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Tobacco Cessation in Utah Health Plans

Tobacco Cessation is Critical

Tobacco use cessation treatment is the single most cost-effective health insurance benefit for adults.1,2,3

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In 1999 each adult smoker cost $1,623 in excess medical expenditures. 4
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Smokers are 2-3 times more likely to quit when they have help than when they try to quit on their own.5
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Quitting prevents numerous expensive health problems, including heart disease, stroke, multiple cancers, respiratory diseases, pre-term delivery and low birth-weight.6,7,8
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Tobacco cessation treatments are even more cost-effective than other excellent preventive treatments such as flu shots, pap smears, high blood pressure screening and cholesterol testing.3

Learn more: 

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The Utah Tobacco Quit Line Links Health Plan Enrollees to Services
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Proactive Referrals to the Quit Line
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Complementary Health Systems Tools
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Recommended Tobacco Cessation Benefits
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Tobacco Cessation Benefits Offered by Utah Insurers
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Designing Tobacco Cessation Benefits
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Encouraging Employers to Purchase Tobacco Cessation Benefits
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Contact the Utah Tobacco Prevention and Control Program for further assistance

The Utah Tobacco Quit Line Links Health Plan Enrollees to Services

The Utah Tobacco Quit Line can help health plans encourage enrollees to use covered tobacco dependence treatments. The Quit Line asks callers for their insurance carrier as part of the regular screening process. In addition to providing callers with quit kits and some counseling services, the Quit Line can inform insured callers of their health plan tobacco cessation benefits and/or transfer them to their health plan customer service department or cessation service provider for assistance. The Quit Line offers these services free of charge to health plans and their clients. If you are a health plan administrator and would like to inform the Quit Line of your cessation services, contact TheTRUTH@utah.gov. Learn more about the Utah Tobacco Quit Line.

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Proactive Referrals to the Quit Line

You can ensure that your clients receive Quit Line services by implementing the Utah Tobacco Quit Line Proactive Fax Referral System. Healthcare providers can fax consent forms signed by their patients to the Quit Line. In response, the Quit Line will call the client directly to provide services. Clinicians may also refer patients and employees to the Quit Line by giving the tobacco user the Quit Line’s toll free phone number; however some people are uncomfortable initiating contact with the Quit Line and others lose the phone number before they have an opportunity to call. Directly referring tobacco users with the Utah Tobacco Quit Line Fax Referral Form prevents these problems. After calling fax-referred clients, the Quit Line faxes intervention results to the referring agency, providing useful information for the patient’s health record and facilitating follow-up with the client.

An additional advantage of the fax referral system is that the Quit Line tracks referrals made through the system and creates feedback reports that are accessible to health plans, clinicians, and local health department staff. Such feedback has been demonstrated to increase the rate of tobacco cessation referrals by healthcare providers. 9

Learn more about the Fax Referral System and how to download fax forms.

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Complementary Health Systems Tools

The Utah Department of Health offers several resources and tools to assist healthcare organizations in making referrals. Order free resources for clinicians.

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Recommended Tobacco Cessation Benefits

Your enrollees are more likely to stop using tobacco with the help of a comprehensive quitting program to complement the support services of the Utah Tobacco Quit Line and Utah QuitNet. Because tobacco users are more likely to quit with the aid of both counseling and medications combined, and because some individuals respond better to nicotine replacement therapy and others respond better to bupropion SR or varenicline, an evidence-based benefit package includes ALL of the following elements:

Food and Drug Administration (FDA) Approved Medications

  • Nicotine Replacement Therapy
  • Bupropion SR (Zyban)
  • Varenicline (CHANTIX)

Group or individual cessation counseling.

Individual counseling may be offered by phone. Total counseling time should last 90-300 minutes and be divided into at least four sessions 5
The greatest economic and health benefits of cessation coverage occur when co-payments for tobacco cessation treatments are low or eliminated. 10

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Tobacco Cessation Benefits Offered by Utah Health Plans

View some of the cessation programs offered by Utah insurance companies:
Go to table of benefits.

