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Building a sustainable tobacco control program

within a health plan

Marc Manley, MD, MPHBlue Cross and Blue Shield of Minnesota

National Conference on Tobacco or Health

December 11, 2003

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Overview

Blue Cross and Blue Shield of Minnesota and tobacco

Tobacco control in a health plan Project sampler

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Blue Cross and Blue Shield of Minnesota

2.5 million members Not-for-profit Statewide network of clinicians Full portfolio of commercial and

government health insurance products Individuals national employers

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Blue Cross’ litigation v. tobacco industry Co-plaintiff with State of Minnesota First private sector health plan to sue and

settle Settlement outcomes (May 1998)

Financial Public health gains

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Five years post-settlement….

Blue Cross’ use of settlement funds is delayed now by a subscriber lawsuit

Timeline for lawsuit resolution unknown

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In the meantime...

Created Center for Tobacco Reduction and Health Improvement

Began implementation of a comprehensive program

Will expand with settlement dollars

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Evolving role of health plans

Pay claims for tobacco-

caused disease

Benefits and services for the

treatment of tobacco use

Comprehensivepopulation-

basedtobacco control

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Tobacco control in a health planChallenges

Customers: employers, individuals, governments

Time horizon: month to month Return on investment: desire for

immediate return Population: continual turnover Expertise: payment for acute care

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Tobacco control in a health planBenefits

Fresh thinking New capacity: market research,

communications New relationships: businesses, business

organizations Legislative savvy Action oriented

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Tobacco control in a health planStrategies

Prove that it works Pay attention to the core business Communicate in understandable terms Bring “value” to the organization Innovate Diversify beyond tobacco

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What should health plans do?

Cover: Cover effective treatments Counsel: Provide counseling services Collaborate: Lobby for effective public

policies Capitalize: Invest people and money Count: Measure progress

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Blue Cross of MinnesotaPhysician counseling policy

Covers appointments for specific purpose of getting help to quit smoking

Physicians reimbursed for cessation counseling office visit as part of member’s coverage for clinic visits

No limit on number or length of visits

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Providing telephone counseling services in Minnesota

Health plans provide the services for their members.

State-funded program pays for uninsured and underinsured.

Callers are transferred (live) to their health plan’s service.

Blue Cross aggressively advertises its own line to increase participation.

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Lobby for effective public policies

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Promoting cessation

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Resources:

The Role of Health Plans in Tobacco Control. Annual Review of Public Health, 2003, 24:247-66.

Addressing Tobacco in Managed Care: A Resource Guide for Health Plans. http://www.aahp.org/atmc/ATMC_Toolkit.pdf