Geri-PACT: Veteran Health Administration’s Geriatric-Focused Patient-Centered Medical Home
By Katie Voss
With the aging population, primary care must find ways to meet the complex healthcare needs of older adults. Many practices are moving to a Patient-Centered Medical Home (PCMH) model of care to aid with patient health needs.
Veterans Health Administration (VHA) call these teams Patient Aligned Care Teams or PACTs. A PACT team includes a provider (physician, nurse practitioner, or physician’s assistant), registered nurse, licensed practical nurse, clerical staff, social worker, pharmacist, dietician, and a mental health practitioner that partner with
Veterans to address their health problems (U.S. Department of Veterans Affairs, 2021).
Outside of VHA, many primary care practices are recognizing the benefits of interprofessional teams including a social worker and pharmacist, especially when caring for older adults who have a decline in functional status and polypharmacy associated with multimorbidity (Buhr, 2019; Klein, 2022).
VHA has created Geriatric Patient-Aligned Care Teams or Geri-PACTs, specialized panels for older adults that are two-thirds the size of standard primary care VHA panels with similar team members as standard PACTs (Department of Veterans Affairs Veterans Health Administration [VHA], 2021).
With the reduced panel size, team members have additional time for coordinating care for Veterans who have typical geriatric syndromes including frailty, cognitive impairment, depression, gait disorders, incontinence, polypharmacy, and malnutrition (Sullivan et al., 2018; VHA, 2021).
Reduced panel size is essential in providing the care needed to better serve and care for this complex patient population. Geri-PACTs can reduce frail older adult Veterans’ healthcare costs when compared to receiving standard primary care (Shay et al., 2017).
Katherine Voss, AGNP-C
catherine.lange.voss@gmail.com
Sources and Resources References
Buhr, G., Dixon, C., Dillard, J., Nickolopoulos, E., Bowlby, L., Canupp, H., … McConnell, E. (2019). Geriatric resource teams: Equipping primary care practices to meet the complex care needs of older adults. Geriatrics (Basel), 4(4), 59. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960766
Department of Veterans Affairs Veterans Health Administration (VHA). (2021). Geriatric patient aligned care team. VHA Directive 1140.07(2).
Klein, S. (2022). In focus: Using pharmacists, social workers, and nurses to improve the reach and quality of primary care. Commonwealth Fund. https://www.commonwealthfund.org/publications/newsletter-article/focus-using-pharmacists-social-wor…
Sullivan, J.L., Eisenstein, R., Price, T., Solimeo, S., & Shay, K. (2018). Implementation of the geriatric patient-aligned care team model in the Veterans Health Administration (VA).
Journal of the American Board of Family Medicine, 31(3), 456-565. https://doi.org/10.3122/jabfm.2018.03.170272
Shay, K. Phibbs, C., Intrator, O., Kinosian, B., Scott, W., Dally, S., & Allman, R. (2017). Evaluation of the costs for veterans receiving care in geriatric medical homes (GERIPACT).
Innovation in Aging, 1(Suppl. 1), 1329.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6183477/pdf/igx004.4871.pdf
U.S. Department of Veterans Affairs. (2021). The fourth component of PACT is the concept of “team-based care.” https://www.patientcare.va.gov/primarycare/pact/Team-Based.asp