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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In their recent article, Costantini et al¹ assert that their study "provides evidence that an active care management approach is superior to clinical practice guidelines alone in improving quality and efficiency of care in hospitalized patients with congestive heart failure." While this may be the case, their data suggest that the differences in outcomes noted were due to selection bias and not the impact of the care management team.

The study compared clinical and economic outcomes of hospitalized patients with congestive heart failure managed by a nurse and physician care management team with both historical and concurrent control groups. One would expect outcomes for the 2 control groups to be similar. This was clearly not the case. The median cost per case in the non–care-managed (concurrent control) group was 50% higher than the median for patients during the baseline (historical control) period. Further, the median cost per intensive care unit . . . [Full Text of this Article]