Okay – so let’s say you DO have the support of policy makers
(thanks to Jennifer Singleterry’s tips in last week’s blog). What other
partnerships might be important in moving forward with quitline sustainability
efforts? Anyone? Anyone? Bueller…
Yes! Public-private partnerships! To tell us a little more
about what makes quitlines a powerful tool in building
public-private partnerships we
asked David Zauche, Senior Program Officer for Partnership for Prevention and
also a new addition to NAQC’s Advisory Council, to weigh in. Here is what David
had to say:
"How do tobacco cessation quitlines bring value to public-private
partnerships (P3’s)? To answer that question it would help to know just how
such a partnership is defined. But this is not as easy as it sounds - many
definitions exist. A common strain among definitions seems to be:
Public-private partnerships are cooperative ventures between public
agencies and the private sector through which the skills and assets of each are shared for the common good. This generally involves an allocation
of resources for the delivery of a public service, for which both partners share in the recognition.
P3’s have become very popular in the U.S. in the past two decades,
though they have existed for hundreds of years. These partnerships have
benefited the public in a variety of sectors including transportation, schools,
energy, and urban development. Governments
all over the world are dealing with enormous budget shortfalls and they are
increasingly turning to P3 models to deliver services. This is certainly true
in the health care sector. In fact, P3’s have become a valuable public
health tool at the community level.
There are many good examples of
successful P3’s that impact public health and some are specific to the tobacco
control realm. For example, the Department of Health and Human Services’ (HHS)
Million Hearts initiative aims to prevent one million heart attacks and strokes
in the next five years, improving Americans’ health and increasing
productivity. The CDC’s Thomas Frieden, MD wrote, "Through this public-private partnership, Million Hearts focuses on the
areas that will save the most lives. It leverages and aligns current
investments and is a great example of getting more health value from our
existing health investments.” Many different partners have joined forces
including the American Heart Association, the American Medical Association, the
American Nurses Association and Walgreens. HHS will target more than $200
million in new and refocused investments to achieve the goals of Million
Integris Health partnered with the Oklahoma Hospital Association, the state
department of health, and the state tobacco settlement endowment trust to
institute a hospital tobacco treatment program. As a result, tobacco-free
campuses were established; tobacco cessation assistance is provided to
employees and family members; physicians take an active role in helping their
patients quit; and patients are referred to 1-800-QUIT NOW for quitline
assistance after the hospital intervention.
a Tobacco Cessation and Sustainability Partnership was formed to support health
plans in providing evidence-based tobacco cessation interventions and to build
a framework to sustain the state’s quitline. These key stakeholders from health
plans, state agencies, the clinical community, and the advocacy community
engaged in a collaborative process to educate
purchasers about the value of providing tobacco cessation benefits.
In Massachusetts, a
partnership developed between eight commercial Medicaid health plans and the
Massachusetts Department of Public Health. Provider representatives from the
health plans delivered a tobacco cessation kit called Quitworks door-to-door to
thousands of practices. Patients enrolled in QuitWorks were offered free
proactive counseling. The program linked 12,000 health care providers and their
patients to proactive telephone counseling
So, back to the original question – why would a
quitline make a good partner in public health? Well, there are many reasons.
- Tobacco cessation
works. Smokers may have to try and fail before they succeed, but tens of
millions of Americans have successfully quit.
- Quitlines work.
Effectiveness rates have been documented in the 2008 Public Health
Service guideline and elsewhere. But many quitlines face severe financial
handicaps which limit hours of operation, services, promotion, reach and,
ultimately, even greater success than is currently realized.
- Return on
investment. No preventive service – not hypertension treatment, mammography,
cholesterol treatment – has a better payoff in health impact and cost
effectiveness than tobacco cessation services.
key to public-private partnerships is shared strengths and benefits. Quitlines
will be well-served by increased funding, promotion, reach, and sustainability.
But insurers, employers, health systems, and government agencies will also
benefit through shared recognition for evidenced-based services delivered,
healthier workforces, fewer hospital admissions, and a superior return on
have a long history of serving as the bridge that brings partners together and
increasing awareness of the importance of offering cessation assistance. It is
a lengthy process to build cost-sharing partnerships with the private sector
(and the public one, for that matter!) and one that can have many starts and
stops along the way. However, if we are to truly focus on the issue of
sustainability and be successful in doing so, we simply must take the first
step. Have you?