Multimorbidity, which is defined as the co-occurrence of two or more chronic conditions, has moved onto the priority agenda for many health policymakers and healthcare providers. Patients with multimorbidity are high utilizers of healthcare resources and are some of the most costly and difficult-to-treat patients in Europe. Preventing and improving the way multimorbidity is managed is now a key priority for many countries, and work is at last underway to develop more sustainable models of care. Unfortunately, this effort is being hampered by a lack of basic knowledge about the aetiology, epidemiology, and risk factors for multimorbidity, and the efficacy and cost-effectiveness of different interventions. The European Commission recognizes the need for reform in this area and has committed to raising awareness of multimorbidity, encouraging innovation, optimizing the use of existing resources, and coordinating the efforts of different stakeholders across the European Union. Many countries have now incorporated multimorbidity into their own healthcare strategies and are working to strengthen their prevention efforts and develop more integrated models of care. Although there is some evidence that integrated care for people with multimorbidity can create efficiency gains and improve health outcomes, the evidence is limited, and may only be applicable to high-income countries with relatively strong and well-resourced health systems. In low- to middle-income countries, which are facing the double burden of infectious and chronic diseases, integration of care will require capacity building, better quality services, and a stronger evidence base.

Primary health care (PHC) in Slovenia is delivered mainly by a network of 63 public community-based primary health care centres (CPHCs), serving as entry points to the health system. Here, multidisciplinary teams provide an array of preventative, diagnostic, therapeutic, palliative, and health promotion services under one roof. Since 2011, several reforms in PHC highlight integrated care. A national scale-up of Family Medicine Practices is underway, where all family medicine teams include a 0.5 FTE registered nurse to improve prevention, early diagnosis and care coordination of chronic patients. Health promotion centers (HPCs) are being introduced in CPHCs to support people in healthy lifestyle, with currently 28 HPCs managed by CPHCs and supported operationally by the National Institute of Public Health. New mental health centers facilitate access to comprehensive mental health care. In 2020, dedicated temporary COVID-19 units in CPHCs played a key role in treating mild/moderate cases and shielding hospitals from overburden. Regarding implementation, pilots have been critical to creating a strong evidence base to enable sustainable (sometimes external) financing, while innovations capitalize on existing links between Slovenia's primary care and public health functions and the Ministry of Health for governance and the flexibility of the multidisciplinary, multiple-practice care model represented by CPHCs. Though this has eased their initial introduction into existing structures, challenges remain. These include dissatisfaction among family physicians due to high administrative burden and an outdated CPHC governance model that limits managers’ authority as well as workforce shortages in public health and primary care. Financial incentives, task shifting, and adjustments to education and training have been used to mitigate these issues. Slovenia's experience may serve as a case study for countries interested in improving their primary healthcare services.