Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Center for Health Policy Research at the George Washington University, Washington, DC.
Nicotine Tob Res. 2021 May 24;23(6):1074-1078. doi: 10.1093/ntr/ntaa213.
Cigarette smoking prevalence is higher among adults enrolled in Medicaid than adults with private health insurance. State Medicaid coverage of cessation treatments has been gradually improving in recent years; however, the extent to which this has translated into increased use of these treatments by Medicaid enrollees remains unknown.
Using Medicaid Analytic eXtract (MAX) files, we estimated state-level receipt of smoking cessation treatments and associated spending among Medicaid fee-for service (FFS) enrollees who try to quit. MAX data are the only national person-level data set available for the Medicaid program. We used the most recent MAX data available for each state and the District of Columbia (ranging from 2010 to 2014) for this analysis.
Among the 37 states with data, an average of 9.4% of FFS Medicaid smokers with a past-year quit attempt had claims for cessation medications, ranging from 0.2% (Arkansas) to 32.9% (Minnesota). Among the 20 states with data, an average of 2.7% of FFS Medicaid smokers with a past-year quit attempt received cessation counseling, ranging from 0.1% (Florida) to 5.6% (Missouri). Estimated Medicaid spending for cessation medications and counseling for these states totaled just over $13 million. If all Medicaid smokers who tried to quit were to have claims for cessation medications, projected annual Medicaid expenditures would total $0.8 billion, a small fraction of the amount ($45.9 billion) that Medicaid spends annually on treating smoking-related disease.
The receipt of cessation medications and counseling among FFS Medicaid enrollees was low and varied widely across states.
Few studies have examined use of cessation treatments among Medicaid enrollees. We found that many FFS Medicaid smokers made quit attempts, but few had claims for proven cessation treatments, especially counseling. The receipt of cessation treatments among FFS Medicaid enrollees varied widely across states, suggesting opportunities for additional promotion of the full range of Medicaid cessation benefits. Continued monitoring of Medicaid enrollees' use of cessation treatments could inform state and national efforts to help more Medicaid enrollees quit smoking.
参加医疗补助（Medicaid）计划的成年人的吸烟率高于拥有私人健康保险的成年人。近年来，州级医疗补助对戒烟治疗的覆盖范围逐渐扩大；然而，这在多大程度上转化为医疗补助受保人对这些治疗方法的使用增加，目前仍不得而知。
我们利用医疗补助分析提取（MAX）文件，估算了试图戒烟的医疗补助按服务付费（FFS）参保者中获得戒烟治疗和相关支出的州级情况。MAX 数据是医疗补助计划唯一可用的全国性个人数据。我们使用每个州和哥伦比亚特区（District of Columbia）（2010 年至 2014 年）最新的 MAX 数据进行了此项分析。
在有数据的 37 个州中，过去一年有戒烟尝试的 FFS 医疗补助吸烟者中，有平均 9.4%的人有戒烟药物的报销，范围从 0.2%（阿肯色州）到 32.9%（明尼苏达州）。在有数据的 20 个州中，过去一年有戒烟尝试的 FFS 医疗补助吸烟者中，有平均 2.7%的人接受了戒烟咨询，范围从 0.1%（佛罗里达州）到 5.6%（密苏里州）。这些州的戒烟药物和咨询估计医疗补助支出总额略高于 1300 万美元。如果所有试图戒烟的医疗补助吸烟者都有戒烟药物的报销，预计每年医疗补助支出总额将达到 8 亿美元，这只是医疗补助每年用于治疗与吸烟有关的疾病的 459 亿美元的一小部分。
FFS 医疗补助受保者获得戒烟药物和咨询的比例较低，各州之间差异很大。
很少有研究调查医疗补助受保者对戒烟治疗的使用情况。我们发现，许多 FFS 医疗补助吸烟者尝试戒烟，但很少有人有经证实的戒烟治疗的报销，尤其是咨询。FFS 医疗补助受保者获得戒烟治疗的比例在各州之间差异很大，这表明可以进一步推广全面的医疗补助戒烟福利。继续监测医疗补助受保者对戒烟治疗的使用情况，可以为帮助更多医疗补助受保者戒烟的州和国家努力提供信息。
