Measuring Performance

MCC Measurement Framework 

Project Status: Completed

Multiple Chronic Conditions (MCC) Measurement Framework

Access the Endorsement Summary (PDF) |Access the Full Report  

The Opportunity 

Patients with multiple chronic conditions (MCCs) represent a growing segment of the population, and currently include over one quarter of the U.S. population.1, 2   Despite the growing prevalence of individuals with MCCs, these patients are largely not addressed by available quality measures.

Uses of condition-specific performance measures for pay-for-performance programs, public reporting, or quality improvement may result in poor quality care and even harm to patients with MCCs, as well as provide misleading feedback for their physicians.3 Therefore, NQF-endorsed measures that cross clinical care settings and are meaningful to patients are particularly germane to this population.

Under the guidance of a multi-stakeholder steering committee, NQF will develop a patient-centric measurement framework for individuals with MCCs. Specifically the framework will:

  • Establish definitions, domains and guiding principles that are instrumental for measuring and reporting the efficiency of care for patients with MCCs
  • Adapt the NQF-endorsed Patient-focused Episodes of Care Measurement Framework for patients with MCCs who have overlapping episodes of care; addressing the population at risk, the interplay among multiple evaluation and initial management stages and the unique nature of follow-up care.
  • Build upon the National Quality Strategy, HHS’s Multiple Chronic Conditions Framework and the work of other private sector initiatives such as the National Priorities Partnership.
  • Support the development and application of measures by identifying measure gaps, guiding endorsement decisions, guiding selection of measures for public reporting and payment programs and informing research.

About the Project

This project began in April 2011.


NQF seeks to develop and endorse a Measurement Framework for Multiple Chronic Conditions as a foundation for the future endorsement of performance measures that explicitly address MCCs.

NQF Process 

Measures will be considered for NQF endorsement as national voluntary consensus standards based on the recommendations developed through NQF’s formal Consensus Development Process (CDP, Version 1.8). This project involves the active participation of represent from across a broad spectrum of healthcare stakeholders and will be guided by a Steering Committee.


This project is supported under a contract provided by the Department of Health and Human Services.

Related NQF Work 

Contact Information 

For further information, contact Aisha Pittman, MPH at 202-783-1300 or via e-mail at


2Kenneth E. Thorpe and David H. Howard The Rise In Spending Among Medicare Beneficiaries: The Role Of Chronic Disease Prevalence And Changes In Treatment Intensity Health Affairs, September/October 2006; 25(5): w378-w388.
3Mary E. Tinetti, Sidney T. Bogardus, Jr., and Joseph V. Agostini Potential Pitfalls of Disease-specific Guidelines for Patients with Multiple Conditions NEJM, December 30, 2004; 351;27 2870-2874.

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