My understanding is that most of these scams use spoofed numbers (or legitimate forwarding numbers), so there's no "just ignore it" remediation. SHAKEN/STIR[1] is meant to address this kind of spoofing, but it's not a stretch to imagine that these kinds of scams mostly target older people who are less likely to have (or understand) Caller ID anyways.
Yeah, they spoof local numbers. I haven't lived in the city my area code is from in a long time. Occasionally I'll answer calls from there when I'm bored and it's always a scammer.
What's even more disturbing is that I'm now getting calls from people talking in Hindi. I answer in English but they ask me to switch to Hindi. (I'm from Pakistan and speak Urdu which is mutually intelligible with Hindi). I'm guessing it's to build familiarity/trust.
They want to pay off my phone, electric and other bills and in return I pay them 50% of the amount. I give them fake info and try to keep them on as long as possible... asking them to repeat multiple times. Sometimes I'll tell how thankful I am that they came to me with this 50% off offer because I'm facing financial troubles. Not once did any of them fell bad about trying to scam a poor person. Their response is usually something like "This is exactly why we are offering this service, to help people like you".
Eventually they get frustrated and hangup. This way I can hurt their ROI just a bit.
[1]: https://en.wikipedia.org/wiki/STIR/SHAKEN