Implementing a New Medicaid Cessation Benefit: The Massachusetts Experience

Medicaid plays a critical role in reaching low income populations in Massachusetts that experience smoking rates more than twice the statewide average. Collaboration between State Departments of Health and state Medicaid agencies can lead to improved cessation coverage, increased promotion, and increased utilization of the benefit by both providers and Medicaid members.

Massachusetts implemented a new Medicaid tobacco cessation benefit in July 2006, mandated under Health Care Reform legislation. A presenter from the Massachusetts Department of Public Health will describe the collaborative process utilized with Medicaid (MassHealth) to design the cessation pharmacotherapy and counseling benefit. The presentation will review the benefit coverage and reimbursement rates and will guide participants through a discussion of key considerations in designing a comprehensive benefit. The need to promote the benefit widely and aggressively will be addressed and examples of Massachusetts promotion strategies will be offered.

The benefit in the first year was utilized by approximately 12% of adult MassHealth members who use tobacco. Details on utilization will be reported, along with results from a household survey administered to Medicaid members on member knowledge, use of the benefit, current smoking status, and barriers to using counseling and pharmacotherapy.