Health Affairs Publishes New Age-Friendly Health Papers in October
Health Affairs has published a new Age-Friendly Health research article in its October issue, "Private Equity-Owned Hospices Report Highest Profits, Lowest Patient Care Spending Compared With Other Ownership Models." Health Affairs Scholar and Forefront also released articles related to age-friendly care.
The research article is part of Health Affairs’ Age-Friendly Health series supported by JAHF.
Health Affairs October issue:
Private Equity-Owned Hospices Report Highest Profits, Lowest Patient Care Spending Compared With Other Ownership Models by Alexander Soltoff, Dunc Williams, and Robert Tyler Braun
Private equity (PE) firms and publicly traded companies own a growing share of U.S. hospices, but little is known about differences in financial outcomes among for-profit hospices. This study used 2022 Medicare cost reports to compare revenue and expense data across four hospice ownership models: PE-owned, publicly traded company-owned, other for-profit, and not-for-profit. Adjusted analyses revealed that compared with for-profit models, not-for-profit hospices spent substantially more on direct patient care, driven by differences in nursing salaries.
The authors' findings suggest that "PE-owned hospices may follow distinct operational strategies, emphasizing nursing facility-based care and administrative efficiency while limiting direct patient care investments...To promote Medicare savings and better align payment with care delivery costs, policy makers could consider modifying the per diem model of hospice payment to reduce reimbursement when beneficiaries are co-located in nursing facilities."
Health Affairs Scholar October issue:
From 4Ms to 5 Domains: Ensuring New CMS Age-Friendly Hospital Measure Improves Care for Older Adults by Julia Adler-Milstein, Sarah W. Rosenthal, Robert Thombley, Stephanie Rogers, Benjamin Rosner, Jarmin Yeh, James D. Harrison
In 2024, the Centers for Medicare and Medicaid Services (CMS) added the Age-Friendly Hospital Inpatient Quality Reporting (IQR) Measure, composed of 10 attestation statements in five domains. The measure is designed to improve care for older adults through promoting care processes and structural capabilities drawn from evidence-based standards included in the Age-Friendly Health Systems (AFHS) 4Ms Framework (What Matters, Medication, Mentation, and Mobility) and operationalized in three programs: Geriatric Surgery Verification, Geriatric Emergency Department Accreditation, and the Institute for Healthcare Improvement's AFHS recognition.
The authors highlight synergies and gaps between these programs and the CMS Age-Friendly IQR measure to guide hospital efforts as they prepare for their first attestation in 2026. They recommend that CMS improve measure validity through better specifications that ensure meaningful impact on care for older adults and to reduce associated reporting burden.
Health Affairs Forefront has published a related paper:
Medicare Can Leverage Home-Based Care To Optimize Value For Homebound Beneficiaries by Christine Seel Ritchie, Bruce Leff, Orla Sheehan, Montgomery Smith, Frank McStay
The authors discuss homebound Medicare beneficiaries and the chasm between their needs and the availability of home-based care. The article presents opportunities for Medicare Advantage and other Medicare Accountable Care models to benefit from a home-based care ecosystem, as well as strategies for value-based care organizations to increase their home-based care footprint. The authors are JAHF grantees working to expand access to home-based primary care.
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