An unusual experiment is underway in Fresno, Calif., that could usher in a new era in managing chronic illnesses and reducing related health care costs for employers and insurers.

The city has embarked on an ambitious program to reduce the rate of asthma-related emergencies among its residents. To fund the effort, it aims to sell special bonds to private investors eager to share in the savings realized by health care providers and payers as a result of fewer ER and hospital visits by asthma sufferers.

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