Cutler Institute

Pent-Up Demand for Care among Dual-Eligible Victims of Elder Financial Exploitation in Maine

The article, "Pent-Up Demand for Care among Dual-Eligible Victims of Elder Financial Exploitation in Maine," was accepted for publication in the Journal of Elder Abuse and Neglect. The research team included Yvonne Jonk, Kimberly Snow, Deb Thayer, Catherine McGuire, Stuart Bratesman, and Erika Ziller. Charles Smith from the University of Maryland provided elder maltreatment subject area expertise. Cutler research staff linked Medicare and Medicaid claims data with Maine Adult Protective Services data to develop 4-year health care cost profiles of victims of elder financial exploitation (EFE) and compare them to a group of matched controls of the non-abused population of older adults in Maine. The research staff found that victims of EFE had higher overall odds of using inpatient and long-term services and supports (LTSS) and higher odds of using LTSS post-investigation than controls. Higher overall levels of outpatient and prescriptions expenditures and higher inpatient expenditures during the APS event year contributed toward APS clients incurring $1,142 higher PMPM total costs than controls. Victims of EFE were experiencing significant pent-up demand for health services post-APS involvement.

As most older adults receive their health and LTSS through the public Medicare and Medicaid programs, the findings of this study will inform policymakers about the severity of the problem of elder financial exploitation and how it relates to the fiscal stewardship of these public health insurance programs. The additional burden EFE places on our public programs provide further incentives for federal and state programs to mitigate the problem. Future research raising awareness and addressing the adequacy of community resources dedicated to screening, identifying, and protecting victims of elder abuse are warranted. This study points to a critical need to build community alliances in support of this mission across the health-care and long-term services and supports system (including providers and insurers), financial institutions, public health agencies, and the general public.