Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106750

Phyllis M. Gingiss, DrPH, Department of Health and Human Performance, University of Houston, 3855 Holman, 104 Garrison Gym, Houston, TX 77204-6015, 713/743-9843, pmgingiss@uh.edu and Melynda C. Boerm, MEd, Health and Human Performance, University of Houston, 3855 Holman, 104 Garrison Gym, Houston, TX 77204-6015.

This study was designed to assess the extent and nature of tobacco cessation coverage provided to Texans through Health Maintenance Organizations (HMOs) as part of the Texas Tobacco Prevention and Control Initiative. The questionnaire was based on a modified edition of an American Association of Health Plans national survey. Texas Department of Insurance's list of top HMOs was used to derive an eligible sample (n=27). 14 (52%) participated, representing 48% of premium market share. Tobacco control infrastructures within HMO organizations are inadequate. None funded tobacco control staff; only half (54%) had departments/units responsible for tobacco control activities; over two-thirds did not have written enrollee tobacco cessation protocols/policies; and only two used established national clinical planning guidelines. Only 40% of plans provided full coverage for at least one form of pharmacotherapy. Bupropion/Zyban was most fully covered, closely followed by Wellbutrin. Few plans (<20%) covered behavioral interventions for cessation. Only 20% provided for patient self-referral to cessation counseling. Less than a third maintained an information system to identify individual enrollees who smoke. Few plans required providers to ask new patients about smoking status or document smoking status on medical records, although approximately half requested providers to document patient smoking status, include smoking status as a vital sign, or ask for new patient smoking status. Over half were familiar with American Cancer Society's Quitline; almost two-thirds indicated interest in working with the state health department to promote Quitline utilization. Recommendations for strengthening tobacco control services within HMOs will be provided.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Identify the scope and nature of tobacco cessation coverage provided by Texas HMOs, and
• Discuss recommendations for strengthening HMO involvement in tobacco control initiatives.

Keywords: Tobacco, Managed Care

Related Web page: www.uh.edu/hnets

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.