Learning Objectives: identify methods to establish cooperation for increasing coverage for tobacco dependence treatment and practices among your state's managed care programs.
Abstract: A study funded by the Robert Wood Johnson Foundation showed that more than 100,000 lives would be saved in the next 20 years if all health-insurance plans covered smoking cessation programs. Managed care organizations in the State of Michigan have not all offered a comprehensive nicotine dependence treatment program and not all health care providers are aware of covered treatment options.
In 2000, the State of Michigan funded the Michigan Association of Health Plans to convene a workgroup of managed care representatives to study the problem and provide recommendations within the group. A total of 12 of Michigan’s 26 managed care plans began work on this issue. At the end of the first year of funding, a benefits chart was created to track 6 measures of cessation coverage. Nineteen plans participated in the charting activity. In the 2001 funding year, this benefits chart was mailed to 12,000 physicians in Michigan and launched on the MAHP website. The website will be expanded by the end of this year to include a physician-training module for intervention and will provide CEUs. The group will also be working to determine standard measurements via HEDIS and to collect baseline data from participating managed care organizations.
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