The Centers for Medicare & Medicaid Services (CMS) has adopted an age-friendly quality hospital measure in its most recent final rule addressing prospective payment systems, policy changes, and quality program requirements for hospitals.

The measure assesses a hospital’s care for patients 65 years or older and seeks to ensure that hospitals implement the 4 Ms, a framework of evidence-based elements of high-quality care developed by industry organizations. The “4 Ms” are What Matters, Medication, Mentation and Mobility. The measure consists of five attestation domains to address clinical care: (1) Eliciting Patient Healthcare Goals, (2) Responsible Medication Management, (3)Frailty Screening and Intervention, (4) Social Vulnerability, and (5) Age-Friendly Care Leadership.

Hospitals will be required to attest “yes” or “no” to elements in attestation statements in each of the five domains on an annual basis through CMS’ Hospital Quality Reporting System. Hospitals must attest positively to all of the elements in a statement to receive a point for that domain. There is no partial credit for a domain for positively attesting to some elements of an attestation statement.

While adopting the measures for calendar year 2025 reporting and fiscal year 2027 payment determination, CMS has advised that it does not expect hospitals to be able to attest positively in each domain in the first reporting year. CMS will not include a voluntary reporting period, but the final rule notes that hospitals can receive a score lower than 5 but not be subject to payment reduction if they attested positively or negatively to each domain.

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