Older adults, particularly those who are poor, often fail to receive health care that meets recommended standards. Counsell and colleagues Article designed a primary care and home-based geriatrics care management program and assessed the quality of care received, acute care utilization, health-related quality of life, and independence in activities of daily living among low-income seniors who were randomly assigned to home-based care management vs usual care. During the 2-year follow-up, the authors found that compared with patients who received usual care, patients in the home-based care management program received higher-quality medical care, reported improvements in health-related quality of life, and had fewer emergency department visits. There were no differences between the intervention and usual care patients in measures of physical function. In an editorial, Reuben Article discusses principles of optimal health care delivery for older persons with chronic health conditions.