“Age Friendly” Hospital Quality Measures in the FY2025 Inpatient Prospective Payment System (IPPS)

The Centers for Medicare & Medicaid Services (CMS) has announced its Fiscal Year (FY) 2025 Inpatient Prospective Payment Systems final rule that includes a new Age Friendly Hospital Measure. Beginning in 2025, hospitals that participate in Medicare’s Hospital Inpatient Quality Reporting (IQR) Program will be required to report on 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 age-friendly leadership.

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.

The FY2025 Inpatient Prospective Payment System final rule has a detailed explanation of the measure starting on p. 1424 (and includes a table, The Age Friendly Hospital Measure’s Five Domain Attestations, on p. 1428).

Hospitals can be successful in meeting this new measure by participating in the following programs:

• Age-Friendly Health Systems (AFHS)
  Health care teams can join no-cost, 7-month learning collaboratives to learn to implement the 4Ms Framework. The American Hospital Association will facilitate the next Action Community beginning in September. Join now.
• Geriatric Surgery Verification (GSV)
  Hospitals that meet standards for age-friendly surgical care can be verified through this program of the American College of Surgeons. Teams can receive guidance through an Implementation Course.
• Geriatric Emergency Department Accreditation (GEDA)
  Emergency departments that meet standards for age-friendly ED care can receive accreditation from the American College of Emergency Physicians. The related Geriatric Emergency Department Collaborative provides training and education on standards related to the GEDA program.
• Center to Advance Palliative Care (CAPC)
  Tools and Training include online courses to help clinicians clarify patient goals of care, scripts and prompts, curated toolkits to assess frailty, cognition and function, clinical games to learn essential de-prescribing skills and more.
• Patient Priorities Care (PPC)
  PPC aligns care among all clinicians with what matters most to their patients. It recognizes that patients are the experts in what they want to achieve from their healthcare, while clinicians are the experts in how to get them there.

Go to the announcement from CMS.
Read the Age-Friendly Hospital Measure.

This will certainly increase the burden of quality reporting on hospitals. It remains to be seen whether this will be of substantive help to patients, but I hope so.

–Caroline