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A group of organizations that created the Age-Friendly Health Systems movement and has seen the practices put in place across the nation is working to spread the initiative to additional U.S. sites.

The partnering organizations, which include CHA and some of its members, want to ensure that the nation's aging population has access to high-quality health care that addresses elders' often-complicated needs in a comprehensive way. The organizations are doing this through the Age-Friendly Health Systems movement founded by The John A. Hartford Foundation. Built up by the foundation's longtime partner, the Institute for Healthcare Improvement, and supported by dozens of health systems and thousands of facilities, the initiative seeks to equip increasing numbers of health care providers to better understand and meet older patients' wants and needs.

Their focus is on the "4Ms": what matters, medication, mobility and mentation.

"The collaborative approach we 're taking helps patients feel the health system knows them and aligns with their needs," says Kimberly Kindred, CommonSpirit Health system vice president of patient experience in the care continuum.

IHI Senior Director KellyAnne Johnson says, "At the end of the day, it's about older adults. They deserve care that is predicated upon what matters, and we as a health system need to do a better job responding to that. "

Decades of work
The New York-based foundation began focusing on improving care for older adults in the 1980s. It helped develop the field of geriatrics, funded the training of geriatricians and built up a network of geriatric centers of excellence.

Beginning about a decade ago, it came up with the Age-Friendly Health Systems idea, secured IHI's partnership, conceptualized the 4Ms based on existing research, helped continue to expand the evidence base on the validity of the 4Ms, and then engaged health systems in creating the practices for and implementing the Age-Friendly Health Systems framework.

Aging experts say it's important for health care providers to be prepared to meet elders' needs, especially since the population of people aged 65 and over is the nation's fastest-growing demographic. As this population ages, many of them are experiencing worsening health; and increasing numbers of elders have multiple, complex, chronic illnesses.

Growing movement
Rani Snyder, vice president of program for the foundation, says the movement has garnered much support, with nearly 5,000 facilities — including hospitals, outpatient clinics, federally qualified health centers, nursing homes and other sites — recognized as Age-Friendly Health Systems. More than 2,000 of those sites are deepening their commitment by providing data to IHI for research and measurement purposes. More than 4.6 million older adults have been reached with 4Ms care, according to IHI. Organizations also can achieve Age-Friendly Health System recognition based on achieving certain milestones. As of August, nearly 5,000 health care organizations had achieved this.

The Age-Friendly Health Systems leaders' goals are to increase the number of participants as well as the number of facilities contributing data on how many older adults have been reached. On its website, IHI provides resources to help facilities become recognized as Age-Friendly Health Systems, and it organizes "action communities, " or groups of facilities that undertake that process together. IHI hosts the spring action communities; and the American Hospital Association, another partner in the Age-Friendly Health Systems movement, hosts them in the fall.

Snyder says being age-friendly helps facilities "achieve the outcomes that are most important to them. " After implementing age-friendly practices, many participating facilities have seen cost of care, patient length of stay and hospital readmission rates decrease and patient satisfaction increase, she says.

Pilots, champions, playbooks
CommonSpirit and Providence St. Joseph Health are among the providers that have embraced age-friendly practices most extensively, says Indu Spugnardi, CHA senior director of community health and elder care. The two ministry organizations are among 30 health systems that are taking part in IHI's first systemwide collaborative to spread the work. That collaborative began in April 2024 and concludes in October 2025.

CommonSpirit has launched an age-friendly pilot in its Lincoln, Nebraska, market, engaging facilities across the care continuum through "champion " staff members. Under those champions' leadership, the facilities developed patient assessments related to the 4Ms, integrated those assessments into the electronic medical record, educated clinicians and other staff about having 4M conversations with patients, and then launched the system. Clinicians since have been assessing patients for the 4Ms and using that information to coordinate care that addresses identified needs.

CommonSpirit has developed a playbook for spreading the 4Ms system-wide.

Providence undertook a similar process, guided by a system-level steering committee. Providence adds a fifth "M " — malnutrition — to the framework.

Suzanne Engelder, executive director of program development for the Providence Institute for Human Caring, says Providence is rolling out the age-friendly approach along with a strategy for measuring progress. Providence ambulatory care facilities in Oregon and Washington state have made the most progress implementing age-friendly practices. Providence hopes to roll out the practices systemwide over the next several years. The system has more than 1,000 facilities in seven states.

Strategic alignment
Dr. Matthew Gonzales, associate vice president, chief medical and operations officer for the Providence Institute for Human Caring, says Providence has made a multiyear investment in this work to ensure that older adults are well cared for and able to live their best lives. He says the vision is that by a decade from now, an older adult would be able to show up at any Providence location and receive care in line with the Age-Friendly Health Systems ideals.

Engelder notes that many of the people leading this work at Providence are geriatricians, and they are heavily engaged in implementing the age-friendly practices. She says a priority of theirs is to ensure that the care elders receive is in line with the goals those elders have.

Kindred at CommonSpirit notes that the age-friendly approach is the "right thing to do for patients and staff " and that the approach is relevant and appropriate for patients of any age — not just elders.

Prentice Lipsey, CommonSpirit Senior Living president and CEO, says the approach is expected to lead to better health outcomes for all patients, especially those who are most vulnerable. He says the way age-friendly practices are implemented promotes unification among disparate facilities in a health system, and this can lead to less fragmented care. This in turn can make a system easier for patients to navigate, particularly for the many patients who have multiple chronic conditions, he says.

Kindred says, "It 's not an easy lift but it is so worthwhile — it's an exciting journey. " She adds that age-friendly work "touches literally every aspect of our strategic plan. "

Patient focus
Lipsey notes that the age-friendly approach also is beneficial when it comes to health equity because the practices call upon providers to speak directly to patients about their goals rather than making assumptions. This helps to reduce patient harm, he says.

He says the work by nature prompts providers to increase their focus on and attention to preventative health and community-based health and outreach.

Camille Haycock is CommonSpirit senior vice president of patient experience and executive sponsor of the Age-Friendly Health Systems initiative. She says that the groundwork that the age-friendly providers are putting in place now will lead to better health care for all. "It hits all of us, " Haycock says. "We have loved ones we 're caring for who need this. But everyone will need this type of care eventually."

Gonzales of Providence adds, "We'd love to have even more partners in this. "