State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments — United States, 2015–2017

DiGiulio, Anne; Jump, Zach; Yu, Annie; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S.; Yembra, Debbie; Armour, Brian S.

doi:10.15585/mmwr.mm6713a3

Cited by 32 publications

(34 citation statements)

References 10 publications

(18 reference statements)

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“…Individual, group, and telephone cessation counseling and FDA‐approved cessation medications are effective in increasing quit rates; the combination of counseling and medication is even more effective than either treatment alone . Barriers to accessing these treatments include lack of health insurance, insurance that does not cover these treatments, and coverage barriers that make it difficult to access covered treatments (eg, copayments, prior authorization, and limits on coverage for annual or lifetime cessation attempts) . Comprehensive coverage of proven cessation treatments with no or minimal barriers can increase the number of people who use cessation treatments and succeed in quitting .…”

Section: Discussionmentioning

confidence: 99%

Annual report to the nation on the status of cancer, part II: Progress toward Healthy People 2020 objectives for 4 common cancers

Henley

Thomas

Lewis

et al. 2020

Cancer

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selected objectives-including death rates, cancer screening, and major risk factors-related to 4 common cancers (lung, colorectal, female breast, and prostate). Baseline values, recent values, and the percentage change from baseline to recent values were examined overall and by select sociodemographic characteristics. Data from national surveillance systems were obtained from the Healthy People 2020 website. RESULTS: Targets for death rates were met overall and in most sociodemographic groups, but not among males, blacks, or individuals in rural areas, although these groups did experience larger decreases in rates compared with other groups. During 2007 through 2017, cancer death rates decreased 15% overall, ranging from −4% (rural) to −22% (metropolitan). Targets for breast and colorectal cancer screening were not yet met overall or in any sociodemographic groups except those with the highest educational attainment, whereas lung cancer screening was generally low (<10%). Targets were not yet met overall for cigarette smoking, recent smoking cessation, excessive alcohol use, or obesity but were met for secondhand smoke exposure and physical activity. Some sociodemographic groups did not meet targets or had less improvement than others toward reaching objectives. CONCLUSIONS: Monitoring trends in cancer risk factors, screening test use, and mortality can help assess the progress made toward decreasing the cancer burden in the United States. Although many interventions to reduce cancer risk factors and promote healthy behaviors are proven to work, they may not be equitably applied or work well in every community. Implementing cancer prevention and control interventions that are sustainable, focused, and culturally appropriate may boost success in communities with the greatest need, ensuring that all Americans can access a path to long, healthy, cancer-free lives. Cancer 2020;126:2250-2266.

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Section: Discussionmentioning

confidence: 99%

Annual report to the nation on the status of cancer, part II: Progress toward Healthy People 2020 objectives for 4 common cancers

Henley

Thomas

Lewis

et al. 2020

Cancer

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“…38,39 To maximize their impact, state Medicaid programs should provide all members with barrier-free access to these medications. 19,40 Studies have found that many programs fall short of this standard. 19,40 Besides cost sharing, additional barriers that could be eliminated include prior authorization, counseling requirements, stepped care requirements, limits on duration of use, and annual or lifetime limits on quit attempts.…”

Section: Discussionmentioning

confidence: 99%

“…19,40 Studies have found that many programs fall short of this standard. 19,40 Besides cost sharing, additional barriers that could be eliminated include prior authorization, counseling requirements, stepped care requirements, limits on duration of use, and annual or lifetime limits on quit attempts. 19,40 Finally, Medicaid programs and plans need better capacity for behavioral support.…”

Section: Discussionmentioning

confidence: 99%

“…19,40 Besides cost sharing, additional barriers that could be eliminated include prior authorization, counseling requirements, stepped care requirements, limits on duration of use, and annual or lifetime limits on quit attempts. 19,40 Finally, Medicaid programs and plans need better capacity for behavioral support. The availability of individual and group counseling is highly variable from locality to locality.…”

Section: Discussionmentioning

confidence: 99%

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The Growing Proportion of Smokers in Medicaid and Implications for Public Policy

