Abstract
VA Office of Geriatrics & Extended Care established Geriatric Patient-Aligned Care teams (GeriPACT) with team members (pharmacy, and social work) added to the panels, and panels 2/3 the size of most VA primary care teams, to better manage aged and frail Veterans. We evaluated GeriPACT effect on expenditures among Veterans with >2 diagnoses based self-care capacity limitations (JEN Frailty Index, JFI>2) cared for at 84 VA facilities. NOSOS, a refinement of Medicare’s HCC model, was used to predict expenditures. Regressions estimated effect of GeriPACT on log expenditures, comparing GeriPACT Veterans to propensity score-matched Veterans receiving regular care. Management by GeriPACT was associated with significantly lower combined VA and Medicare expenditures: 14% less for JFI>2, 8% for JFI>5 and 13% for JFI 3–6. VA expenditures alone had associated savings of 12%, 6%, and 11%, respectively. GeriPACT reduces costs, especially when targeted at appropriate patients, e.g., those with JFI 3–6.