Although people with MCC represent a growing proportion of society who use an increasingly large amount of health care services, existing quality measures do not adequately address comorbidity. Current quality measures are largely based on performance standards derived from clinical practice guidelines for management of a single disease (Tinetti et al., 2004). Evidence-generating clinical trials forming the basis of many clinical practice guidelines often exclude patients with MCC. The randomized clinical trials used in clinical practice guideline development focus mainly on single diseases to produce robust guidance for specific disease treatments. Rigid adherence to these disease-specific guidelines could potentially harm those with MCC. For example, medications prescribed in adherence to guidelines for several diseases individually may result in a patient suffering adverse effects of polypharmacy (American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity, 2012). Few measures exist to evaluate inappropriate care in these situations.