Hospitals Participating in the Medicare Hospital Inpatient Quality Reporting Program Should Take Advantage of National Initiatives to Ensure Delivery of Age-Friendly Care
New York, NY (August 2, 2024)—A new quality measure based on the principles of age-friendly care has been approved by the Centers for Medicare & Medicaid Services (CMS) and will help ensure hospitals better align care with older patients’ goals and preferences. The new measure is included in the FY2025 Inpatient Prospective Payment Systems final rule and will assess a hospital’s commitment to improving care for patients aged 65 years and older who receive services in the hospital, operating room or emergency department.
Beginning in 2025, hospitals that participate in Medicare’s Hospital Inpatient Quality Reporting (IQR) Program will be required to report on the extent to which they meet all elements within five domains of the new Age Friendly Hospital Measure. The domains represent whether hospitals have protocols in place to: 1) elicit patient health care goals, 2) responsibly manage medications, 3) implement frailty screening and intervention (including for cognition and mobility), 4) assess social vulnerability (e.g. social isolation, caregiver stress, elder abuse) and 5) designate leaders to ensure the equitable delivery of age-friendly care.
Hospitals that choose not to participate in the IQR program, which now includes this mandatory measure, face a significant reduction in their annual Medicare payment update. The public will be able to see how hospitals report on this measure through CMS’s Care Compare website.
"Every older person who visits a hospital deserves and should demand age-friendly care that is centered on what matters to them," said Terry Fulmer, PhD, RN, FAAN, president, The John A. Hartford Foundation (JAHF). "With this essential new measure of quality in the Medicare program, hospital leadership will now publicly report on how well they address the most critical factors affecting the health outcomes of older adults, including their medications, mentation and mobility in the context of social vulnerability. The great news is that we philanthropically support programs that can help every hospital say 'yes' when they are asked if they deliver age-friendly care."
The Age Friendly Hospital Measure domains reflect the Age-Friendly Health Systems 4Ms Framework, an approach to care that focuses on addressing the key drivers of good health outcomes for older adults: asking and acting on What Matters to the older patient and assessing and intervening on issues related to their Medications, Mentation, and Mobility. Age-Friendly Health Systems is an initiative of JAHF and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association and the Catholic Health Association of the U.S.
“The CMS Age-Friendly Hospital Measure is a victory for the growing population of older adults in the US, and a recognition of the success and impact of the Age-Friendly Health Systems movement since it began in 2017,” said Kedar Mate, MD, president and CEO of IHI. “This new rule advances the movement’s vision of making the 4Ms Framework the standard of care for older adults. With nearly 5,000 sites of care recognized as Age-Friendly Health Systems Participants, we are confident we have the resources and evidence-based practices in place to support hospitals as they work to implement this new measure.”
The domains also reflect standards developed for optimal surgical and emergency department care through the Geriatric Surgery Verification and the Geriatric Emergency Department Accreditation (GEDA) programs, developed respectively by the American College of Surgeons and the American College of Emergency Physicians (ACEP), with support from JAHF. The Geriatric Emergency Department Collaborative, also supported by the Foundation, provides training and education on standards related to the GEDA program.
“The creation of the Age Friendly Hospital Measure represents a significant step forward in recognizing the unique needs of older patients. We are proud to be strong advocates for this new measure because we are confident that it will lead to improved care and outcomes for this patient population,” said ACS Executive Director & CEO Patricia L. Turner, MD, MBA, FACS. “The ACS GSV Program will help hospitals meet these new requirements, and will also help them improve care, shorten the length of stay for many patients, and reduce the costs for the delivery of care.”
“This measure takes important steps to promote the highest standards of care for older patients,” said Aisha Terry, MD, MPH, FACEP, president of ACEP. “We are proud to be part of this collaborative effort and very pleased that this measure is directly informed by ACEP Geriatric Emergency Department Accreditation program principles. Hospitals, care teams and patients will benefit from the adoption of these evidence-based steps to enhance care delivery.”
In addition to IHI, ACS and ACEP, the Age Friendly Hospital Measure received endorsement from several national organizations including AARP, American Geriatrics Society, Center to Advance Palliative Care, Education Development Center/National Dementia Care Collaborative, Gerontological Society of America, National Alliance for Caregivers, Patients for Patient Safety and West Health Institute, among others.
For more information on how JAHF and its programs can help providers successfully meet the measure, view this page. Read this CMS fact sheet for more information about the rule (see p. 1424).
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Media Contact: Marcus Escobedo, 212-832-7788, marcus.escobedo@johnahartford.org
About The John A. Hartford Foundation
The John A. Hartford Foundation, based in New York City, is a private, nonpartisan, national philanthropy dedicated to improving the care of older adults. For more than three decades, the organization has been the leader in building a field of experts in aging and testing and replicating innovative approaches to care. The foundation has three priority areas: creating age-friendly health systems, supporting family caregivers and improving serious illness and end-of-life care. Working with its grantees, the foundation strives to change the status quo and create a society where older adults can continue their vital contributions. For more information, visit johnahartford.org.