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HHS Issues New
Strategic Framework On Multiple Chronic Conditions
December 15, 2010 - The U.S. Department of
Health and Human Services on Tuesday issued its new Strategic Framework
on Multiple Chronic Conditions, an innovative private, public sector
collaboration to coordinate responses to a growing challenge.
More than a
quarter of all Americans, and two out of three older Americans, have
multiple chronic conditions, and treatment for these individuals
accounts for 66 percent of the country’s health care budget. These
numbers are expected to rise as the number of older Americans increases.
The health care system is largely designed to treat one disease or condition at a time, but many Americans have more than one ― and often several ― chronic conditions. For example, just 9.3 percent of adults with diabetes have only diabetes, according to the Medical Expenditure Panel Survey from the Agency for Healthcare Research and Quality (AHRQ). And as the number of chronic conditions one has increases, so, too, do the risks of complications, including adverse drug events, unnecessary hospitalizations and confusion caused by conflicting medical advice.
The new strategic
framework ― coordinated by HHS and involving input from agencies within
the department and multiple private sector stakeholders ― expects to
reduce the risks of complications and improve the overall health status
of individuals with multiple chronic conditions by
fostering change within the system; providing more information
and better tools to help health professionals
― as well as patients ― learn how to better coordinate and manage
care; and by facilitating research to improve oversight and care.
multiple chronic conditions deserve a system that works for them,” said
Assistant Secretary for Health Howard K. Koh, MD, MPH. “This new
framework provides an important roadmap to help us improve the health
status of every American with chronic health conditions.”
The management of multiple chronic conditions has major cost implications for both the country and individuals. Increased spending on chronic diseases is a key factor driving the overall growth in spending in the Medicare program. And individuals with multiple chronic conditions also face increased out-of-pocket costs for their care, including higher costs for prescriptions and support services.
“Given the number
of Medicare and Medicaid beneficiaries with multiple chronic conditions,
focusing on the integration and coordination of care for this population
is critical to achieve better care and health for beneficiaries, and
lower costs through greater efficiency and quality,” said Centers for
Medicare and Medicaid Administrator Donald Berwick, MD.
Care Act, with its emphasis on prevention, provides HHS with exciting
new opportunities to keep chronic conditions from occurring in the first
place and to improve the quality of life for patients who have them.
“We need to learn
rapidly how to provide high quality, safe care to individuals with
multiple chronic conditions.
AHRQ’s investments assess alternative strategies for prevention
and management of chronic illness, including behavioral conditions, in
persons with varying combinations of chronic illnesses,” said AHRQ
Director Carolyn M. Clancy, MD.
HHS has taken
action in recent months to improve the health of individuals with
multiple chronic conditions. Some examples include:
Aging (AoA)/ Centers for Medicare and Medicaid Administrator (CMS) - AoA
and CMS jointly announced $67 million in grants to support outreach
activities that encourage prevention and wellness, options counseling
and assistance programs, and care transition programs to improve health
outcomes in older Americans.
Healthcare Research and Quality (AHRQ) - AHRQ awarded more than $18
million dollars (American Recovery and Reinvestment Act) in two
categories of grant awards to understand how to optimize care of
patients with multiple chronic conditions.
Secretary for Planning and Evaluation (ASPE) - As part of an existing
$40 million ASPE contract, the National Quality Forum is undertaking a
project to develop and endorse a performance measurement framework for
patients with multiple chronic conditions.
Disease Control and Prevention (CDC) - CDC is supporting a new project ―
Living Well with Chronic Disease: Public Health Action to Reduce
Disability and Improve Functioning and Quality of Life ― in which the
Medicare and Medicaid Services (CMS) - CMS has provided recent guidance
to State Medicaid directors on a new optional benefit available Jan. 1,
2011, through the Affordable Care Act, to provide health homes for
enrollees with at least two chronic conditions, or for those with one
chronic condition who are at risk for another.
•Food and Drug
Administration/ Assistant Secretary for Planning and Evaluation
(FDA/ASPE) - FDA and ASPE launched a study to examine the extent to
which individuals with multiple chronic conditions are being included or
excluded from clinical trials for new therapeutic products.
•Indian Health Service (IHS) - IHS has expanded its Improving Patient Care Program to nearly 100 sites across the tribal and urban Indian health system to assist in improving the quality of health care for patients with MCC.
•National Institutes of Health (NIH) - NIH has committed $42.8 million for a study to determine whether efforts to attain a lower blood pressure range in an older adult population will reduce other chronic conditions.
•Substance Abuse and Mental Health Services Administration (SAMHSA) - SAMHSA awarded $34 million in new funding to support the Primary and Behavioral Health Care Integration Program, which seeks to promote the integration of care with people with co-occurring conditions.
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