The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72711

Amy Conway, MPH, Kaiser Permanente, 1950 Franklin, Oakland, CA 94612, (510) 987-2653, Amy.Conway@ncal.kaiperm.org

Kaiser Permanente in Northern California is an integrated health maintenance organization, which serves 3.2 million health plan members. Kaiser Permanente has offered smoking cessation services to its members since the 1970’s. However, prior to 2003, members paid a fee to attend these programs. Members who were enrolled in a smoking cessation program could obtain a smoking cessation aid such as the nicotine patch at co-pay only once per calendar year.

Beginning in 2003, all Kaiser Permanente smoking cessation programs are available to members at no charge. In conjunction with this improved benefit, drug benefits were augmented to provide smoking cessation pharmacotherapy at co-pay as often as medically necessary. To qualify for this drug benefit, the member must participate in an approved cessation program within 6 months of getting the prescription. The 2000 U.S. Public Health Service Guideline recommends unlimited coverage of tobacco treatments as the best benefit structure to encourage cessation.1 But do more health plan members make a quit attempt as a result of the improved coverage?

To answer this question, Kaiser Permanente is tracking the number of members attending cessation programs and the number of nicotine replacement prescriptions. This data will be compared to program enrollment and prescriptions in previous years. Enhanced benefits are just one of several activities occurring at Kaiser Permanente which could influence smokers to quit. Therefore, we will also do qualitative interviews with members to find out if they know of the benefits and if these influenced their decision to quit.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to:
• Explain the rationale behind covering smoking cessation services as a healthplan benefit.
• Describe a progressive benefits design to encourage smokers to utilize smoking cessation services in a managed care organization.
• Describe how these benefits impact smokers’ participation in a smoking cessation intervention.

Keywords: Tobacco, Health Insurance

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Kaiser Permanente
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employer