Strategies for Tobacco Cessation under Medicaid

1
Strategies for Tobacco Cessationunder Medicaid

• Pacific Center for Health and Tobacco
• Comprehensive Statewide
• Tobacco Leadership Project
• February 2, 2005
• Emory Conf. Center, Atlanta, GA

2
National Cessation Statistics

• 46.2 million adult smokers in the U.S. (23)
• 44.7 million FORMER smokers in the U.S.
• Estimated 45 of Medicaid population smoke (11.5
  million)
• 70 of smokers report a desire to quit
• 41 of smokers attempt to quit each year
• Less than 20 use a cessation aid to do so
• Less than 5 are permanently successful
  (one-year quit)

3
FEDERAL CESSATON RELATED ISSUES

• Medicare Rx Drug Law
• Gives drug discounts and coverage for
  prescription drugs under Medicare (2006)
• - Changes exclusion for smoking cessation
  drugs.
• - No OTC but possible loophole re
  vitamins/supplements prescribed by doctor.
• Medicare Counseling Benefit Proposed Decision
• Proposed to cover counseling services for limited
  Medicare beneficiaries
• - Those diagnosed with a tobacco-related illness
  or health effect
• - Those taking therapeutic agents affected by
  tobacco use
• Decision expected early spring 2005
• National Network for Tobacco Quitlines
• Purpose access to quitline services for every
  American.
• Three components
• CDC OSH funding to states currently without
  quitlines for start-up grants.
• CDC OSH funding to states currently with
  quitlines to expand existing service.
• NCI/CIS will provides national toll-free number
  which will drive callers to existing quitlines
  and provide counseling to those calling from
  states w/o state quitlines.

4
Strategies for Medicaid Expansion/Enhancement

• Determine process for benefits changes
  Regulatory, Legislative, Combo
• Gather partners willing to come to the table
  State health officials/staff, coalition partners,
  quitline staff/directors, tobacco program folks,
  insurers, employers
• Set goal for specific enhancement/expansion more
  services, more eligibility
• Gather/develop materials and resources to inform
  and educate policymakers
• Work on dual track if necessary for coverage and
  funding

5
Medicaid Benefit Costs/Savings
Medicaid Cessation Treatments Benefit could cost
as little as 1/10 of 1 of current spending and
save states between 80 and 200 million
annually.
6
MEDICAID COST ASSUMPTIONS
Notes (1) Reflects a blended prevalence rate of
31.6 (held constant over 10 years) - 36 for
adults and 28 for 14-18 years old, excludes
disabled (2) 2002 figure includes 340,000
pregnant women, 360,000 in 2012.
Campaign for Tobacco Free Kids, Nov.19, 2002
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MEDICAID COST ESTIMATES
8
MEDICAID SAVINGS ESTIMATES
9
Current Technical Assistance Activities

• Medicaid Toolkits Development and Outreach
• Collaboration btwn CTC and National Partnership
  to Help Pregnant Smokers Quit
• Developed Toolkits to help make case for Medicaid
  Coverage for Tobacco Cessation
• Mailed to States in Spring 2004 to
• State Medicaid Directors, State Health Dept.
  Senior Deputies, State Tobacco Control Managers,
  Chronic Disease Specialists, MCH Directors and
  managers, NACCHO Tobacco Advisory Committee,
  National Partnership partners
• Chose list of States to target for Technical
  Assistance Outreach
• Funding proposals with RWJF Tobacco Policy Grants
• Direct T.A. Conf. calls, develop materials and
  assist with strategy for enhancement/expansion
  plan
• Indirect TA resource materials and advise as
  necessary
• Invest in a Healthy State Covering Tobacco
  Cessation Services Under Medicaid
• http//www.ctcinfo.org/tools/toolkits.aspGuides_
  _Toolkits_for_State_Medicaid_Programs
•  
• Helping Pregnant Women Quit Smoking Providing
  Coverage For Tobacco Treatment Under Medicaid
• http//www.helppregnantsmokersquit.org/policy/medi
  caid.asp

10
States Cessation Facts
11
State Specific Costs/Savings Model
12
CTC Contact Info

• Center for Tobacco Cessation
• www.ctcinfo.org
• Sara Hutchinson
• Manager, Federal State Relations
• 202-585-3216
• Sara.Hutchinson_at_cancer.org