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“Name”  QuitlinE Partnering to Improve “Name”  QuitlinE Partnering to Improve

“Name” QuitlinE Partnering to Improve - PowerPoint Presentation

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“Name” QuitlinE Partnering to Improve - PPT Presentation

Tobacco Cessation Coverage in X State Presentation Objectives Demonstrate the problem of tobacco use and gaps in cessation treatment for State employees Understand the costs of tobacco use ID: 787987

cessation tobacco quitline health tobacco cessation health quitline smoking counseling services treatment quit care cost coverage costs effective benefits

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Slide1

“Name” QuitlinE

Partnering to Improve

Tobacco Cessation Coverage in “X State”

Slide2

Presentation Objectives

Demonstrate the problem of tobacco use and gaps in cessation treatment for State employees.

Understand

the costs of tobacco use

.

Demonstrate cost-effectiveness of

tobacco cessation

coverage.

Clarify

the ACA requirements for tobacco

coverage for insurers.

Share

the benefits

and options for partnering

with the

“State

Quitline

”.

Identify opportunities for collaboration to expand cessation coverage and treatment statewide.

Slide3

Accelerating the National Movement to Reduce Tobacco Use

P

rovide

access to barrier-free proven tobacco use cessation treatment including counseling and medication to all smokers, especially those with significant mental and physical

comorbidities.

Expand

smoking cessation for all smokers in primary

and

specialty care settings by having health care providers and systems examine how they can establish a strong standard of care

for

effective

treatments.

U.S

. Department of Health and Human Services.

The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General.

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, 2014.

Slide4

Tobacco Dependency in “State”

Slide5

State”Tobacco

Users Want to Quit

(and need help)

“% of State”

tobacco users made a serious but failed attempt to quit smoking in

“ insert year”

Slide6

Costs Associated with Smoking

Cost of Smoking-Related Illness

Smoking-related illness in the United States costs more than $300 billion each year,

including:

Nearly $170 billion for direct medical care for adults

1

More

than $156 billion in lost productivity,

in addition to $5.6 billion in lost productivity due to secondhand smoke exposure2

1Xu X, Bishop EE, Kennedy SM, Simpson SA, Pechacek TF. Annual Annual Healthcare Spending Attributable to Cigarette Smoking: An Update[PDF–157 KB]

. American Journal of Preventive Medicine 2014;48(3):326–33 [accessed 2015 Apr 7].

2

U.S. Department of Health and Human Services.

The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General

. Atlanta: 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, 2014 [accessed 2015 Apr 3

].

Slide7

Tobacco Use Costs Employers

It is estimated

that

US businesses incur

excess costs in the range of $

5,816

per

year.

1On average, smokers miss 2.74 more days of work per year compared to non-smokers.2

The annual per smoker cost of lost productivity due to unsanctioned smoking breaks is $3,077.24.1Businesses pay an average of $2,289 in workers’ compensation costs for smokers, compared to $176 for nonsmokers.3

1

Berman

M., Crane R.,

Seiber

E.,

Munur

M. Estimating the cost of a smoking employee.

TobControl

2013; 0:1-6.

2

Weng

S.F.,Ali

S.,

Leonardi

-Bee J. Smoking and absence from work: Systematic review and meta-analysis of occupational studies.

Addiiction

2012; 108: 307-319

.

3

Musich S, Napier D,

Edington

D. The association of health risks with worker’s compensation costs.

JOEM

. 2001:43 (6):534-541.

Slide8

Cessation Coverage: Benefits

Over

time, tobacco-use cessation benefits generate financial returns for employers in four ways:

Reduced health care costs

1,2

Reduced absenteeism

1,3

Increased on–the–job productivity 1,3 Reduced life insurance costs

1,3Coverage of tobacco-use cessation treatment (counseling and medications) increases the chance of a successful quit.4Cost analyses have shown that tobacco cessation benefits, from

an

employer perspective, are

cost-saving.

5

1

Warner

KE, Smith RJ, Smith DG, Fries BE. Health and economic implications of a work-site smoking-cessation program: a simulation analysis.

Journal of Occupational and Environmental Medicine

1996;38(10):981–92.

2

Wagner

EH, Curry SJ,

Grothaus

L, Saunders KW, McBride

CM. The

impact of smoking and quitting on health care use.

Archives of Internal Medicine

1995;155(16):1789 015 015–95.

3

Halpern

MT,

Shikiar

R,

Rentz

AM, Khan ZM. Impact of smoking status on workplace absenteeism and productivity.

Tobacco Control

2001;10:233–8.

