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Tuesday, July 27, 2010

Partnership Co-Hosts Tobacco Cessation Briefing at NCSL’s Legislative Summit in Louisville, Kentucky--Briefing Video to Follow


Key Partnership senior staff are on hand at the National Conference of State Legislatures (NCSL) annual legislative summit being held this year in Louisville, Kentucky, July 25-July 28.  Partnership’s Government Affairs team worked closely with the NCSL Health Committee to host a special tobacco cessation briefing for state legislators and their staff members from across the country.  The briefing focused on the impact the Massachusetts Medicaid program experienced when it offered and promoted a comprehensive tobacco cessation benefit.  Although data is still being analyzed, the preliminary results are very promising.

Richard T. Moore, Senate Chairman of the Massachusetts Joint Committee on Health Care Financing and incoming NCSL President told the audience that:

  1. Within just one year, users of the smoking cessation benefit had dramatic reductions in hospitalizations for heart attacks, declines in emergency and clinic visits for asthma, and a significant decrease in acute birth complications.
  2. In the first two and a half years of the benefit over 75,000 MassHealth members have tried to quit smoking.  This represents 40 percent of smokers on MassHealth, a level unprecedented in the nation.
  3. Researchers from the Massachusetts Tobacco Cessation and Prevention Program found that up to 38 percent fewer MassHealth cessation benefit users were hospitalized for heart attacks in the first year after using the benefit and 17 percent fewer benefit users visited the emergency room for asthma symptoms in the first year after using the benefit.
  4. Researchers also found that there were 17 percent fewer claims for adverse maternal birth complications since the benefit was implemented.

In addition, the briefing included an important presentation from the MassHealth Deputy Medical Director Roger L. Snow, MD, MPH.  Dr. Snow reviewed the history of the MassHealth benefit and credited Senator Moore for having the vision to recognize that the availability and utilization of a comprehensive benefit could save lives and help control spending in the Medicaid program.  At Senator Moore’s urging, the legislature directed MassHealth to expand upon the Mass Department of Public Health’s limited telephone consultation service and adopt a comprehensive cessation benefit.

 
A copy of Dr. Snow’s slides can be viewed here.
 
Please be sure to check back to the prevent.org web site next week to see a video of the entire NCSL briefing and discussion “Cessation Saves Lives.”
 
Ripley Forbes
Director, Government Affairs
Partnership for Prevention


Posted by: Brian McCue at 12:00 AM
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Labels: Massachusetts, Medicaid, NCSL, tobaccocessation



Tuesday, July 20, 2010

New Partnership Guide Offers States Guidance on Helping Medicaid Recipients Quit Tobacco


Partnership for Prevention’s ActionToQuit initiative has developed a comprehensive state-by-state analysis of Medicaid coverage of tobacco cessation. Prepared in collaboration with the American Lung Association, Saving Lives and Money – Helping People on Medicaid Quit Tobacco offers clear guidance to states on necessary steps to provide a comprehensive cessation benefit in accordance with recommendations of the United States Public Health Service (USPHS).

In 2004, the U.S. Medicaid expenditures for tobacco related illnesses totaled $22 billion, which was 11% of the overall Medicaid expenditure.  States like New Hampshire and Montana, with smoking prevalence rates among the Medicaid population at 80% and 70% respectively, both attributed 15% of Medicaid costs to smoking. Their combined smoking attributable costs to Medicaid were $173 million.  Although both Arizona and Washington’s prevalence rates were lower than 70% in 2004, both states attributed 18% of Medicaid costs to smoking, totaling $841 million. Since a large portion of Medicaid’s funding goes toward treating tobacco related diseases, an up-front investment in prevention, including tobacco cessation, must be a consideration.

As mapped out in Saving Lives and Money, six states currently cover all the treatments Medicaid recipients need to quit tobacco – Minnesota, Indiana, Massachusetts, Nevada, Oregon and Pennsylvania.  Twenty-one states provide most, but not all, recommended cessation treatments to all of their Medicaid recipients; eighteen states provide only a few cessation treatments or have uneven coverage; and four states fail to cover any of the recommended medications or counseling for Medicaid recipients who want to quit.

The 2010 Patient Protection and Affordable Care Act requires that all Medicaid programs cover a comprehensive cessation benefit for pregnant women on Medicaid beginning this fall. The Act also provides a one percentage point increase in the federal Medicaid matching rate to states that cover all preventive services given an ‘A’ or ‘B’ by the USPHS (including tobacco cessation) with no cost-sharing.  These are important steps in the right direction but, as Saving Lives and Money points out, there is still much to be done.

The guide will be introduced next week at an important session of the National Conference of State Legislatures’ (NCSL) Health Committee meeting in Louisville, Kentucky. At Partnership’s urging, this year the NCSL Health Committee is hearing a presentation on the remarkable success of the Massachusetts Medicaid program in promoting a comprehensive tobacco cessation benefit and achieving unprecedented success in reducing tobacco prevalence among the Medicaid population and reducing tobacco related health care costs.

Please visit the ActionToQuit website, Resources section to download the guide: http://actiontoquit.org/resources/

Brandi Robinson
Program Associate
Partnership for Prevention


Posted by: Brian McCue at 12:00 AM
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Labels: ActionToQuit, Medicaid, tobaccocessation



Thursday, July 15, 2010

Electronic Medical Records


In 2009, the Obama administration and Congress passed the Health Information Technology for Economic and Clinical Health Act (HITECH) to increase the use of Electronic Health Records (EHR’s). The law authorizes incentive payments through Medicare and Medicaid to clinicians and hospitals when they use EHR’s to achieve improvements in care delivery. On July 13, 2010 Secretary Sebelius announced the final rules to support meaningful use of EHR’s, officially launching a concentrated five-year national initiative to improve the health of Americans and reduce health care costs through their adoption and use.

Earlier this year Partnership for Prevention joined with its colleagues at Trust for America’s Health in submitting public comments on the HITECH rules, requesting that the clinical quality measures have a focus on preventive care, specifically those clinical preventive services that provide the highest value as recommended by the National Commission on Prevention Priorities (NCPP). These include influenza immunization rates, smoking cessation counseling, BMI screening and follow-up, cervical cancer and chlamydia screening, and aspirin therapy. We applauded the Department of Health and Human Services for including public health among its goals for implementation.

While the final rules do not include all the measures recommended, smoking status for patients 13 years old or older was included as a measured functionality. This is a victory for tobacco control advocates because recording smoking status may lead to an increase in the number of patients who receive smoking cessation treatment. The age threshold is important as counseling for adolescent smokers has been shown to be effective, approximately doubling long-term abstinence rates in the multiple studies. Additionally, this measure will be in accord with the 2008 Update to the Public Health Service Clinical Practice Guideline on Treating Tobacco Use and Dependence.

This is an exciting time in healthcare in America. Paper-based treatment, surveillance, and recordkeeping is yielding to same-time health communication. The 2009 law and the July 13 announcement of its rules will go a long way toward operationalizing these advances.

For more information:

http://www.hhs.gov/news/press/2010pres/07/20100713a.html

http://healthcarereform.nejm.org/?p=3732

David Zauche
Senior Program Officer
Partnership for Prevention


Posted by: Brian McCue at 12:00 AM
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Labels: electronicmedicalrecords, HHS




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