How is HHS addressing Multiple Chronic Conditions?
HHS administers a large number of federal programs directed toward the prevention and management of MCC. HHS also provides leadership in improving health outcomes in individuals with MCC.
- Multiple Chronic Conditions: A Strategic Framework
- Inventory of HHS Programs, Activities, and Initiatives Focused on Improving the Health of Individuals with Multiple Chronic Conditions
- Evaluation of the Strategic Framework
- Multiple Chronic Conditions Among Medicare Beneficiaries
- Multiple Chronic Conditions Measurement Framework
- MCC Research Network
Multiple Chronic Conditions: A Strategic Framework
Recognizing the importance of MCC to patients, caregivers, and the health care system, the Assistant Secretary for Health convened an HHS-wide work group on MCC to identify options for improving the health of this population. The work group, in conjunction with other stakeholders, developed Multiple Chronic Conditions: A Strategic Framework [PDF - 245kb] The Framework serves as a national-level roadmap for assisting HHS programs and public and private stakeholders to improve the health of individuals with MCC. It also helps to ensure a more coordinated and comprehensive approach around MCC. Made available in late 2010, the Framework is organized by four major goals:
- Strengthening the health care and public health systems.
- Empowering the individual to use self-care management.
- Equipping health care providers with tools, information, and other interventions.
- Supporting targeted research about individuals with MCC and effective interventions.
The Framework is directed to clinical practitioners, policy makers, researchers, and others. It is designed to address the needs of all population groups with MCC. Since the Framework’s release, HHS agencies and external partners have worked together to align their respective programs, activities, and initiatives in support of the framework’s goals, objectives, and strategies. Improving Health for Individuals with Multiple Chronic Conditions: One-Year Achievements Aligned with the HHS Strategic Framework describes HHS achievements during the first year following the release of the Framework.
In early 2012, HHS developed the Implementation of the Strategic Framework, a work plan focusing on several areas of the Framework. Activities in the plan include:
- Examining how the Affordable Care Act supports individuals with MCC.
- Increasing the dissemination of HHS data and patient-centered outcomes research.
- Advancing the quality measures agenda.
- Facilitating self-care management activities.
- Integrating MCC into clinical practice guidelines.
- Including individuals with MCC in clinical trials.
- Promoting MCC curricula for health workforce sectors.
- Educating federal, private, public and international sectors about MCC-related issues.
Inventory of HHS Programs, Activities, and Initiatives Focused on Improving the Health of Individuals with Multiple Chronic Conditions
In September 2011, HHS released the Inventory of Programs, Activities, and Initiatives Focused on Improving the Health of Individuals with Multiple Chronic Conditions. [PDF - 1.13MB] listing of existing programs and activities for researchers, providers, and organizations concerned about improving the care of individuals with MCC. This inventory is intended to increase communication and collaboration between existing HHS programs and to identify gaps to support the implementation of the goals and objectives outlined in the Framework. The listing is organized according to the Framework, making it easy to locate programs and activities that address each of the Framework’s goals and objectives.
Evaluation of the Strategic Framework
HHS is evaluating the implementation of the Framework to assess the progress of other federal, public and private organizations in their response to the strategies provided. In support of this effort, a searchable list of MCC-related programs, activities, and initiatives sponsored by other federal, public and private organizations is being developed. Gaps in both inventories were identified to determine which activities further the implementation of the Framework. As a result, scheduled for summer 2012 are stakeholder meetings to discuss effective strategies for addressing two identified gaps:
- Sustaining self-care management
- Identifying the most appropriate interventions for targeted subgroups of individuals with MCC.
The overall aim of the meetings is to continue advancing the HHS goals for MCC.
Multiple Chronic Conditions Among Medicare Beneficiaries
The Centers for Medicare and Medicaid (CMS) prepared the Chronic Conditions Chart Book to highlight the prevalence of chronic conditions, including MCC, among Medicare beneficiaries. It also shows the impact of chronic conditions on Medicare service utilization and spending. This information is intended to provide health policy makers and the public health research community a better understanding of the burden of chronic conditions among the Medicare Fee-for-Service population. The Chart Book provides preliminary insights into tailoring prevention and management strategies to improve care and reduce costs for those with chronic conditions.
Multiple Chronic Conditions Measurement Framework
On May 3, 2012, the National Quality Forum (NQF), supported by HHS, released a Measurement Framework 
for individuals with MCCs. This framework addresses the complex circumstances of these individuals and serves as a guide for future MCC measure development. The framework will:
- Help guide measure selection for public reporting and payment.
- Suggest a roadmap for new care delivery models.
- Inform related research.
MCC Research Network
The Agency for Healthcare Research and Quality’s (AHRQ) MCC Research Network advances the field of MCC research by providing needed guidance for clinicians and patients and advising policy makers about improved methods to measure and promote quality care for complex patients. The AHRQ MCC Research Network includes:
- 18 original grants funded in 2008 (two of which received additional funding in 2009).
- 27 grants funded in 2010 under the American Recovery and Reinvestment Act of 2009.
- A Learning Network and Technical Assistance Center designed to support the overall effort.