National Working Group for ACTTION

November 20, 2009

People who receive Medicaid benefits smoke at higher rates than the general population. This is also a population that, by definition, has a low income and is less able to pay out-of-pocket costs for any cessation treatments or services. With these barriers in place, few states are actually providing comprehensive coverage to help smokers on Medicaid quit – a missed opportunity for the tobacco control community to reach numerous smokers. However, in Massachusetts, where the new MassHealth insurance benefit is offering comprehensive cessation services to Medicaid recipients who smoke, the state is starting to see the investment pay off.

The Massachusetts Tobacco Cessation and Prevention Program (MTCP) and MassHealth worked together to design a barrier-free benefit that includes all FDA-approved smoking cessation medications and behavioral counseling. In July 2006, MassHealth began providing coverage of smoking cessation as part of the state’s health care reform initiative. MTCP promoted the new benefit through radio and transit ads and extensively in the community. The benefit was introduced into an environment that encourages quitting smoking, including Massachusetts’ smoke-free workplaces, high cigarette taxes, and a non-smoking social norm, all of which contributed to smokers’ willingness to quit.

“The significance of this research demonstrates how important it is to provide comprehensive tobacco cessation services to smokers and to make sure they know about them,” said Department of Public Health Commissioner John Auerbach. “We know that smokers who get support and use stop-smoking medicines like the patch are more than twice as likely to be able to quit for good as those who try to quit on their own.”

Since the program’s initiation in 2006, more than 75,000 MassHealth members have used the benefit to try to quit smoking, representing 40 percent of smokers on MassHealth, a level unprecedented in the nation. Researchers 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 that 17 percent fewer benefit users visited the emergency room for asthma symptoms in the first year after using the benefit. It was also seen that there were 17 percent fewer claims for adverse maternal birth complications since the benefit was implemented.

The Multi-State Collaborative for Health Systems Change is a collaborative of tobacco control programs working to facilitate sustainable changes in health care systems within our states and nationally in order to reduce tobacco use and prevalence. Working as a community of practice, we seek to effect change by: sharing knowledge and practices widely about how state tobacco control programs support system changes in health care; documenting emerging and promising practices at the state level to build the evidence base for national health systems change; and identifying and serving as chief advocate for changes needed in policies and practice at the national level that serve as barriers to effective change at the state level. 

Your Call to Action: Learn more about the Multi-State Collaborative for Health Systems Change by visiting the organization’s Web site.