Integrating the Age-Friendly Health Systems Movement in Veterans Health Administration: National Advance Care Planning via Group Visits and the 4Ms Framework

A ccording to the U.S. Census Bureau, the population of Americans ages 65 and older is expected to nearly double over the next 30 years, reaching an estimated 83.7 million by 2050 (Ortman et al., 2014).Due to the growth and longevity of this population, healthcare organizations are challenged to ensure they are providing quality care to this burgeoning population of older adults (Institute for Healthcare Improvement [IHI], 2022).By mission, the U.S. Department of Veterans Affairs (VA) Veterans Health Administration (VHA) delivers healthcare to adults across the age continuum who served in the U.S. uniformed services.To meet this challenge of a growing population of older adults, VHA is implementing the Age-Friendly Health System (AFHS), which seeks to maximize the health, safety, and well-being outcomes of older adults.The age-friendly care movement is based on the implementation of evidence-based interventions for older adults (VA, 2022c) across four core elements, known as the 4Ms: What Matters, Medication, Mentation, and Mobility (IHI, 2022).Given the unique attributes of VHA's national healthcare system-more than 171 medical centers and 1,112 outpatient clinics of varying complexity (VA, 2022a)-age-friendly care and the 4Ms holds promise to focus on the specific healthcare needs of older veterans within VHA.