Cutler Institute

The Health Care Costs of Elder Abuse in Maine

Kimberly Snow

Kimberly Snow presented findings from the National Institute of Justice funded research study* to estimate the health care costs associated with elder abuse at the Maine Council for Elder Abuse Prevention's sixth annual summit at the Augusta Civic Center on May 16, 2019. The summit was attended by over 200 doctors, lawyers, Adult Protective Services (APS) workers, social workers, long-term services and supports providers, and legislative representatives who work to prevent, detect, and respond to elder abuse, neglect and exploitation. 
Kim and her colleagues, Yvonne Jonk, Deb Thayer, Cathy McGuire, Stuart Bratesman, and Erika Ziller, have just recently completed the three-year study that linked Maine Adult Protective Services data with MaineCare and Medicare data. The team focused on adults age 60+ who were dual eligible and had substantiated APS investigations of financial exploitation. For each case, they looked an APS client's MaineCare and Medicare claims one year prior to the investigation, during the investigation year, and the following two post-investigation years. Propensity scores facilitated matching the APS clients to a control group made up of Maine's general, dual eligible, older adult population using nearest kernel techniques. APS clients and controls were matched on factors that likely influence health care expenditures such as age, gender, urban/rural residence, and the number and type of chronic conditions. 
Compared to the matched controls, APS clients with substantiated cases of financial exploitation were twice as likely to be hospitalized during their 4-year period of study. The APS clients also showed a spike in costs of nearly $800 per member per month during their APS investigation year, compared to the control group. Additionally, the APS clients were twice as likely to use nursing facility services and three times as likely to use prescriptions, but only one-third as likely to use outpatient services over their 4-year period of study. Overall total MaineCare and Medicare costs were an average of $27,000 (in 2014 dollars) higher for the APS clients over the four years. Kim and her colleagues are in the process of securing more funding to complete similar analyses on the other types of abuse including caregiver neglect; physical, emotional, and sexual abuse; and self-neglect. 
Kim and the team hope that their findings will help policymakers understand some of the hidden costs of elder abuse. Fighting abuse and exploitation has fiscal implications for all of us, even if we don’t know a victim personally. When it results in higher costs to public programs, we all end up paying for elder abuse. 
*This project was supported by Award No. 2015-ZD-CX-0003, awarded by the National Institute of Justice Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and 
conclusions or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect those of the Department of Justice.