HHS Initiative on Multiple Chronic Conditions

HHS is pleased to issue an updated compilation of programs, activities, and initiatives in support of the goals and objectives of the HHS Multiple Chronic Conditions Strategic Framework – the U.S. Department of Health and Human Services Inventory of Programs, Activities, and Initiatives Focused on Improving the Health of Individuals with Multiple Chronic Conditions. [PDF - 1.13MB]

The inventory provides basic information about existing (as of September 2011) HHS programs for researchers, providers, and organizations concerned about improving the care of individuals with multiple chronic conditions.

The information has been self-reported by HHS agencies and includes programs that are primarily focused on the MCC population.

The inventory is intended to assist HHS by creating linkages and synergies between existing programs in the Department, as well as by delineating the gaps that exist in supporting the implementation of the goals and objectives outlined in the HHS Framework. It is also meant to inform external stakeholders and the public and catalyze collaboration between the private and public sectors to improve the health status and quality of life for individuals with multiple chronic conditions.

Multiple Chronic Conditions: A Strategic Framework

In December 2010, HHS issued its new Strategic Framework on Multiple Chronic Conditions ― an innovative, private-public sector collaboration to coordinate responses to a growing challenge.

• Report: Multiple Chronic Conditions: A Strategic Framework [PDF - 245kb]
• Improving Health for Individuals with Multiple Chronic Conditions: Recent Actions by HHS Agencies
• Newsletter article for stakeholders: The Challenge of Managing Multiple Chronic Conditions

The U.S. Department of Health and Human Services administers a large number of federal programs directed toward the prevention and management of chronic conditions. HHS also must provide leadership in improving health outcomes in individuals with MCC. 

To identify HHS options for improving the health of this population, the Assistant Secretary for Health convened a departmental workgroup on individuals with MCC with participation by nearly all HHS operating divisions. As a result, the workgroup developed a strategic framework containing a vision statement, goals, objectives, and discrete strategies to guide the department in coordinating its efforts internally and collaborating with stakeholders externally. The framework is designed to address the spectrum of all population groups with MCC.

Background

• More than one in four Americans have multiple (2 or more) concurrent chronic conditions (MCC), ¹ including, for example, arthritis, asthma, chronic respiratory conditions, diabetes, heart disease, human immunodeficiency virus infection, and hypertension.
• In addition to comprising physical medical conditions, chronic conditions also include behavioral health problems such as substance use and addiction disorders, mental illnesses, dementia and other cognitive impairment disorders, and developmental disabilities. 
• Chronic illnesses are “conditions that last a year or more and require ongoing medical attention and/or limit activities of daily living.” ²
• The prevalence of MCC among individuals increases with age and is substantial among older adults, even though many Americans with MCC are under the age of 65 years. As the number of chronic conditions in an individual increases, the risks of the following outcomes also increase: mortality, poor functional status, unnecessary hospitalizations, adverse drug events, duplicative tests, and conflicting medical advice.^{1 2 3 4 5}

Contact Information

For more information or to provide comments regarding HHS’ initiative on multiple chronic conditions, please send e-mail to mcc@hhs.gov.

 ¹ Anderson G. Chronic Care: Making the Case for Ongoing Care. Princeton, NJ: Robert Woods Johnson Foundation, 2010. Available at  http://www.rwjf.org/files/research/50968chronic.care.chartbook.pdf. Last accessed May 11, 2010.

 ² Warshaw G. Introduction: advances and challenges in care of older people with chronic illness. Generation  2006;30(3):5–10. (see also: Hwang W, Weller W, Ireys H, Anderson G. Out-of-pocket medical spending for care of chronic conditions. Health Affairs 2001;20:267-78)

 ³ Lee TA, Shields AE, Vogeli C, Gibson TB, Woong-Sohn M, Marder WD, Blumenthal D, Weiss KB. Mortality rate in veterans with multiple chronic conditions. J Gen Intern Med  2007;22(Suppl 3):403–407.

 ⁴ Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, Blumenthal D. Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med  2007;22(Suppl 3):391–395.

 ⁵ Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med  2002;162(20):2269–2276.