Geriatric Resources for Assessment and Care of Elders (GRACE): A New Model of Primary Care for Low-Income Seniors

Steven R. Counsell, MD; Christopher M. Callahan, MD; Amna B. Buttar, MD, MS; Daniel O. Clark, PhD; Kathryn I. Frank, RN, DNS


J Am Geriatr Soc. 2006;54(7):1136-1141. 

In This Article


This study demonstrates the feasibility of the GRACE model of primary care in a public health system serving low-income seniors. Patients and their PCPs were highly receptive to this new model of care. The GRACE intervention is being evaluated, and it is hypothesized that patients enrolled in the GRACE intervention will have better health status, greater functional independence, fewer emergency department visits and hospitalizations, and fewer nursing home days over 2 years of follow-up than patients receiving usual care. Although this model is resource-intensive, the disproportionately high total healthcare costs of low-income seniors position the GRACE intervention as a potentially cost-effective intervention for this targeted population. Older adults eligible for both Medicare and Medicaid have approximately twice the healthcare expenditures of those eligible for Medicare alone.[28] If shown to be effective in achieving these outcomes, the GRACE intervention may represent a promising new model of primary care for low-income seniors.

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