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Designing Tobacco Cessation Benefits

These resources can help health plans create and implement tobacco cessation benefits:

Addressing Tobacco in Managed Care: A Resource Guide for Health Plans.
This comprehensive, step-by-step guide by America’s Health Insurance Plans (formerly American Association of Health Plans) details everything you need to know about developing, implementing and evaluating a tobacco control initiative in a health plan, including specific examples of model health plan programs.
http://www.bvsde.paho.org/bvsacd/cd41/tobaco6.pdf

Coverage for Tobacco Use Cessation Treatments
This brief handout by the Centers for Disease Control and Prevention describes evidence-based tobacco cessation interventions and their cost-effectiveness.
PDF format
HTML format

Build a Financial Infrastructure: Health Plan Benefits and Provider Reimbursement
This report by the Pacific Center on Health and Tobacco discusses HEDIS and other quality improvement measures that are improved by comprehensive cessation programs. It offers advice on how to address concerns within the health plan and from purchasers about cessation coverage and provides examples of some model health plan programs.
http://www.tcln.org/cessation/pdfs/3a.REIMBURSEMENTrev6-29-05web.pdf  (4.5 MB)

California Tobacco Control Alliance
Find out what a group of insurers, health plan purchasers and public health partners are doing to improve cessation coverage in California. This site includes several useful reports about cessation coverage options.
http://www.tobaccofreealliance.org/

Treating Tobacco Use and Dependence: A Systems Approach
Six strategies recommended by the Public Health Service to health care administrators, insurers, managed care organizations, and purchasers that support tobacco use and dependence treatment.
Go to strategies.

Reimbursement for Smoking Cassation Therapy
This guide by PACT (Professional Assisted Cessation Therapy) instructs healthcare providers and administrators on how to obtain reimbursement for cessation counseling, including advocating for coverage and navigating around coverage deficiencies.View Source

Encouraging Employers to Purchase Tobacco Cessation Benefits

 These resources can help health plans and advocates to persuade employers to purchase cessation benefits as part of their employee health plans.

Invest in Tobacco Cessation for a Healthy, Productive Workforce.
This pamphlet by the Pacific Center on Health and Tobacco encourages employers to compare the cost of tobacco-using employees to purchasing tobacco cessation benefit.
http://www.tcln.org/cessation/PCHT.html

 Health Insurance Benefits for Treatment of Tobacco Dependence: Summary
This brief and clear summary by the Pacific Center on Health and Tobacco explains the financial costs of tobacco use to employers compared to the costs of purchasing smoking cessation benefits.
http://www.tcln.org/cessation/PCHT.html

Employer’s Smoking Cessation Guide: Practical Approaches to a Costly Workplace Problem
This guide explains how employers can implement and benefit from workplace smoking bans and health insurance coverage that includes tobacco cessation.
http://endsmoking.org/resources/employersguide/pdf/employersguide-2nd-edition.pdf

Making Your Workplace Smoke-free: A Decision Maker’s Guide
Chapter 4, Support for Employees who Smoke, emphasizes how tobacco cessation treatment coverage complements smoking bans in workplaces.
http://www.fourcorners.ne.gov/documents/MakingYourWorkplaceSmokefree.pdf

Contact the Utah Tobacco Prevention and Control Program for Assistance

For assistance in designing and implementing a cessation program in your health plan, contact: TheTRUTH@utah.gov.


Sources
1. Warner KE. Cost effectiveness of smoking-cessation therapies. Interpretation of the evidence and implications for coverage. Pharmacoeconomics 1997;11(6):538–49.
2. Cummings SR, Rubin SM, Oster G. The cost-effectiveness of counseling smokers to quit. Journal of the American Medical Association 1989;261(1):75–79.
3. Coffield AB, Maciosek MV, McGinnis JM, et al. Priorities among recommended clinical preventive services. American Journal of Preventive Medicine 2001;21(1):1–9.
4. Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost, and economic costs—United States, 1995Ð1999. Morbidity and Mortality Weekly Report 2002;51(14); 300–03.
5. Fiore MC, Bailey WC, Cohen SJ, et. al. Treating Tobacco Use and Dependence: Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. October 2000.
6. U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress: A Report of the Surgeon General: 1989 Executive Summary. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1989.
7. National Cancer Institute. Health Effects of Exposure to Environmental Tobacco Smoke. The Report of the California Environmental Protection Agency. Smoking and Tobacco Control Monograph 10. U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. NIH Pub. No. 99–4645, 1999.
8. U.S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2001.
9.. Rigotti, N.A. & Schneider, L.I. (2004, April1). Maximizing Provider Utilization of a State Tobacco Dependence Treatment Reimbursement Program. In Addressing Tobacco as a Public Health Issue. Miami: America’s Health Insurance Plans.
10. Schauffler HH. Defining benefits and payment for smoking cessation treatments. Tobacco Control. 1997; 6 Suppl 1:S81-5.

 

 

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