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Medicaid smoking cessation benefit would provide significant savings

Research published in the open access journal PLoS One shows that a smoking cessation benefit for Medicaid members saves an estimated $388 per member, per year and could yield billions in savings for state insurance programs across the country.

The study, "The Return on Investment of a Medicaid Tobacco Cessation Program in Massachusetts," conducted by researchers from the George Washington University School of Public Health and Health Services, found that every dollar spent in program costs resulted in an average program savings of $3.12, which represents a $2.12 return on investment.

"Smoking is the leading cause of preventable death in the United States," said lead researcher Leighton Ku, PhD, professor of Health Policy at the GW School of Public Health and Health Services, in a press release announcing the study results. "In 2004, smoking-related Medicaid expenditures for all states combined was $22 billion, which represented 11 percent of all Medicaid spending. Investments in comprehensive tobacco cessation services in Medicaid can improve the health of patients, as well as save money for states and the federal government."

[See also: CMS expands Medicaid coverage for smoking cessation services.]

The research was conducted in Massachusetts comprising 805 Medicaid recipients between the ages of 18-64 who self-identified as smokers and were using the state’s smoking cessation benefit. The study tracked the patients for 70 weeks – or about 1.3 years – to see the overall effects on hospital admission rates both before and after the use of smoking cessation benefits.

The data show that investing in smoking cessation programs can result in lower levels of smoking, which in turn lead to reductions in hospital admissions for heart related problems.

[See also: Poll shows more Americans smoking despite restricted access to basic necessities.]

Massachusetts’ program predates federal health reform and was begun in 2006. It lowered co-payments for FDA-approved smoking cessation medications to $1 to $3 per month and did not require pre-authorization for members to begin using specified medications. In addition, it provided as many as five free telephone counseling sessions for people looking to quit smoking.

Earlier research has shown that the participation rate in the program was 37 percent, which in turn led to a 10 percent reduction in overall smoking by members.

The researchers noted that 47 states have some form of smoking cessation program, though most offer these as limited benefits. The Patient Protection and Affordable Care Act (PPACA) also increased benefits for smoking cessation. Since 2010 it has required states to provide comprehensive smoking cessation services to pregnant women. By 2014 it will also require states to cover the costs of all smoking cessation medications.

The study authors contend that expanding on these policies could have a much greater effect on improving health and lowering costs within state-sponsored health insurance programs.

“Despite the budgetary problems faced by Medicaid program administrators and state and federal officials, efforts to implement comprehensive tobacco cessation programs for Medicaid enrollees (not just those who are pregnant) may be an element of evidence-based policy to both improve public health and reduce health care expenditures,” wrote the study authors. “Because Medicaid provides health insurance coverage, including coverage for preventive services, for a very large share of a high-risk, low-income population, public health objectives include recommendations for comprehensive smoking cessation coverage under Medicaid.”

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