Advocacy at the State Level: Improving Tobacco Treatment

Coverage under Medicaid

Partnering to Bring You Tools and Strategies

• Center for Tobacco CessationMission:

Serves as the source of the best available science on tobacco cessation and works with national partners (business, health care and community leaders) to expand the use of effective tobacco dependence treatments

• The National Partnership to Help Pregnant Smokers QuitVision:

To provide all pregnant smokers (and new mothers) with the help they want and the support they need to quit smoking and stay tobacco-free by translating science-based interventions into effective programs and policies.

Membership: Over 50 Organizations, including Smoke-Free Families, Campaign for Tobacco-Free Kids,

CTC, CDC, AMCH, ASTHO, March of Dimes, Porter Novelli, ACS,and others

How We Can Help You

Raise the awareness of this issue

Provide educational materials

Offer referrals to data and other information

Link you with other states and organizations working on this issue

Raising the Awareness: Scientific Consensus

Raising the Awareness:Compelling Messages

• Tobacco Treatment Saves Lives and Money

• Tobacco Treatment is Evidence-Based and It Works

• Tobacco Treatment is More Effective than other Preventive Services

Raising the Awareness:

Media

Providing Educational MaterialsFact Sheets:

• Benefit coverage options under Medicaid

• Status of Medicaid coverage for tobacco treatment

• State Medicaid expenditures and costs attributed to smoking

• Health benefits of smoking cessation

• Treatment approaches, including availability of quit lines

• Lessons learned from other states

Help People Quit Smoking: Providing Tobacco Treatment

under Medicaid

Offering referrals to data

• Information available at the following web sites:

www. ctcinfo.org

www. cdc.gov.org/nccdphp

www. gwhealthpolicy.org/newsps/tobacco

www. partnershiptohelppregnantsmokersquit.org

www. marchofdimes.com/Peristats

www. smokefreefamilies.org

Obtaining referrals to data: Calculating Net State

Savings • Calculate smoking attributable expenditures per

person (birth) receiving Medicaid, using SAMMEC or MCH SAMMEC

http://apps.need.cdc.gov/sammec

• Apply specific assumptions to generate net cost savings for a specific state

Estimate program reach Calculate program costs Estimate quit rate Calculate program savings Subtract program costs from program savings

Hypothetical Net State Savings for a Tobacco Treatment Program

for Pregnant Smokers

Step 1: Apply MCH SAMMEC

Step 2: Estimate program reach: 25% of the 3,932 pregnant smokers on Medicaid

Step 3: Calculate program costs: $30 per participant for one counseling session

Step 4: Estimate quit rate: 18%

Step 5: Calculate program savings

Step 6: Estimate net savings by subtracting program costs from program savings

• $615 SAE per Medicaid birth

• 983 pregnant smokers on Medicaid participate in treatment

• 983 participants x $30 = $29,490 program costs

• 983 participants x 0.18 = 177 quit smoking

• $615 SAE x 177 quitters = $108,855 program savings

• $108,855 - $29,490 = $79,365 in net savings

Linking you with other states and organizations

• Provide case studies of successful partnerships between Medicaid, MCH, and Tobacco Programs

• Offer bimonthly telephone calls with states working on this issue

• Discuss strategy and tactics with CTC, SFF, CTFK, and others

Recommended Next Steps for Advocates

Join our conference calls

Educate yourself about how Medicaid benefits are regulated in your state

Organize and coordinate with others in your state interested in this issue

Gather state-specific facts on existing treatment programs, quit lines, smoking prevalence and costs, Medicaid data

Talk with other states about how they have succeeded!

7 States with comprehensive tobacco treatment coverage under

Medicaid, 2002

Our Collective Vision for the Future:

All States, All Smokers