Frail elderly veterans who received care at a Department of Veterans Affairs medical center and whose spouse-caregivers participated in support groups to which they had been randomly assigned had lower health care costs over a 1-year period than did control participants. The greatest impact was observed for participants perceived by their spouse-caregivers to be in the poorest health. What is important to consider about this result in terms of health care policymaking is that support groups targeted for spouse-caregivers of elderly veterans in poor health produced significant outpatient, inpatient, and total cost savings for the care recipients, and were cost effective.