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改善老年人护理的途径:通过实施医疗保险和医疗补助服务中心(CMS)的老年友好医院措施优化医疗保险和医疗补助支付。

A Path to Better Care for Older Adults: Optimizing Medicare and Medicaid Payments Through Implementation of the CMS Age Friendly Hospital Measure.

作者信息

Pelton Leslie J, Mate Kedar, Snyder Rani E, Fulmer Terry

机构信息

The John A. Hartford Foundation, New York, NY, USA.

出版信息

Inquiry. 2025 Jan-Dec;62:469580251342460. doi: 10.1177/00469580251342460. Epub 2025 Jul 16.

Abstract

Over 95% of US hospitals rely on the Centers for Medicare & Medicaid Services (CMS) for at least 50% of their revenue, and almost all participate in the CMS Inpatient Quality Reporting (IQR) Program. Starting January 1, 2025, hospitals in the IQR program will avoid Medicare payment reductions by reporting on the 5 domains of the CMS Age Friendly Hospital Measure. This is essential because the population of older adults is increasing, as are the harms older adults experience in US hospitals. Meeting these 5 domains is associated with providing higher-quality care for older adults, leading to improved outcomes and reduced costs. Reporting on the CMS Age Friendly Hospital Measure will be visible to older adults and their family caregivers through CMS Care Compare. There are evidence-based initiatives that hospitals can implement to achieve the CMS Age Friendly Hospital Measure and to prevent or reduce iatrogenic harm in older adults such as falls, adverse drug events, and delirium, reduce length of stay in emergency departments, improve outcomes and reduce length of stay, and reduce overall cost of care to Medicare.

摘要

超过95%的美国医院至少50%的收入依赖医疗保险和医疗补助服务中心(CMS),并且几乎所有医院都参与了CMS住院质量报告(IQR)项目。从2025年1月1日起,参与IQR项目的医院通过报告CMS老年友好医院指标的5个领域,将避免医疗保险支付减少。这至关重要,因为老年人数量在增加,美国医院中老年人所遭受的伤害也在增加。满足这5个领域与为老年人提供更高质量的护理相关,从而带来更好的治疗效果和降低成本。通过CMS护理比较,老年人及其家庭护理人员可以看到关于CMS老年友好医院指标的报告。医院可以实施基于证据的举措来实现CMS老年友好医院指标,并预防或减少老年人的医源性伤害,如跌倒、药物不良事件和谵妄,减少急诊科的住院时间,改善治疗效果并缩短住院时间,以及降低医疗保险的总体护理成本。

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