Geri-a-FLOAT: Patient Priorities Care/ What Matters

Patient Priorities Care (PPC) — a structured method to identify older adults' health priorities and align treatments to them — is gaining traction as U.S. healthcare confronts an accelerating demographic shift and new policy requirements.

The immediate catalyst is the CMS Age-Friendly Hospital Measure, effective January 2025 for hospitals in the Inpatient Quality Reporting program. It mandates attestation to five domains of age-friendly care, starting with 'Eliciting Patient Healthcare Goals' — a direct call to incorporate patients' own priorities, mirroring PPC's core process of clarifying desired outcomes and acceptable trade-offs.

This arrives against a backdrop of profound population aging. The share of Americans 65 and older climbed to 18% by 2024, with the 85+ group set to triple in coming decades. Multimorbidity is common, and conventional guideline-driven care often imposes heavy treatment burdens without delivering what patients value most, such as functional independence or time with loved ones.

Caregiver shortages compound the issue: projections show the ratio of traditional caregivers (ages 45-64) to those 80+ dropping sharply by 2040, while home care and nursing costs routinely exceed $70,000–$100,000 annually, straining families and public programs like Medicare and Medicaid.

PPC offers a countermeasure by focusing first on 'What Matters' — the keystone of the Age-Friendly Health Systems 4Ms (What Matters, Medication, Mentation, Mobility). Evidence from recent implementations in VA home-based care, community living centers, and PACE programs indicates reduced treatment burden, fewer unwanted interventions, and improved alignment with patient goals.

With 2025 updates to PPC resources, collaborations with professional groups, and journal publications reinforcing its utility, the framework is positioned as a practical response to policy, demographic, and clinical realities that demand more personalized, less burdensome care for older adults.