Multiple chronic conditions (MCC) are commonly defined as the co-occurrence of two or more chronic physical or mental health conditions (Bierman, et al. (2021). The National Center for Chronic Disease Prevention and Health Promotion estimates there are approximately 130 million U.S. adults with MCC. Currently, there is a lack of measures addressing MCC.

Measuring Quality of Care for Persons with MCC

CMS noted in the Chronic Conditions Charts: 2018 that the prevalence of two or more chronic conditions among fee for service (FFS) Medicare beneficiaries in 2017 was 69%. These individuals constitute a challenge to the health care system because their conditions complicate each other, are ongoing, and are extremely costly to the persons involved and the nation overall. The effects of their comorbidities are more than simply additive; they multiply both morbidity and mortality (Tinetti et al., 2011). CMS found in 2017 that Medicare beneficiaries with MCC were the heaviest
users of health care services. Those with six or more chronic conditions accounted for 62% of Medicare spending on hospitalizations. However, Giovannetti et al. (2013) identified a few specifically designed measures to evaluate the quality of care provided to people with MCC.

Assessment of the quality of care provided to the MCC population should consider persons with two or more concurrent chronic conditions requiring ongoing clinical, behavioral, or developmental care from members of the health care team and whose conditions act together to significantly increase the complexity of management and coordination of care—including, but not limited to, potential interactions between conditions and treatments.

Looking from an individual patient’s perspective, the MCC Measurement Framework stated the presence of MCC would

• affect functional roles and health outcomes across the lifespan
• compromise life expectancy
• hinder a person's ability to self-manage or a caregiver's capacity to assist in the individual's care (p.8)