National Working Group for ACTTION

October 13, 2009

Improving workforce health, productivity and “bending the curve” of health care costs are critical business imperatives for U.S. employers, particularly in today’s highly competitive and global economy. There is no greater opportunity for improving workforce health and controlling costs than motivating employees and their dependents to stop smoking. With its eValue8™ Request for Information (eValue8 RFI), the National Business Coalition on Health (NBCH) conducts an annual assessment of health plans on behalf of health care coalitions, their purchaser members, and national employers. A recent report was conducted and released that created a snapshot of eValue8 data on health plan strategies to address tobacco cessation.

Tobacco-related illness is the leading cause of preventable death in the United States posing a tremendous public health and economic burden on society – accounting for approximately 20 percent of all deaths annually. In addition to the public health concern, in 1999, lost productivity due to smoking and smoking-related illnesses cost employers $2,312 per smoking employee. Excess medical expenses due to smoking and smoking-related illnesses cost employers $2,132 per smoking employee (both figures are adjusted to year 2008 dollars).

While most agree on the scope and potential impact of solving this problem, the challenge for private employers is finding solutions that work. Employers are beginning to recognize the value of providing smoking cessation benefits to employees relative to overall employee health and health care costs; however, many are not aware of what constitutes a comprehensive smoking cessation benefit. Employers must provide more robust smoking cessation benefits to help smokers quit while simultaneously realizing cost savings.

“Counseling and pharmacotherapy are effective when used by themselves. However, a combination of counseling and pharmacotherapy are more effective than either alone,” said Dennis White, Senior Vice President of Value-Based Purchasing, NBCH.  “Studies show that covering the full cost of smoking cessation intervention increased the number of quit attempts, the number of successful quitters, and the use of smoking cessation treatment attempts. Therefore, reducing or eliminating out-of-pocket costs for patients who wish to quit smoking will yield better results.”

The role of employers may include both worksite programs and health benefits support for tobacco cessation, as well as tobacco-free worksite policies and promotion of similar state and community efforts. A large part of the employer’s role involves helping to educate employees and their families not only about the health impact of tobacco use but also about the programs and services that are available to aid tobacco cessation.

According to the recent tobacco cessation eValue8 report findings, employers want to enhance the health plans’ efforts through worksite campaigns and programs that assist with identification of smokers, educate on benefit programs and implement workplace policies to create an environment conducive to quitting. It also found that there are significant variations in coverage, which suggests a need for better alignment of plan design with value-based benefits. It’s also important that employers and health plans continue to work together to determine and evaluate incentives and education efforts with physicians and improve practitioner engagement.

Some essential next steps for employers to promote accountability and performance improvement related to tobacco use cessation include:  

• Employers need to understand the evidence based plan design elements for tobacco cessation and make these part of their benefit program.
• Employers can promote the benefits of the tobacco cessation program as part of the communication process and reinforce the importance of the issue with workplace policies.
• Employers need to continue to use evaluation tools such as eValue8 to measure the performance of health plans and to promote quality improvement for tobacco cessation.

Your Call to Action: Learn more by accessing the NBCH eValue8™ tobacco cessation report.