Tennessee health plan tobacco cessation coverage.
OBJECTIVE
To evaluate the smoking cessation coverage available from public and private Tennessee health plans.


METHODS
Cross-sectional study. The sampling frame for private plans was a register of licensed plans obtained from the Tennessee Commerce Department. Government websites and reports provided TennCare data.


METHODS
Data were abstracted from plan manuals and formularies for benefit year 2012. Classification of coverage included comprehensive-all seven recommended medications plus individual and group counseling; moderate-at least two forms of nicotine replacement therapy (NRT) plus bupropion and varenicline and one form of counseling; inadequate-at least one treatment, or none-no medications or counseling, or coverage only for pregnant women.


RESULTS
Of nine private plans, one provided comprehensive coverage; two, moderate coverage; four, inadequate coverage, as did TennCare; and two plans provided no coverage. Over 362,800 smokers had inadequate access to cessation treatments under TennCare, while 119,094 smokers had inadequate or no cessation coverage under private plans.


CONCLUSIONS
In 2012, Tennessee fell short of Healthy People goals for total managed care and comprehensive TennCare coverage of smoking cessation. If Tennessee mandates that all health plans provide full coverage, 481,900 smokers may immediately be in a better position to quit.
University of Tennessee Health Science Center, Memphis, Tennessee.
Folasade M
FM
Kolade
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health; D008297:Male; D011247:Pregnancy; D017149:Private Sector / Q000706:statistics & numerical data*; D015397:Program Evaluation; D017150:Public Sector / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016540:Smoking Cessation / Q000379:methods; D013221:State Health Plans / Q000458:organization & administration*; D013714:Tennessee
Medicaid; Tennessee; managed care; public health; smoking cessation