4

Moehle McCallum D,

Fosson

GH,

Pisu

M. Making the case for Medicaid funding of smoking cessation treatment

programs:an

application to state-level health care savings. Journal of Health Care for the Poor and Underserved, 2014; 25(4): 1922-1940.

5

Campbell

KP,

Lanza

A, Dixon R,

Chattopadhyay

S,

Molanari

N, Finch RA, editors.

A purchaser’s guide to clinical preventive services: moving science into coverage.

Washington, DC: National Business Group on Health; 2006

.

Slide9

“Paying

for an employee’s tobacco cessation treatment provides more return on investment than any other adult treatment or prevention

benefit.”

National Business Group on Health

Slide10

Massachusetts Medicaid Program

After two and half years of offering comprehensive coverage for pharmacotherapy and counseling…

smoking rates dropped from 38% to 28%

1

hospital claims for acute heart attacks dropped by 46% and

coronary heart disease dropped by 49%

2

Medical savings to the Medicaid program of $3.12 for every $1.00 spent (ROI of $2.12)

31

Land, T, Warner, D,

Paskowsky

, M, et al. Medicaid coverage for tobacco

dependence treatments

in Massachusetts and associated decreases in smoking prevalence.

PLoSONE

2010 March;5(3): e9770

.

2

Land

, T,

Rigotti

, NA, Levy, DE, et al. A longitudinal study of Medicaid coverage

fortobacco

dependence treatments in Massachusetts and associated decreases in

hospitalizations for

cardiovascular disease.

PLoS

Med 2010 Dec;7(12): e1000375

.

3

Richard

, P, West, K, Ku, L. The return on investment of a Medicaid tobacco

cessation program

in Massachusetts.

PLoS

ONE 2012 Jan;7(1): e29665.

Slide11

Return-On-Investment for an Employer

Tobacco-dependence treatment is highly cost-effective and

cost-saving.

1

The return-on-investment for tobacco cessation treatment has been shown to be positive after one year due to increases in employee productivity alone.

2

Recent studies have shown that medical cost savings within 18 months for smokers who quit compared to those who continued smoking.

3,4

Up to 70% of current smokers' excess medical care costs is preventable by quitting.5

1

Fiore

, MC, Jaen, CR, Baker, TB, et al. Treating tobacco use and dependence: 2008 update. Clinical Practice Guideline. Rockville, MD:

U.S. Department

of Health

and Human

Services. Public Health Service, 2008. Available at: www.surgeongeneral .

gov

/ tobacco/ treating_tobacco_use08 .

pdf

.

2

American Health Plan Insurance

. Making the Business Case for Tobacco Cessation.

Retrieved from

http://www.businesscaseroi.org

3

Hockenberry

, JM, Curry, SJ, Fishman, PA, et al. Healthcare costs around the time

ofsmoking

cessation. Am J

Prev

Med 2012 Jun;42(6): 596– 601.

4

Richard

, P, West, K, Ku, L. The return on investment of a Medicaid tobacco

cessationprogram

in Massachusetts.

PLoS

ONE 2012 Jan;7(1): e29665.

5

Maciosek

M., Xu X.,

Butani

A.,

Pechacek

.

Smoking-attributable medical expenditures by age, sex, and smoking status estimated using a relative risk approach.

Prev

Med

2015;

77:162-167.

Slide12

Partnering with

Quitline

Makes Good Sense

Slide13

ACA : Tobacco Cessation Coverage

ACA –

Since 2010, most insurers are required to provide tobacco cessation coverage

May 2014 -

Guidance issued by the U.S. Departments of Health and Human Services, Labor and Treasury stating…

To comply with ACA, cessation benefits should include:

Screening

for tobacco use.

Two quit attempts per year, consisting of:

Four sessions of telephone, individual and group cessation counseling lasting at least 10 minutes each per quit attempt; and, All medications approved by the FDA as safe and effective for smoking cessation, for 90 days per quit attempt, when prescribed by a health care provider. Cost-sharing (i.e., copays) and prior authorization for any of these treatments should not be required.

Slide14

Current State Employee Benefits

Add coverage in format of ACA recommendation (previous slide

Identify gaps

For example:

Reliance

on

QuitLine

Tobacco cessation drugs not in formulary

Plans don’t include specific tobacco cessation coverage

Slide15

We Know What Works

Research indicates the most effective tobacco treatment is a combination of:

evidence-based coaching and

FDA approved medications.

