Agency Seeks to Chart a New Course for Patients With Multiple Chronic Diseases

The US Department of Health and Human Services (HHS) is seeking to find a more effective means of treating people with multiple chronic conditions, including cancer, based on a recently developed framework aimed at encouraging better coordination and management of patient care across the healthcare system.

The strategic framework has 4 main goals: foster systemic changes to improve the health of individuals with multiple chronic conditions; maximize proven self-care management strategies; provide tools and information to healthcare, public health, and social services workers who provide care to individuals with multiple chronic conditions; and facilitate research to fill knowledge gaps about patients in these populations.

The current system is "largely designed to treat 1 disease or condition at a time," Assistant Secretary for Health Howard K. Koh, MD, MPH, said at a recent press conference announcing the initiative. "Individuals with multiple chronic conditions deserve a system that works for them. This new framework provides an important roadmap to help us improve the health status of every American with chronic health conditions."

More than one-quarter of Americans are currently living with multiple chronic conditions, the HHS said.

Among cancer patients, more than 85% report at least 1 comorbid condition, and the majority report more than 2 conditions, according to an article in Health Care Financing Review (2008;29[4]:41-56).

Overall, people with multiple chronic conditions are far more likely to use medical services. Gerard Anderson, PhD, of the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, found that the United States spends 65 cents of every healthcare dollar to treat people with 2 or more chronic conditions. Anderson's data also show a trend in rising rates of chronic diseases, according to the Partnership to Fight Chronic Disease, which released the report in 2007.

Federal officials also cited cost implications when they discussed the framework for managing multiple chronic conditions in December. In recent months, HHS has directed more than $160 million to programs intended to help people better manage their care.

These include outreach programs to encourage prevention and wellness among older Americans, grants to analyze ways of optimizing care for patients with multiple chronic conditions, and research into whether lower blood pressures will reduce other chronic health problems. For more information about the Strategic Framework on Multiple Chronic Conditions, visit http://www.hhs.gov/ash/initiatives/mcc.