Washington, DC – 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.
“Performance measurement is critical to improving the health and well-being of individuals with multiple chronic conditions,” said Janet Corrigan, PhD, MBA, president and CEO of NQF. “This measurement framework will be critical in helping inform future efforts to identify and evaluate performance standards for measuring and reporting the quality of care provided to these individuals.”
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.
“As the healthcare community looks to implement new care delivery models, we must consider how individuals with multiple chronic conditions will be affected,” said Caroline Blaum, co-chair of the Multiple Chronic Conditions Steering Committee. “This framework outlines a potential path for new models that thoughtfully takes into account the needs of this population.”
In addition, the report identifies several timely strategic opportunities for applying the framework that are relevant to current policy context. These include: a coordinated approach for filling measure gaps; building a common data platform to consistently and seamlessly collect information, including patient reported data; opportunities to apply the core tenets of the framework as new delivery models are implemented and tested; and transparency through public reporting to enable consumer decision-making.
“Supporting individuals with multiple chronic conditions requires a patient-centered approach,” said Barbara McCann, co-chair of the Multiple Chronic Conditions Steering Committee. “This framework will be vital in helping public and private sector quality improvement initiatives shift from a disease-specific model and ultimately improving care for this population.”
NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of this framework by submitting an appeal no later than May 31. To submit an appeal, please email appeals@qualityforum.org. For an appeal to be considered, the notification must include information clearly demonstrating that the appellant has interests directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.
NQF operates under a three-part mission to improve the quality of American healthcare by:
- building consensus on national priorities and goals for performance improvement and working in partnership to achieve them;
- endorsing national consensus standards for measuring and publicly reporting on performance; and
- promoting the attainment of national goals through education and outreach programs.