Quitline

is

evidence-based

Slide16

Cessation Benefits

Cessation Benefits Should Include ALL of These Treatments:

MEDICATIONS

COUNSELING

Nicotine

Gum

Individual

Nicotine

Patch

Group

Nicotine

Lozenge

Phone

Nicotine Nasal Spray

Nicotine Inhaler

Bupropion

Varenicline

Barriers to Avoid:

Co-pays

Prior authorization

Duration limits

Annual limits on quit attempts

Dollar limits

Requirements to try one medication before another

Requirements to pair medications with counseling

Helps meet ACA criteria

Slide17

Mechanism to Meet the Need

Quitline

helps meet ACA requirements

Slide18

Quitlines: Evidence-Based and Effective

Quitlines

are telephone-based tobacco cessation services that help tobacco users quit through a variety of services,

including:

Counseling

FDA-approved medications

Information

and self-help materialsQuitlines reach many smokers, even underserved and rural populations

Quitline counseling can more than double a smoker’s chances of quitting. 1Quitline counseling combined with medication can more than triple the chances of quitting.

1

1

Fiore

MC, et al. Treating Tobacco Use and Dependence: 2008 Update – Clinical Practice Guideline, US Public Health Service, May 2008,

http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf

.

Slide19

Quitlines: Evidence-Based and Effective

Face-to-face

counseling and interactive telephone counseling are more effective than services that only provide educational or self-help

materials.

1,2

The effectiveness of counseling services increases as their intensity (the number and length of sessions)

increases.

1

Smokers are more likely to use telephone counseling than to participate in individual or group counseling sessions.2,31

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; 2000.2McAfee T, Sofian N, Wilson J, Hindmarsh M. The role of tobacco intervention in population-based health care. American Journal of Preventive Medicine

1998;14:46–52.

3

McAfee T. Increasing the population impact of

quitlines

. Paper presented at the North American

Quitline

Conference, Phoenix, AZ, 2002.

Slide20

Quitline Telephone Counseling

C

onvenient

More flexible than a group counseling session

Accessible regardless of location

L

ess expensive than individual face-to-face counseling

Counselors trained specifically for tobacco cessation treatment based on latest research

Slide21

6 Month Quit Rates Comparison

10%

Physician Advice Alone

*

(

)

% (

QuitlineName

)Counseling

**

( )%

Quitline

***

Counseling & NRT

*Fiore,

Treating Tobacco Use and Dependence, Clinical Practice Guidelines

2008 Update

** (Reference)

*** (Reference)

Quitline

is high quality and effective

Slide22

“State” Quitline Services

Consists of five outbound coaching sessions and unlimited support

calls.

Special protocol and treatment sessions

for pregnant women

Highly

trained, professional

Quit Coaches

Coaching supported in multiple languages

NRT mailed directly to tobacco user’s home

Accessible

(

add state’s

quitline

hours

)

Integrated with an

interactive web

based tobacco treatment program

Online

registration

Slide23

Quitline

Infrastructure: No Capitol Outlay

Financial

Benefits

Infrastructure in

place

Quit Line set-up fees are minimal (one-time $) and minimal annual maintenance fees

($).

Reporting – No charge for monthly utilization reports.Plans or Employer Groups may have their members/employees

who call warm transferred directly to the Plan’s internal program. The charge for this is $ () /warm transfer.Plans or employer groups are charged only when a service is provided compared to a pmpm

fee.

It is easy to partner with

Quitline

Slide24

Quitline Infrastructure: No Capitol Outlay

Service

Benefits

Externally validated 6/7 month quit rate of XX percent for “insert state” callers.

Ability to use 1-800-QUIT-NOW which has high consumer and health care provider recognition.

Individual meetings upon request

.

High referral rates by health care providers.

Statewide quitline media campaigns and national campaigns provide free advertisement to your employees.

It is easy to partner with the Quitline

Slide25

Coaching Services

For no more than $() per member, evidence-based comprehensive integrated telephone and internet coaching services will be provided.

Quitline

is very cost effective

Slide26

Nicotine Replacement Therapy Costs are no more than:

Four weeks $

Eight weeks $

Four weeks $

Eight weeks $

Four weeks $

Eight weeks $

Quitline

is very cost effective

Slide27

In Summary

Providing a tobacco cessation benefit for employees is cost-effective and shown to be cost-saving.

The Affordable Care Act requires insurers, including self-insured employers to provide tobacco use treatment (counseling and medication).

Quitlines

are an cost-effective resource for providing an evidence-based cessation treatment.

Quitlines

provide a wide array of services to meet an individual’s need.

Quitlines

are accessible and have excellent outcomes.

Slide28

It’s Easy to Participate

Agree to contract with the

“ vendor or agency”.

Promote “

State

Quitline

” to your employees with the assistance of our professional marketing staff.

AND WE DO THE REST!

It is easy to partner with the

Quitlne

Slide29

Contact Us

Add Contact Information