VETERANS HEALTH ADMINISTRATION GERIATRICS AND EXTENDED CARE HOME AND COMMUNITY-BASED PROGRAMS

The Veterans Health Administration (VHA) provides care to about 7 million Veterans annually in 141 VA Medical Centers (VAMC) and over 900 clinics, nationally. VHA’s Office of Geriatrics & Extended Care (GEC) “aspires to be integral to the solution for the unsustainable rise in healthcare costs in the United States”. Its vision is to “empower Veterans and the Nation to rise above the challenges of aging, disability, or serious illness while honoring Veterans’ preferences for health, independence and well-being by advancing expertise, programs and partnerships”. By mid-2016 GEC services spanned a broad array of home and community based services (HCBS) including both medical and personal care programs. GEC programs care for over 400,000 Veterans of whom over 350,000 receive some community-based care and about 110,000 receive some care in nursing homes. Services are provided by VAMCs or purchased. Nationally, Veterans using GEC programs account for 6% of all VHA users but 30% of VHA’s total expenditures. This symposium will highlight some of GEC’s largest HCBS programs: Home Based Primary Care (HBPC), Geriatric Patient Aligned Care Teams (GeriPACT) and small scale implementations of innovative home based programs such as caregiver support for Veterans with dementia, advanced care planning and shared decision making and others. The effectiveness of GEC investment in HCBS in reducing overall VA and taxpayers’ costs of care will be presented. Discussion of GEC’s national role as a model for providing extensive but cost containing care will round up the symposium.