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Designing Health Insurance Benefits



Useful Resources for Designing Benefits

  • Sample purchasing specifications, which provide valuable contract language that can be used by employers and purchasers to structure benefits related to tobacco-use prevention and cessation, are available to assist states in implementing evidence-based tobacco-dependence treatment and improve Medicaid contracts. These sample specifications, developed by CDC in conjunction with George Washington University Center for Health Services Research and Policy, are available at http://www.gwumc.edu/sphhs/departments/healthpolicy/CHPR/newsps/tobacco/.
  • Build a Financial Infrastructure: Health Plan Benefits and Provider Reimbursement combines evidence-based recommendations with the experiences of the Pacific Center on Health and Tobacco (PCHT), a consortium of five western states (California, Oregon, Washington, Arizona, and Hawaii) concerning tobacco cessation benefits and provider reimbursement. The report is designed to guide planning and decision-making by states and other groups that are working to implement tobacco cessation programs. Also available are two summaries: (1) Health Insurance Benefits for Treatment of Tobacco Dependence and (2) Invest in Tobacco Cessation for a Healthy, Productive Workforce. Visit the PCHT Web site.
  • Employers' Smoking Cessation Guide: Practical Approaches to a Costly Workplace Problem, a guide published by the Professional Assisted Cessation Therapy (PACT) consortium for large and small employers interested in enacting an affordable, effective smoking cessation program, is available at http://www.endsmoking.org.
  • Reimbursement for Smoking Cessation Therapy: A Health Care Practitioner's Guide, published by the Professional Assisted Cessation Therapy (PACT) consortium for health care providers on how to obtain reimbursement for cessation services can be helpful to employers in the implementation of a tobacco cessation benefit. It is available at http://www.endsmoking.org.
  • Data on insurance status and type (national and by state) from a survey conducted jointly by the Bureau of Labor Statistics and the Bureau of the Census are located at http://www.census.gov/hhes/www/hlthins/hlthins.html.
  • Coverage of Smoking Cessation Treatment by Union Health and Welfare Funds [Barbeau E, Li Y, et al. American Journal of Public Health 2001; 91(9):1412-1415]. This article presents the results of a survey to determine the level of insurance coverage for smoking cessation treatment and factors associated with coverage among health and welfare funds affiliated with a large labor union. Information on purchasing a copy of this article is located at http://www.ajph.org/cgi/reprint/91/9/1412.
  • Data concerning changes in coverage of tobacco-dependence treatments by state Medicaid programs from a study conducted by the Center for Health and Public Policy Studies at the University of California, Berkeley, and links to publications addressing health insurance policy and tobacco control are available at http://chpps.berkeley.edu/smoking/index.htm.
  • A guide to purchasing prevention benefits that was developed for employers in North Carolina by North Carolina Prevention Partners contains information that may be helpful to employers in other states. The guide can be found at http://www.ncpreventionpartners.org/.

Resources Useful for Employers

  • Quitline Resource Guide, published by CDC's Office on Smoking and Health, provides information on contracting for quitline services and key components of quitline services, such as counseling, staffing, quality assurance, promotion, and evaluation. The guide (in press when this document was published) will be available at http://www.cdc.gov/tobacco.
  • Linking a Network: Integrate Quitlines with Health Care Systems, published by the Pacific Center on Health and Tobacco, describes the importance of linking state quitlines with health care systems and presents case studies describing linkages with health care systems. This resource (in press when this document was published) will be available at http://www.paccenter.org.
  • A Quick Reference Guide to Effective Tobacco Cessation Treatments and Activities and other resources are available from the Center for Tobacco C essation's (CTC) Web site. CTC, which is jointly funded by the American Cancer Society and The Robert Wood Johnson Foundation, serves as a source of science-based information on cessation and works with national partners to expand the use of effective tobacco dependence treatment and activities.
  • Information on tobacco cessation counseling can be found on the American Cancer Society Web site. Type "cancer AND counseling" in the search box located in the upper right corner of the home page.
  • Information on tobacco cessation and the effects of tobacco use on specific populations can be found on the American Lung Association Web site.

 
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