How Organization of Care Affects Health Outcomes and Costs for Elderly Patients with Chronic Conditions


Medicare's health delivery and financing system was originally designed to address acute care needs. Today's Medicare beneficiaries, however, are more likely to require care for chronic health conditions—and more likely to receive their care from multiple providers, with little or no coordination among them. This project will examine and compare patterns of care provided to three groups of elderly veterans with selected chronic conditions: those treated exclusively in the Veterans Health Administration (VHA) system, those getting care through both the VHA and Medicare, and those getting care exclusively through Medicare. The results will shed light on how continuity of care, costs, and outcomes in a coordinated care environment like the VHA compare with those in a more fragmented environment like fee-for-service Medicare. The findings will also indicate areas of care that Medicare may wish to target for improvement.

Grant Details

Grantee Organization:
Mount Sinai School of Medicine
Principal Investigator:
Salomeh Keyhani
Award Amount:
Approval Date:
July 10, 2007

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