aligns the patient’s individual needs with health services tailored to meet those needs. Coordination of services will be insufficient unless they are driven by plans designed to anticipate the health needs of the patient over time. A proposal to do this is “prospective care,” a strategic approach that combines personalized health planning with integrated care services to focus on individualized health promotion, disease prevention, monitoring, and early intervention. Personalized health planning has the potential to effectively engage individuals with any aligned delivery system and serve as a foundation for payment models for valued outcomes. To deliver prospective care, 3 interrelated elements are essential: (1) a care model that uses personalized and predictive health planning, patient engagement, and processes to track health status, anticipate events, and personalize care when disease occurs; (2) care delivery systems to support the patient’s strategic health plan and medical needs in a coordinated, integrated fashion; and (3) a reimbursement system that supports prospective approaches and provides incentives for effective interventions. A problem with the current approach to care is that it is reactive, as exemplified by the medical work-up that starts with the “chief complaint and history of the present illness” and attempts to find the root cause of the disease and treat it. This model is well designed to treat disease events but not to promote health, prevent disease, or effectively treat chronic disease. Currently, many patients take little responsibility for their health, resulting in adherence barriers to effective prevention and treatment of long-term conditions. Existing reimbursement rewards interventions for disease events rather than prevention and continuity of care. Moreover, the current approach does not align with scientific concepts of disease development that indicate that an individual inherits a range of susceptibilities to chronic diseases and that, depending on exposures, health may improve or deteriorate into recognizable illnesses. Based on these concepts and emerging research enabling clinical prediction, the idea of prospective care, a strategic approach to personalized medicine, was developed. Personalized medicine refers to all factors that distinguish an individual’s health characteristics and risks, including family history, clinical data, behavioral factors, and genomics when applicable. Prospective care uses personalized health planning as its underlying approach to effectively link the patient and the delivery system. Personalized health planning is based on the understanding that an individual’s genetic inheritance creates baseline risk for diseases that are modified by environmental factors, resulting in development of or resistance to disease. Given the time dependency of the disease process, an individual’s health risks and status can be quantified and tracked over time, with strategies developed to engage patients and caregivers to minimize diseases and treat them appropriately when they occur. The personalized health plan consists of a health risk assessment, a process to track risk factors, and a wellnesstherapeutic plan that involves patients and maximizes their commitment. Thus, the plan serves as a point of coordination between the patient and the delivery system over time, ensuring maximum engagement on the part of both toward the goals of enhancing the patient’s well-being and minimizing disease. Inherited and acquired risks continue to be identified for many common diseases. The fields of genomics, proteomics, metabolomics, and bioinformatics will improve individual risk prediction accuracy, but they are not required to get started. A key element in the proposed medical workup is the identification of the patient’s specific susceptibilities to chronic diseases and the risk factors that allow tracking of disease development. Physicians are trained to anticipate disease risks based on numerous clinical factors including family history, physical findings, and results of laboratory tests. It will be important to adopt a more formal approach using the latest evidence-based standards and health