How Well Can Medicare Records Identify Seniors with Cognitive Impairment Needing Assistance with Financial Management?

23 Pages Posted: 20 Feb 2019

See all articles by David Weir

David Weir

University of Michigan at Ann Arbor - Institute for Social Research (ISR)

Kenneth Langa

University of Michigan at Ann Arbor

Date Written: October 2018

Abstract

Aging countries should have an interest in policies to assist older beneficiaries in managing finances when there is a need. This project investigated the value of Medicare records as a guide to identifying persons with cognitive impairment in need of assistance with financial management. It used data from the Health and Retirement Study (HRS) on persons 65 and older, who consented to linkage to Medicare records at a rate of approximately 90 percent. Sampling weights were adjusted to account for linkage rates. The HRS survey data provided direct evidence on cognitive impairment and difficulty managing finances. The Medicare records are an imperfect guide to cognitive impairment as a medical diagnosis. About 40 percent of persons with impairment consistent with dementia are not identified in Medicare, and about 40 percent of persons with a diagnosis in Medicare records do not have impairment that severe. The records are even worse as a guide to who perceives or is perceived by others as needing assistance with financial management. Outside of institutional settings, Medicare records identify fewer than half the people needing assistance with financial management, and point to a substantial number of people who say they do not. The use of Medicare records alone to identify older beneficiaries in need of assistance with financial management would lead to substantial errors in coverage.

Keywords: cognitive impairment, Medicare, fraud

Suggested Citation

Weir, David and Langa, Kenneth, How Well Can Medicare Records Identify Seniors with Cognitive Impairment Needing Assistance with Financial Management? (October 2018). Michigan Retirement Research Center Research Paper No. 2019-391 . Available at SSRN: https://ssrn.com/abstract=3338016 or http://dx.doi.org/10.2139/ssrn.3338016

David Weir (Contact Author)

University of Michigan at Ann Arbor - Institute for Social Research (ISR) ( email )

Ann Arbor, MI 48106-1248
United States

Kenneth Langa

University of Michigan at Ann Arbor ( email )

500 S. State Street
Ann Arbor, MI 48109
United States

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