Addressing Tobacco in Managed Care: A tobacco coverage survey among 6 health insurers in Louisiana

Forty-five million Americans are smokers resulting in high medical costs and an increasing impact on our economy. Coupling the health consequences of tobacco usage and the cost to treat users, tobacco management has become a crucial issue for health insurers. The Addressing Tobacco in Managed Care Survey was last administered nationwide in 2004. Currently, Louisiana is only the third state to administer this survey independently at the state level.

The 32-item survey was disseminated among the top health insurers in Louisiana in 2007. The medical director and staff of each health insurer completed the survey, which was designed to assess barriers, opportunities, and coverage as they relate to tobacco treatment and cessation options among health insurers. Six health insurers, which account for 98% of the total market share in Louisiana, completed the survey. Half of those surveyed have some type of written clinical guidelines for smoking cessation and identifying smokers. However, only 33% provide full coverage for pharmacotherapy, and 66% face barrier(s) when addressing tobacco control. Conversely, 50% of these health insurers have implemented strategies to inform members about tobacco cessation benefits and to encourage them to take advantage of covered treatment and cessation options.

Great strides have been made in addressing tobacco control since administering this survey. These results will be used for future initiatives, including a tobacco cessation benefit package, which is the final goal for health insurers. Ultimately, the improvement in efforts to combat the detrimental outcomes of tobacco dependence will be achieved.