One year ago, passage of the Patient Protection and Affordable Care Act was no doubt a great step forward for chronic disease prevention and wellness. In fact, U.S. Department of Health and Human Services Secretary Kathleen Sebelius reaffirmed this during her testimony to the Senate Finance Committee last week when she spoke about additional preventive care now available to Medicare beneficiaries because of the Affordable Care Act. However, while much has been accomplished over the past year, the road ahead remains long. The Partnership to Fight Chronic Disease (PFCD) and its partners continue to actively push national and state leaders to make chronic disease prevention and management a top priority and urge continued investment in both the public and private sectors. The data clearly demonstrate that focusing on chronic disease prevention and management improves health outcomes and reduces health care spending. Seventy-five percent of health care spending is linked to chronically ill patients. While we have the knowledge and the tools to improve health by preventing chronic disease onset and progression, changes are needed to put that know-how to broader use. Those changes include policies that realign our health care system to promoting health and enabling individuals to make healthier choices. With almost one in two Americans having a chronic disease, successful reform means doing a better job both preventing the onset and progression of these costly illnesses. Making strategic investments that promote prevention, enhance care coordination and management and support better adherence and self-management are critical to reducing the human and economic burdens. Much more could and should be done. Understanding what is in the health care legislation that could help make this shift and supporting those efforts is an important start. We must make health improvement a priority – both politically and personally – to bend the health care cost curve and promote sustainable economic growth. While the past year can be considered successful, continuing to focus on chronic disease prevention and management is essential in creating a sustainable 21st century health care system.