Zhu

Anderson

Wong

et al. 2018

American Journal of Preventive Medicine

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Introduction: This study examined survey data from before and after California expanded its Medicaid program under the Affordable Care Act. It assessed changes in the insurance status of smokers, the proportion of smokers in Medicaid, and the health and well-being of those smokers relative to their counterparts in other insurance groups. Methods: The study compared two data sets from the California Health Interview Study, the 2011−2012 (N=42,935) and 2016 (N=21,055) surveys. Measures include health insurance status, smoking status, chronic health conditions, frequency of doctors' visits, and psychological distress. Data were analyzed in 2018. Results: From 2011−2012 to 2016, the estimated number of California smokers in Medicaid nearly doubled from 738,113 to 1,447,945, and the proportion of smokers covered by Medicaid increased from 19.3% to 41.5%. Compared with those with private insurance, smokers in Medicaid were more likely to have chronic disease, have made five or more doctors' visits in the past year, and be in severe psychological distress. In 2016, a total of 51.4% of all adult smokers with chronic disease conditions and 57.8% of those in severe psychological distress were covered by Medicaid. Conclusions: With Medicaid covering a much higher proportion of smokers, especially of those smokers with chronic disease and in psychological distress, state Medicaid programs and plans must make tobacco cessation a top priority. They should encourage clinicians to ask, advise, and assist all smokers, track progress in reducing smoking prevalence, employ mass communication strategies to drive quit attempts, improve access to medications, and develop or expand programs to help smokers quit. Supplement information: This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.

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“…edicaid recipients smoke at rates nearly double those of the general population. 1,2 In the U.S., while adult smoking prevalence declined significantly from 20.9% in 2005 to 15.5% in 2016, 3,4 it remained almost unchanged among Medicaid recipients during 1997−2013 (from 33.8% to 31.8%). 5 This disproportionately higher smoking prevalence places Medicaid recipients at greater risk for smoking-related morbidity and mortality.…”

mentioning

confidence: 99%

Economic Impact of Financial Incentives and Mailing Nicotine Patches to Help Medicaid Smokers Quit Smoking: A Cost–Benefit Analysis

Sung

Penko

Cummins

et al. 2018

American Journal of Preventive Medicine

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An RCT designed to increase Medicaid smokers' quitting success was conducted in California during 2012−2013. In the trial, alternative cessation treatment strategies were embedded in the state's ongoing quitline services. It found that modest financial incentives of up to $60 per participant and sending nicotine patches induced significantly higher cessation rates compared with usual care alone and usual care plus nicotine patches. Building upon that study, this study assessed potential population-level costs and benefits of integrating financial incentives and nicotine patches in a quitline setting for Medicaid smokers. A cost−benefit analysis was undertaken from the Medicaid program's perspective. The Cardiovascular Disease Policy Model was used to simulate future healthcare expenditures over a 10-year horizon for each treatment strategy for a study cohort of California Medicaid enrollees who were aged 35−64 years in 2014 (n=2,452,000). To simulate potential population-level benefits under each treatment strategy, each treatment was applied to all active smokers in the study cohort (n=478,300). Sensitivity analyses were conducted by varying key parameters, such as cessation costs, discount rate, relapse rates, and time horizon. Adding both financial incentives and nicotine patches to usual quitline care would result in $15 million net savings over 10 years, with a benefit−cost ratio of 1.30 compared with the usual care plus nicotine patches strategy. It would yield $44 million net savings, with a benefit−cost ratio of 1.90 compared with usual care alone. The strategy of providing financial incentives and mailing nicotine patches directly to Medicaid smokers who call the quitline is cost saving. Supplement information: This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.

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State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments — United States, 2015–2017

Cited by 32 publications

References 10 publications

Annual report to the nation on the status of cancer, part II: Progress toward Healthy People 2020 objectives for 4 common cancers

Annual report to the nation on the status of cancer, part II: Progress toward Healthy People 2020 objectives for 4 common cancers

The Growing Proportion of Smokers in Medicaid and Implications for Public Policy

Economic Impact of Financial Incentives and Mailing Nicotine Patches to Help Medicaid Smokers Quit Smoking: A Cost–Benefit Analysis

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