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 Multiple Chronic Conditions Activities: Database of Programs, Tools, and Research Initiatives to Address the Needs of Individuals with Multiple Chronic Conditions & the Innovative Profiles Report
- Evaluation of the Strategic Framework
- Multiple Chronic Conditions Among Medicare Beneficiaries
- Multiple Chronic Conditions Measurement Framework
- MCC Research Network
- Implementation Actions by HHS Agencies
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 - 245 KB] 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 Multiple Chronic Conditions Activities: Database of Programs, Tools, and Research Initiatives to Address the Needs of Individuals with Multiple Chronic Conditions & the Innovative Profiles Report
In January 2013, HHS expanded its HHS Inventory of Programs, Activities, and Initiatives Focused on Improving the Health of Individuals with Multiple Chronic Conditions (MCC) to include MCC-related programs and activities that take place in the public and private sectors. This inventory is a database of programs, tools, and initiatives that address individuals with multiple chronic conditions. This new database will benefit researchers, providers, and organizations interested in improving the care of individuals with MCC. The inventory database is organized according to the HHS StrategicFramework on MCC [PDF - 245 KB], making it easy to locate programs and activities that address each of the Framework’s goals and objectives. OASH also developed a companion piece that provides additional detail on a subset of activities that support the goals of the Framework. The report titled Private Sector Activities Focused on Improving the Health of Individuals with Multiple Chronic Conditions: Innovative Profiles [PDF - 3.78 MB] features successful activities that make use of an innovation. The profiles present a new or innovative use of the workforce, a technology, or individuals who themselves have MCC.
These tools provide valuable information on the interventions, strategies, tools, training and research to assist those who manage or provide care for those with MCC.
Evaluation of the Strategic Framework
HHS evaluated 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 database 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, the following two stakeholder meetings were held in the summer of 2012:
- Sustaining self-care management [meeting summary, PDF - 790 KB]
- Identifying the most appropriate interventions for targeted subgroups of individuals with MCC [meeting summary, PDF - 868 KB]
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) developed the following data resources which highlight the prevalence of chronic conditions, including MCC, among Medicare beneficiaries:
- Chronic Conditions Chart Book
- Chronic Conditions Dashboard
- State Level Chronic Condition Reports
- MMWR Data Brief: Multiple Chronic Conditions Among Medicare Beneficiaries: State-level Variations in Prevalence, Utilization, and Cost, 2011 [PDF]
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.
Results from the AHRQ MCC Research Network were published in the March 2014 special issue of Medical Care.