Cognitive decline is a condition that impacts many older adults and which can have a significant impact on how they participate in their healthcare. While there are many screeners that give a bird’s-eye view of a person’s cognitive functioning (including the MMSE, MoCA, and SLUMS) these alone do not comprehensively represent the challenges and strengths of the individual. Many older adults who score in the mildly cognitively impaired range or lower are referred to neurologists or neuropsychologists for further evaluation which can include costly and lengthy tests and scans with questionable benefit. Moreover, this additional evaluation does not necessarily provide information that is useful to the patient, their families or their healthcare team in a timely fashion. For the past three years, our Arizona clinics have been providing brief neuropsychological assessments within our walls with a focus on determining the cognitive strengths and challenges of the patient as well as their current functional abilities and the goal to provide practical information for the patient and their families regarding safety, quality of life, functional assistance in addition to providing meaningful information to the healthcare team regarding their needs for any accommodations in communication, ability to manage their healthcare independently, and future planning for their healthcare. This presentation will describe the evolution of this project, the impact it has had on our patients and how a company that aspires to the PCBH model in value-based care is finding creative, quality interventions that are cost-effective.