Functional decline in an elderly person can be the first indicator of a chronic condition ready to snowball out of control. Patricia Zinkus, director of case management at Fallon Community Health Plan, and Susan Legacy, FCHP's senior manager of case management, describe how their collaborative multidisciplinary intervention monitors for these changes, and why the program's social component is just as critical as home visits and case management outreach. Ms. Zinkus and Ms. Legacy will share details from FCHP's risk-sharing model during "Identifying Functional Decline in Chronic Care Patients To Reduce Preventable Healthcare Utilization," 45-minute webinar on April 27, 2011.