Managed Care - June 2008 - (Page 40)

Smoking Programs Succeed For Plans and Patients Employers want cessation efforts, and not-for-profit plans, as well as a few for-profits, have come through By Lola Butcher Contributing Editor lmost everyone agrees that tobacco use is the single most preventable cause of death in the United States and a key factor in America’s $1 trillion annual bill for chronic care. Yet until recently, the major payers for health care have done nothing to bring the smoking rate down. That is changing, thanks in part to a few not-forprofit health plans that have proven that a combination of benefit design, clinical intervention, and commitment can diminish the smoking rate in a health plan’s membership. Inspired by their success, America’s largest employers have made tobacco use a primary target in their wellness initiatives, hoping to reduce health care costs by getting workers off cigarettes, snuff, and chew. Employers are pushing major health insurers to offer smoking cessation support, dramatically increasing the array and visibility of programs to diminish tobacco use. They have their work cut out: 44.5 million Americans still smoke, about 438,000 tobacco-related deaths will occur this year, and the national smoking rate is 21 percent. Those are daunting statistics, but a few others provide reason for hope. Kaiser Permanente of Northern California drove its adult smoking prevalence from 12.2 percent to 9.2 percent in three years. Group Health Cooperative in Seattle saw its adult smoking rate drop from 25 percent to 14.5 percent, well below the Washington state average. “There is a still lot of opportunity for improvement,” says Kim Orchard, Group Health clinical services administrator. Her company, like many others around the country, is tweaking its smoking cessation program to make it more effective. In doing so, it is putting pressure on its peers to join in the effort. Many insurers are busy repositioning themselves as prevention-oriented health services companies, for economic reasons. Under fully insured models, an insurer is not motivated to offer smoking cessation programs because individual members are likely to be insured by another company by the time any long-term health problem shows up. Likewise, it is economics that now lures insurers onto the smoking cessation bandwagon. As more employers become self-insured, health plans provide only administrative services to their clients, and tobacco cessation programs are an extra service that brings a new revenue stream to the health plan. And it may be that the selfinsured employer will still employ that worker when his smokingrelated condition becomes apparent. So it’s a service that clients are demanding. When Dawn Robbins, tobacco program director for the Washington Health Foundation, started promoting tobacco cessation several years ago, she found it difficult to engage insurers.“When we talked to insurers, those who weren’t providing coverage would say, ‘No one is asking for it.’” That’s why she took her message to employers. Make It Your Business: Insure a Tobacco-Free Workforce (www.makeityourbusiness.net) is a campaign now implemented in several communiIVAN MEDIA DESIGN INC./MEDNET/CORBIS A 40 MANAGED CARE / JUNE 2008 http://www.makeityourbusiness.net

Table of Contents Feed for the Digital Edition of Managed Care - June 2008

Managed Care - June 2008 Editor’s Memo Contents Viewpoint Letters News and Commentary Legislation & Regulation Medication Management Compensation Monitor Plans Chart Course in Rough Waters A Conversation With Barbara Starfield, MD Smoke Signals from Payers Slow Going for Clinical Decision Support Back Pain and Physical Therapy Formulary Files PlanWatch Outlook

Managed Care - June 2008

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