Medicaid Clients To Get Help To Quit Smoking

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Starting Jan. 1, the state will help Medicaid subscribers quit smoking, with services funded by a lawsuit Connecticut settled with the tobacco industry more than a decade ago.

Connecticut is currently one of only four states not paying for smoking cessation treatment for Medicaid users, though pregnant clients gained the benefit last year as required by federal health care reform law.

“The governor came out in front and included this in his budget,” said Patricia Checko, chairwoman of the non-profit Mobilize Against Tobacco for Children’s Health.

From January to July of 2012, the state will draw $2.7 million from the tobacco settlement trust to fund cessation services.  Another $3.5 million in settlement funds is committed for the next 12 months.

Counseling, nicotine replacement and, if those fail, prescription drugs will all be covered, said Dr. Robert W. Zavoski, medical director for the state Department of Social Services.

Zavoski termed the benefit “part of a bigger reform effort to change the way Medicaid is provided in Connecticut.”

The rollout of the cessation benefit will coincide with a move toward medical homes for Medicaid users, said Zavoski.  Medical homes are a primary care model where a clinician coordinates all of a patient’s care.  A provider with an ongoing relationship with a patient can seize on “a teachable moment” to counsel quitting, said Zavoski.

Only 15 percent of the state’s general population smokes, but 36 to 40 percent of Medicaid clients do, said Checko. People with serious mental illness make up 7 percent of the state’s population but account for 31 percent of all smokers, according to the 2008 Connecticut Tobacco & Health Trust Fund report.

A 2006 statewide study found that: 24.6 percent of Hispanics smoke, as do 22.2 percent African Americans and 15.9 percent of whites. Checko noted that mentholated cigarettes, which the Food and Drug Administration may ban based on research showing they are more addictive, are smoked at higher rates by people of color.

Publicity around the new benefit will not target any specific demographic, said Zavoski. “We have to do a massive outreach to everybody,” he said.

Outcomes from other states have shown savings from covering smoking cessation under Medicaid. For example, Massachusetts linked the benefit with reductions in heart attacks and emergency room visits for asthma attacks.

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