Is Geriatrics-focused Primary Care (GeriPACT) Better? A Podcast with Nicki Hastings, Kristie Hsu, and Ken Covinsky

Is Geriatrics-focused Primary Care (GeriPACT) Better? A Podcast with Nicki Hastings, Kristie Hsu, and Ken Covinsky

Author: Alex Smith, Eric Widera September 4, 2025 Duration: 46:08

On today's podcast, we talk about an innovative specialized primary care model for older veterans called the Geriatric Patient Aligned Care Team (GeriPACT) program.  It's designed with smaller patient panels and enhanced social worker and pharmacist involvement, and its approach is aimed at improving care and outcomes for our aging population.

We unpack the intriguing findings of a recent JAMA Network Open study authored by one of our guests, Susan "Nicki" Hastings, looking at GeriPACT that compares it to a traditional Patient Aligned Care Team (PACT).  While GeriPACT successfully delivered more attention to geriatric conditions, it surprisingly didn't translate into expected improvements like more time at home or better self-rated health.

We discuss the potential reasons behind this with our other two guests, one a geriatrics fellow, Kristie Hsu, and the other a recurring guest and host of the podcast, Ken Covinsky.  Was it just that it didn't work, or were there other things going on, from the intensity of "usual care" to the challenges of measuring complex health outcomes and the possibility that 18 months simply wasn't long enough to see the full benefits?

Despite what was ostensibly a negative trial, we highlight some reassuring aspects and future hopes for GeriPACT and how we can all incorporate some of these components into the care of our patients. We'll also pose critical questions for future research, emphasizing why continued development and evaluation of new care models are essential for the health of our older population.


Hosted by UCSF physicians Alex Smith and Eric Widera, GeriPal-A Geriatrics and Palliative Medicine Podcast creates a vital space for conversation at the intersection of aging and serious illness care. This isn't a dry lecture series; it's a dynamic dialogue where Eric and Alex bring on leading experts to unpack the complexities of geriatric and palliative medicine. They delve into the latest research that should change practice, tackle the ethical dilemmas that provoke debate, and explore the nuanced clinical challenges that professionals face daily. The tone is engaging and often surprisingly lighthearted, with moments of humor and even the occasional song, making profound topics more accessible. Whether you're a clinician, nurse, social worker, or any professional dedicated to this field, this podcast offers a blend of evidence-based insights and practical wisdom you can use. It’s a resource that acknowledges the weight of the work while fostering connection and continued learning. For those seeking formal education credits, AMA PRA Category 1 CME and MOC credit are also available through the show. Tune in to join a community committed to improving care for older adults and those with serious illness.
Author: Language: English Episodes: 100

GeriPal - A Geriatrics and Palliative Medicine Podcast
Podcast Episodes
Implementing Palliative Care in Nursing Homes [not-audio_url] [/not-audio_url]

Duration: 48:06
The need for better palliative care in nursing homes is significant. Consider this: the majority of the 1.4 million adults residing in U.S. nursing homes grapple with serious illnesses, and roughly half experience dement…
Lucid Episodes: Andrea Gilmore-Bykovskyi & Andrew Peterson [not-audio_url] [/not-audio_url]

Duration: 48:55
Have any of you watched the movie "The Notebook"? At the end, one of the characters, who has dementia, experiences an episode of lucidity. When I watched it, between tears (I'm a complete softie) I remember thinking, "Oh…
Music as Medicine: Jenny Chen, Tyler Jorgensen, & Theresa Allison [not-audio_url] [/not-audio_url]

Duration: 42:03
As you know, dear listeners, I love music. We start each podcast with a song in part to shift the frame, taking people out of their academic selves and into a more informal conversation. Well, today's guests love music a…
HIV, Aging, and Palliative Care: Peter Selwyn and Meredith Greene [not-audio_url] [/not-audio_url]

Duration: 48:59
Peter Selwyn, one of today's guests, has been caring for people living with HIV for over 40 years. In that time, care of people with HIV has changed dramatically. Initially, there was no treatment, then treatments with m…
Loss of DEI Hurts Everyone: Farah Stockman, Ali Thomas, Ken Covinsky [not-audio_url] [/not-audio_url]

Duration: 47:18
I read Farah Stockman's article in the NYT on why attacks on DEI will cost us all, and thought, "Yes, and 'everyone' includes harm to our healthcare workforce, our patients, and their families." So we're delighted that F…
RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest [not-audio_url] [/not-audio_url]

Duration: 50:34
Early in my research career, I was fascinated by the (then) frontier area of palliative care in the emergency department. I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DN…