One of three components of the system in the Medicare program that is used in bringing fees for professional services in line for the region where each physician practices. It is pronounced “gypsies.” Under the resource-based relative value scale (RBRVS) of the Medicare fee schedule, the indices are numbers used to adjust the Relative Value Units for each component of a service (physician’s work, practice’s overhead, and malpractice costs) to reflect geographic differences in cost to provide the services. Each component is multiplied by its own GPCI. The GPCI is a single measure that combines the three fixed shares, whereas the geographic adjustment factor (GAF) of the Medicare fee schedule allows for each service to reflect different shares, thus creating a GAF for each service.

Adjusted length of stay for all-patient allowances (diagnosis-related groups [DRGs]) for outliers, transfers, and negative outliers that would otherwise skew the data. The GMLOS is used to establish the per diem payment only for transfer cases.

Systematic collection and review of data (test results, signs, symptoms) pertaining to the elderly to identify problems, check functionality, and establish appropriate treatment.

Individual (usually social worker or nurse) who assists older people and their families in meeting the elderly person’s health care needs (e.g., fill out insurance forms, perform a comprehensive needs assessment, identify available community resources, screen and arrange for in-home services, resolve disputes among family members). GCM services are typically not covered by insurance.

Ambulatory health care facility for the elderly that offers professional and community services for maximizing the patients’ function and independence.

Medical doctor (MD) who is licensed and certified, and who has specialized postgraduate education and experience in the medical care of older adults.

Branch of medicine that specializes in handling the physiological characteristics of the elderly and the diagnosis and treatment of their medical problems.

Study of the biological, clinical, psychological, economical, and social processes of elderly adults and their problems as individuals, as well as society as a whole.