학술논문

Implementation of a Comprehensive Tobacco-Cessation Policy in Medicaid Managed Care Plans in California
Document Type
article
Source
American Journal of Preventive Medicine. 59(4)
Subject
Public Health
Health Sciences
Tobacco
Tobacco Smoke and Health
Behavioral and Social Science
Prevention
Cancer
Clinical Research
Health Services
3.1 Primary prevention interventions to modify behaviours or promote wellbeing
Prevention of disease and conditions
and promotion of well-being
Good Health and Well Being
California
Humans
Managed Care Programs
Medicaid
Policy
Tobacco Use Cessation
United States
Medical and Health Sciences
Education
Biomedical and clinical sciences
Health sciences
Language
Abstract
IntroductionIn 2016, the California Department of Health Care Services issued All Plan Letter 16-014 to the Medi-Cal Managed Care plans to provide information on requirements for comprehensive tobacco-cessation services. Researchers at the University of California, San Diego set out to (1) examine Medi-Cal's Managed Care plans' progress in implementing each section of All Plan Letter 16-014, (2) understand various factors related to implementation of the All Plan Letter, and (3) make recommendations to improve implementation.MethodsResearchers surveyed health educators within California's 25 Medi-Cal Managed Care plans to document each one's smoking-cessation services and policies in 2018. Data were collected for 24 of the 25 Medi-Cal Managed Care plans (96%) through 3 methods, including: (1) a web-based survey, (2) an in-depth phone interview, and (3) collection of smoking cessation-relevant documents.ResultsManaged Care plans demonstrate low levels of full implementation, with only 1 fully implementing all 20 provisions of the All Plan Letter. On average, Managed Care plans implemented 13 of the 20 provisions. Managed Care plans had the highest implementation rates for provisions related to requirements for coverage of the 7 U.S. Food and Drug Administration-approved medications for tobacco cessation, in which 12 (55%) fully implemented all related required provisions. Managed Care plans had lowest implementation rates for provisions related to data collection, with only 4 (18%) fully implementing all 3 requirements.ConclusionsAlthough All Plan Letter 16-014 was successful in creating more comprehensive and consistent benefits across Managed Care plans, 95% of Managed Care plans have not fully implemented it. Further guidance from the Department of Health Care Services and integration with the California Smokers' Helpline may be needed to achieve full implementation.