America’s Hospitals Are Transforming Care for an Aging Nation
By Rani E. Snyder, President, The John A. Hartford Foundation and Dr. Chris DeRienzo, AHA Chief Physician Executive/President of AHA’s HRET
As the U.S. population ages, hospitals and health systems are reimagining how care is delivered to better meet the needs of older adults. With the number of Americans age 65 and older projected to reach 94 million by 2060—nearly one-quarter of the population—healthcare teams are rising to meet the moment by striving to ensure older people receive evidence-based care.
Across the country, hospitals are modernizing care for older Americans by investing in workforce training, embracing innovative technologies and redesigning care models. From using artificial intelligence to reduce patient falls and improve staff well-being to developing programs that train the next generation of age-friendly care leaders, hospitals are leading a transformation that is urgent and essential.
Older adults often face complex health challenges, including managing multiple chronic conditions and medications and an increasing risk of falls or mobility limitations. Many also navigate difficult transitions such as moving from independent living to relying on caregivers, or social and financial strains such as isolation or fixed incomes. Hospitals are responding by adopting approaches to enable older patients to remain in their homes via telehealth and hospital-at-home models of care, as well as evidence-based approaches to make care in the hospital more coordinated and aligned with what matters most to older patients.
A National Movement for Age-Friendly Care
At the center of this transformation is Age-Friendly Health Systems, an initiative of The John A. Hartford Foundation, the Institute for Healthcare Improvement and the American Hospital Association.
This national movement provides hospitals and other care providers—including medical practices, pharmacies, nursing homes and home health agencies—with tools and frameworks to deliver better care for older adults.
A cornerstone of the initiative is the 4Ms Framework, which focuses on:
- What Matters: Aligning care with each patient’s goals and preferences
- Medications: Using age-friendly medications that avoid harm
- Mentation: Preventing and treating dementia, depression and delirium
- Mobility: Supporting safe movement to maintain independence
Organizations that successfully implement the 4Ms and demonstrate sustained results earn recognition as Age-Friendly Health Systems. As of July 2026, more than 6,100 health care organizations nationwide have achieved this distinction, including an Illinois-based academic health system and a large Los Angeles academic medical center designing specialized care pathways for older adults.
Advancing Geriatric Care in the Emergency Department
Hospitals have also been working to optimize care for older adults who enter the emergency department (ED), where the fast-paced, high-intensity environment can be challenging for patients. Older adults who visit the ED may have cognitive impairments, complex medical histories or mobility limitations that require specialized care approaches. To better meet these needs, hospitals are pursuing Geriatric Emergency Department (GED) accreditation, which promotes geriatrics-focused protocols, environments and clinical expertise.
As of August 2026, nearly 670 EDs have earned GED accreditation. Evidence shows that this approach is making a measurable difference. Research published in the Journal of the American Geriatrics Society found that older adults treated in GEDs experienced a:
- 39% lower likelihood of hospital admission
- 38% lower 30-day mortality rate
Supporting Hospitals on the Path to Age-Friendly Care
To help accelerate adoption of age-friendly systems, the AHA and its partners offer tools, learning opportunities and national recognition for hospitals and health systems:
- Age-Friendly Health Systems Action Communities: Structured, seven-month learning collaboratives facilitated by the AHA and the Institute for Healthcare Improvement that provide hands-on learning, peer support and guided implementation of the 4Ms Framework.
- Pathway Selection Tool: Helps organizations assess their readiness and choose the best approach for implementing age-friendly care, supported by consultation with the AHA Age-Friendly Health Systems team.
- Geriatric ED Collaborative: A worldwide network dedicated to improving emergency care for older adults, supported by The John A. Hartford Foundation and West Health.
- AHA Age-Friendly Healthcare Impact Award: This new award, supported by The John A. Hartford Foundation, honors hospitals and health systems that are driving transformation by embedding the 4Ms into strategy, operations and daily practice.
Age-friendly care is a commitment to dignity, safety and quality of life for older adults. It is also incredibly meaningful to real people, in real communities. By sharing best practices, scaling proven models and continuing to innovate, hospitals and health systems are building a future where every older adult receives care respecting their needs and priorities, no matter where they live or where they seek care.