Opportunities for Quality Measurement to Improve the Value of Care for Patients With Multiple Chronic Conditions

Quality measurement efforts have not historically focused on pa-tients with multiple chronic conditions (MCCs), despite them com-prising one quarter of the population and two thirds of health care spending. The Patient Protection and Affordable Care Act (ACA) creates several mechanisms for the Centers for Medicare & Med-icaid Services (CMS) to transform quality measurement into an organized enterprise designed to support clinicians caring for this vulnerable population. This article highlights 3 emerging policy op-portunities for CMS to guide public and private quality measure-ment efforts for patients with MCCs. First, it discusses infusing an MCC framework into measure development to promote patient-centered, as opposed to single-disease–specific, performance mea-surement. Second, it describes the importance of using common performance measures for individual clinicians, hospitals, and com-munities to accelerate meaningful improvement in the prevention and management of chronic conditions across local populations. Finally, the need for longitudinal measurement as a foundation for sustained quality improvement is presented. The ACA’s expansion of insurance access and portability necessitates collaborative align-ment of chronic condition quality measurement efforts between public and private programs to develop a high-value lifelong health system