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​Older adults in the US deserve safe, effective, and patient-centered care in the settings in which they receive their care. Recognizing the challenge of meeting this increasingly urgent need, The John A. Hartford Foundation has adopted the aim of producing meaningful improvements in the outcomes that matter to older adults and their families.

To achieve this aim, The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) are partnering on the Age-Friendly Health Systems initiative. The goal of the initiative is to develop an Age-Friendly Health Systems model and rapidly spread the model to 20 percent of US hospitals and health systems by 2020.

​Video: Age-Friendly Health Systems Initiative

Terry Fulmer, President and CEO of The John A. Hartford Foundation, and Kedar Mate, IHI Chief Innovation and Education Officer, give an overview of the initiative.

What Is an Age-Friendly Health System?

An age-friendly approach will measurably improve the quality of care for older adults and optimize value for health systems. It is a health care system in which:

  • Older adults get the best care possible;
  • Healthcare-related harms to older adults are dramatically reduced and approaching zero;
  • Older adults are satisfied with their care; and
  • Value is optimized for all — patients, families, caregivers, health care providers and health systems.

The initial focus of the health systems participating in the initiative will be four high-level interventions (referred to as the "4 Ms"):

  • What Matters: Understand and actively support what matters to older adults
  • Mobility: Review mobility plans for each patient
  • Medications: Discuss whether medications are unnecessary or potentially harmful
  • Mentation: Improve mentation by addressing problems like dementia, delirium, and depression​

Phases of Work

The initiative has a bold and important aim of implementing and spreading a model for age-friendly health systems in 20 percent of US hospitals and health systems by 2020.

Stage 1: Testing and Scaling the Prototype (begins April 2017 through 2018)

  • Testing the Age-Friendly Health System Prototype and scaling up the model with five US health systems
  • Output: Age-Friendly Health Systems model and scale-up guidance

Stage 2: Spread and Scale-Up of the Age-Friendly Health System Model (2019)

  • Spread the model to an additional 10 to 15 US health systems initially
  • A national campaign aims to scale up the model to 20 percent of US hospitals and health systems by 2020
  • Output: 1,000+ Age-Friendly Health Systems with evidence of improved outcomes for older adults


The Age-Friendly Health Systems initiative is funded by The John A. Hartford Foundation and led by the Institute for Healthcare Improvement, in partnership with the American Hospital Association (AHA) and the​ Catholic Health Association of the United States (CHA).