the National Quality Forum (NQF) Board of Directors has approved for endorsement a measurement framework for individuals with multiple chronic conditions. The framework addresses the complex circumstances of these individuals, and is intended to serve as a guide for future measure development and NQF-endorsement decisions pertaining to measures that address this vulnerable population. In addition, the framework will help guide measure selection for public reporting and payment; suggest a roadmap for new care delivery models; and inform research.
People with multiple chronic conditions now comprise over one-quarter of the population. As the population continues to age, that percentage is expected to grow. This population is at significantly higher risk of adverse outcomes and complications, and is more likely to see multiple clinicians, take several medications, and receive fragmented, incomplete, and ineffective care. Yet despite wide recognition of this problem from the healthcare community, existing quality measures largely do not address multiple chronic conditions.
As a result, NQF convened a multi-stakeholder Steering Committee to develop this measurement framework under contract with the Department of Health and Human Services. Specifically, the framework:
- Establishes a definition for multiple chronic conditions in order to achieve a common understanding and a shared vision for effectively measuring the quality of care for affected individuals;
- Identifies high-leverage measurement areas for the multiple chronic conditions population in an effort to mitigate unintended consequences and measurement burden;
- Presents a conceptual model that serves as an organizing structure for identifying and prioritizing quality measures; and
- Offers guiding principles to address methodological and practical measurement issues.