OBJECTIVE: To determine the outcomes associated with a falls risk-reduction program. METHODS: Medical and pharmacy claims data for 33,208 Medicare supplemental insurance plan patients ? 75 years of age were evaluated. Each patient’s individual diagnosis- and drug-related risk factors were analyzed, and providers for those patients at greatest risk received a patient-specific educational intervention. Intermediate outcomes (the mean number of high-risk drugs and the total number of drugs prescribed) were evaluated before and for 9 months post-intervention in a study population of 1,818 patients. RESULTS: Pre-intervention there was a trend of escalating drug use in this population. Post-intervention, there was a reduction (p ? 0.01) in the mean number of drugs (-0.61) and high-risk drugs (-0.49). A retrospective comparison population of 2,211 patients showed an increase (p <0.01) in the mean number of drugs (+ 2.2) and high-risk drugs (+0.77) prescribed over a similar time interval. Regression to the mean and selective mortality do not appear to account for the results observed. Examining the medical and economic benefits resulting from this reduction in drug use has proven to be problematic. Falls are poorly documented in claims data. Consequences of falls (e.g. hip fracture) can be identified through claims review, but the incidence of these consequences is relatively low, and differentiation between initial and follow up care is difficult. Several comparison populations were evaluated for use in outcomes assessment, but each has significant limitations. Also, medical and economic benefits from a risk-reduction program would be expected to accrue over an extended period of time. CONCLUSION: The intervention impacted the intermediate outcomes, but barriers prohibited analysis of potential medical and economic benefits.