Population Health Approach to Optimizing Medications in Older Adults

Inclusion Criteria: * Patients will be invited to enroll in the study if they are in the top decile of risk selected by a risk prediction model of polypharmacy-related adverse events. The risk prediction model includes variables such as: age, sex, recent healthcare encounters, current and past medications, current and past lab tests, current and past diagnoses. * 65 years of age or older * Have a primary care clinician within the Cedars-Sinai Health System who uses MyCSLink (electronic health record used by Cedars-Sinai). * Part of a Cedars-Sinai Health System population health registry (e.g., enrolled in an Accountable Care Organization, Medicare Advantage plan, or Primary Care First program) * Diagnosis of Mild Cognitive Impairment or Dementia at baseline (for one intervention group) on the problem list Exclusion criteria include: * Patients for whom there is an active substance use disorder (defined by a physician) and thus for whom the intervention may not be appropriate * Patients with an organ transplant * Visits with a Cedars-Sinai Medical Center pharmacist for a polypharmacy consult within the last 6 months * Patients who previously indicated in the EHR that they wish to opt out of participating in research studies. * Patients enrolled in CS360, a program for highly complex medical patients, who already receive polypharmacy services.