Where There's Smoke, There's Financial Incentive To Put Out The Fire
Article Highlights
- Study Title
- Where There's Smoke, There's Financial Incentive To Put Out The Fire
- Study Authors
- Julie Miller, et al.
- Publication Date
- July
The Problem
Only in the past few years has research been conducted on the most cost-effective evidence-based solutions for smoking cessation programs in the managed care environment. As a result, managed care executives have often provided cessation programs that are either too costly or too ineffective to be continued. Yet, the smoking cessation program is needed for the following reasons:
- Approximately 25% of American adults smoke
- 440,000 Americans die each year from smoking-related illnesses
- The United States spends $157 billion a year in direct medical costs and lost productivity due to smoking.
Examples of Managed Care's Efforts to Reduce Smoking
Managed care executives across the country have employed smoking cessation programs to reduce the prevalence of smoking among their enrollees but they have also reached further into smoking cessation by becoming involved in local tobacco legislation.
For example, executives at Blue Cross Blue Shield of Minnesota (BCBSMN) worked on state-wide legislative issues including smoking bans in restaurants and bars as well as tax increases on cigarette sales. BCBSMN also worked with local media to advertise the state Quit Line (smoking cessation telephonic program) and the health impact of smoking. In Minnesota, smoking-related diseases add more than $1.6 billion to the state's healthcare bill annually - the incentive to reduce smoking rates is strong.
New York City has also reduced the adult smoking rate by more than 10% between 2002 and 2003 through the addition of smoking bans in restaurants and bars as well as a $1.50 increase in tobacco taxes. Combined with public health campaigns on the effects of smoking and the availability of group or individual counseling cessations, New York City has seen a significant decline in smoking rates, which translates to a significant increase in savings.
The Solution
Managed care organizations and health plans should implement basic tobacco-reduction interventions, at a cost of about $0.22 per-member, per-year. If they do so, they can expect a return on investment of $4.08 per every $1.00 spent after just five years of operation. Such an intervention should include the Public Health Service's 5 A's - "Ask, Advise, Assess, Assist, and Arrange." Integrating the smoking cessation with provider efforts can produce higher rates of cessation while remaining cost effective for the overall organization.
Many scientific studies show that a combination of pharmacotherapy and cessation counseling provides better quit rates than either treatment method on its own. A collective approach is needed for smoking cessation wherein smokers have easy, no-cost access to pharmacotherapy, encouragement from their primary care physicians to quit, and access to convenient, high-quality counseling programs. By providing coverage for pharmacotherapy, tangible physician support, and access to a quality cessation program, managed care organizations and health plans can expect significant participation rates, significant cessation (quit rates), and a positive return on investment within just five years.