THE GIFT THAT KEEPS GIVING: VHA INVESTMENT IN HOME CARE PROGRAMS IMPROVES QUALITY, DECREASES COSTS

As around the world, the Veterans Health Administration’s Office of Geriatrics & Extended Care has been developing and promoting non-institutional care (GEC NIC) in order to provide Veteran-aligned care, better access to services, care coordination and to balance quality and budget. Each of 141 medical centers has adopted GEC programs with penetrations among Veterans served of 2–16% rising from an average of 4% in 2008 to 6% in 2015. We found that a 1% point higher GEC NIC penetration reduced the risk of long-term institutionalization by 2% for a Veteran at no cost difference, among 80+ year old male Veterans with ≥ 6 diagnoses-based self-care capacity limitations (JEN Frailty Index, JFI≥ 6, equivalent to 3 ADLs), adjusting for other Veteran characteristics. This result was maintained for JFI 3–5 and among similar cohorts of women Veterans. These promising results empower GEC as it strives to improve the care of frail Veterans.