Assessing private and public insurers’ coverage of tobacco cessation treatment is a great first step in understanding the gaps in coverage within a state, as well as providing states an opportunity to educate insurers on what constitutes comprehensive coverage and available cessation resources.

Through NAQC’s private-public partnership (PPP) initiative, a number of states have assessed private and public insurers about the cessation benefits offered to their members/employees. States have employed various assessment tools, including written survey instruments and interview guides, as well as compiling benefit information for a segment of the insurance market such as Medicaid Managed Care Organizations and state employee benefits. Some state examples and links to resources are listed below.

State examples:

• Massachusetts worked with a private contractor to conduct in-person interviews with their largest health plans. The contractor had a history of working with health insurers and was very comfortable administering an in-person verbal assessment using an Interview Guide developed in collaboration with state staff. Massachusetts tobacco program staff also compiled cessation coverage information for all the insurance plans providing benefits to state employees. The information was captured in a spreadsheet that clearly identified inconsistencies in coverage among the various plans.
  
• Kentucky adapted Colorado’s preventive services survey instrument to meet their state’s needs. The Kentucky survey instrument was used to assess cessation coverage among their largest health plans and employers, including their Medicaid MCOs.
  
• Colorado’s survey tool assesses a multitude of preventive service s including tobacco cessation coverage. A Summary Brief and Call-to-Action was developed utilizing the survey findings and shared with insurers who completed the survey, as well as other stakeholders.
  
• Rhode Island tobacco program staff worked collaboratively with their largest health plans, who actively participate on their cessation coalition, to develop an assessment tool for distribution to health plans in their state.
  
• Maryland enlisted interns from the University to develop an on-line survey tool that will be used in the future to assess coverage among their state’s largest health plans and employers.
  
• Additional information about state activities may be found in the 11 state briefs NAQC published last month

Assessment Resources:

• State Cessation Coverage Assessment Worksheet. All of the states participating in the NAQC PPP initiative have utilized the assessment worksheet to guide their work in completing a comprehensive assessment of cessation coverage. The assessment information is used to identify priority areas, opportunities for advancing comprehensive coverage and for strategy development.
  
• Oregon Health Plan – Managed Care Organizations – Tobacco Cessation Services Survey. This survey instrument is very comprehensive and an excellent resource for assessing coverage among MCOs.
  
• Implementation of Tobacco Cessation Coverage Under the Affordable Care Act: Understanding How Private Health Insurance Policies Cover Tobacco Cessation Treatments. This article provides an excellent overview to assessing health plans and the potential challenges. A summary at the end of the article (page 31- ) provides a comprehensive listing of questions that can be used in assessing cessation coverage.
  
• NAQC cessation assessment resources
  
• NAQC webinar on assessment of coverage

For additional information, please contact  Deb Osborne, Public -Private Partnership Initiative manager at dosborne@naquitline.org.