Talking about Bladder Control

There are many types of accidents in life, but today let’s discuss one that most patients don’t like to mention…a bladder accident. They can be embarrassing, but HealthTeam Advantage is here to help you have those discussions with your patients. 

Let’s face it, bladder control issues (when not treated or planned for) can cause people to avoid their normal activities. However, incontinence often can be stopped or controlled. Urinary incontinence (UI) is common in older adults but is not always caused by aging. In the United States, 51% of women and 14% of men experience UI, which often impairs physical, psychological, and social well-being.¹ Unfortunately, adults who experience UI report worse physical health, mental health, and quality of life.¹ 

Managing Bladder Control 

Did you know that Medicare monitors health plans and their providers’ management of bladder control for Medicare beneficiaries through an Improving Bladder Control measure within the CMS Star Ratings Program? This measure is calculated using patients’ responses on the Medicare Health Outcomes Survey (HOS)². The survey asks: 

• • Many people experience leaking of urine, also called urinary incontinence. In the past six months, have you experienced leaking of urine? (This is a yes or no question. If your patient answers yes, they continue to another question.) 
  • There are many ways to control or manage the leaking of urine, including bladder training exercises, medication, and surgery. Have you ever talked with a doctor, nurse, or other healthcare provider about any of these approaches? 

Medicare monitors the patient’s initial response of “Yes” to the second question and follow-up responses two years later. Then CMS provides health plans with a performance rate. For the 2025 Medicare Star Ratings, HealthTeam Advantage received a 39 out of 100 for the HMO contract and 45 out of 100 for the PPO contract. So the majority of our members, your patients, do not believe they are having these conversations with their providers. By understanding patient experiences and outcomes, healthcare providers can identify areas for improvement and enhance the quality of care. 

Getting the Conversation Started 

During office visits, complete a comprehensive assessment discussing each elderly patient’s bladder control including frequency, urgency, and incontinence occurrences.  Then consider underlying medical conditions, medications, and lifestyle factors that may contribute to bladder dysfunction. We are just encouraging providers and patients to have the conversations needed to identify a plan of action for treatment or effective management, whether it be lifestyle modifications or even medications, if deemed appropriate. 

HealthTeam Advantage encourages providers to have a one-page office visit checklist with HOS-related questions. Patients can complete it at check-in, and this can help guide the discussion about bladder control, fall risks, and the patient’s physical and mental health status³. Reach out to our Quality Department ([email protected]) for an example. HealthTeam Advantage also offers exam room posters that highlight these discussion topic reminders. 

Since this is a longitudinal measure, we also encourage providers to track and monitor patients’ progress over time regarding bladder control concerns or symptoms. By focusing on bladder control, healthcare providers can improve patient outcomes and satisfaction, while also positively impacting HOS scores. We are here to help you get the conversation started. 

For more information about the overall HOS survey, please read this article.  

Footnotes

1. https://www.ncqa.org/hedis/measures/management-of-urinary-incontinence-in-older-adults/ 
2. October 3, 2024, CMS, Medicare 2025 Part C & D Star Ratings Technical Notes, https://www.cms.gov/files/document/2025-star-ratings-technical-notes.pdf 
3. https://hosonline.org/en/hos-and-the-star-ratings/