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HHS Strategic Framework on Multiple Chronic Conditions One-Year Anniversary

Posted Dec 14 2011 12:01am

Today marks the one-year anniversary of the release of the U.S. Department of Health and Human Services’ Strategic Framework on Multiple Chronic Conditions, a plan aimed at improving the overall health status of individuals with multiple chronic conditions. 

One in four Americans – and two out of three over 65 – have multiple chronic conditions. According to a new report issued by the Centers for Medicare & Medicaid Services (CMS), care for its beneficiaries with multiple chronic conditions accounts for 93 percent of Medicare expenditures.

The HHS plan has identified more than 100 programs, activities and initiatives that focus on improving the health of those with multiple chronic conditions.

“Integrating strategies to care for some of our sickest patients will improve health outcomes, lower costs and maximize quality of life,” said Howard K. Koh, MD, MPH, HHS assistant secretary for health.

In addition to the new CMS data on numbers of Original Medicare beneficiaries with multiple chronic conditions, the agency also reported in its Chronic Conditions Among Medicare Beneficiaries report that Medicare beneficiaries with multiple chronic conditions are more likely to be hospitalized and are the biggest users of other high-cost health care services.

The information in the report is based on the roughly 65 percent of Medicare beneficiaries who were enrolled in the Original Medicare Fee-for-Service program for the entire year, and does not include beneficiaries who have a private Medicare plan. 

“These data confirm the importance of moving forward with so many of our efforts to implement the Affordable Care Act, including the utilization of preventive services and coordinated care models that help keep Medicare patients healthy. Our Chronic Conditions Among Medicare Beneficiaries report will be an important resource for us, our partners, and providers, to help us make even more informed decisions about how to best treat patients with chronic conditions,” said CMS Acting Administrator Marilyn Tavenner.

The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA) are facilitating the integration of primary care and behavioral health services through the recently launched Primary Care and Behavioral Health Integration program.  In addition to the work being done by HRSA in community health centers to integrate care, approximately 22,000 adults have received primary behavioral healthcare services through this grant program with more than13,000 individuals with mental illnesses receiving much needed primary care services and another 9,000 individuals receiving primary care health screenings. 

“By providing high quality health care services to more than 19 million patients at more than 8,100 service delivery sites, community health centers continue to be an ideal vehicle for the integration of primary care and behavioral health services,” said HRSA Administrator Mary Wakefield, Ph.D., R.N.  “This remains one of the greatest opportunities to leverage Federal and community resources to strategically improve the health care delivered to the nation’s most vulnerable populations.”

"By bringing together behavioral health and primary care where people enter health care services, SAMHSA and HRSA are bringing federal resources to bear on improving the overall health status of individuals with multiple chronic conditions,” said SAMHSA Administrator Pamela S. Hyde. “All too often people with behavioral health problems suffer from premature morbidity and mortality as a result of poor diet, lack of exercise and primary prevention services.” 

Through the Administration on Aging (AOA)’s Chronic Disease Self-Management Program (CDSMP) grant, more than 50,000 older adults – the majority with multiple chronic conditions –completed an intensive self-care management program. CDSMP, developed with support from the National Institute on Aging and the Agency for Healthcare Research and Quality, benefits participants by improved symptom control, improved quality of life and reduced emergency room visits and hospital days.

“This program demonstrates how CDSMP can  add value to the HHS effort to provide better population health through the delivery of low-cost interventions to  large numbers of older people across various settings and audiences,” said HHS Assistant Secretary for Aging Kathy Greenlee.

Several private sector-led activities are also under way.  Today, the National Quality Forum, an HHS external partner, released for public comment a draft performance measurement framework for individuals with multiple chronic conditions. Few quality measures currently exist for this population, despite the growing prevalence of individuals with multiple chronic conditions. This framework will establish the definitions, domains and guiding principles that will be critical for measuring and reporting the quality and cost of care for individuals with multiple chronic conditions, so they may be better served in the future. 

As the HHS strategic framework is fully implemented, many of the multifaceted issues that exist for this population will be mitigated and the overall health of Americans with multiple chronic conditions will be significantly improved.

 For more information about the HHS Strategy on Multiple Chronic Conditions and the Inventory of HHS Programs, Activities and Initiatives, go to: http://www.hhs.gov/ash/initiatives/mcc/


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