OBJECTIVE: This paper describes the role of a consultant pharmacist on a geriatric assessment service team. SETTING: The Geriatric Assessment Service (GAS) is part of an Independent Practice Association (IPA) in Rochester, New York. PRACTICE DESCRIPTION: The consultant pharmacist is responsible for the promotion of appropriate, cost-effective prescribing of drug therapy in physician offices affiliated with the IPA. PRACTICE INNOVATION: A team included a consultant pharmacist, social worker, and registered nurse with the objective of providing support to community physicians in the care of at-risk, frail, medically complex, community-dwelling adults 75 years of age or older. Assessments completed varied according to patient needs. Recommendations were made to the primary care provider based on the results of each patient assessment. MAIN OUTCOME MEASUREMENTS: Caregiver Strain Index, Drug Appropriateness Measure, Patient satisfaction, Physician satisfaction. RESULTS: Enrollment rate in the program rose from 19% in the first quarter to 63% in the fourth quarter. The Drug Appropriateness Measure on average improved to greater than 60% for patients enrolled. Member satisfaction averaged 90%. The Caregiver Strain Index showed an improvement of 28%. An observational comparison of GAS-enrolled patients to noninterventional patients showed a lower per-member, per-month cost change from 2005 to 2006. CONCLUSION: The GAS program provided assistance to primary care providers caring for community-dwelling, at-risk seniors, resulting in improved pharmaceutical care, reduction in caregiver strain, and positive patient satisfaction.