| 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 |
|
|
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
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| Learn
more: |
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The
Utah Tobacco Quit Line Links Health Plan Enrollees
to Services |
|
Proactive
Referrals to the Quit Line |
|
Complementary
Health Systems Tools |
|
Recommended
Tobacco Cessation Benefits |
|
Tobacco
Cessation Benefits Offered by Utah Insurers |
|
Designing
Tobacco Cessation Benefits |
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Encouraging
Employers to Purchase Tobacco Cessation Benefits |
|
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.
Back to Top
|
| 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.
Back
to Top
|
| 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.
Back
to Top
|
| 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:
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| Food
and Drug Administration (FDA) Approved Medications
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Nicotine
Replacement Therapy |
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|
Bupropion
SR (Zyban) |
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|
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
Back
to Top
|
| Tobacco
Cessation Benefits Offered by Utah Health Plans |
| View
some of the cessation programs offered by Utah
insurance companies:
http://www.tobaccofreeutah.org/tobcessbenprivins.html
Back
to Top
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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.aahp.org/atmc/ATMC_Toolkit.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: http://www.cdc.gov/tobacco/educational_materials/cessation/ReimbursementBrochureFull.pdf
HTML format:
http://www.cdc.gov/tobacco/educational_materials/cessation/index.html
|
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.paccenter.org/public/reports_folder/reimbursement_web.pdf
|
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.
HTML format:
http://www.surgeongeneral.gov/tobacco/systems.htm
PDF format: http://www.coloradoguidelines.org/pdf_files/tobacco/systems.pdf
|
Coding
and Reimbursement for the Treatment of Tobacco Use
The Tobacco-Free Coalition of Oregon created these
guidelines for creating feasible coding and coverage
strategies, including which aspects of the 5 A’s
intervention should be reimbursed.
http://www.paccenter.org/public/reports_folder/coding_web.pdf
|
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
Back
to Top
|
| 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://www.endsmoking.org/resources/employersguide/employersguide.asp
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|
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.cdc.gov/tobacco/research_data/environmental/etsguide.htm
Back
to Top
|
| 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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