Barriers to Utilizing Medicaid Smoking Cessation Benefits

Abstract

Introduction. Smoking is the number one preventable cause of death
in the United States. Under the Affordable Care Act, Kansas Medicaid
covers all seven FDA-approved smoking cessation therapies.
However, it is estimated only 3% of Kansas Medicaid smokers use
treatment compared to the national estimate of 10%. The objective
is to determine systemic barriers in place that prevent optimal utilization
of Medicaid smoking cessation benefits among KU Medical
Center Internal Medicine patients.

Methods. For this quality improvement project, a population of 169
Kansas Medicaid smokers was identified who had been seen at the KU
Internal Medicine Clinic from January 1, 2015 - February 16, 2016.
Phone surveys were completed with 62 individuals about smoking
status, interest in using smoking cessation treatment options, and
awareness of Medicaid coverage of treatment.

Results. Of the 62 respondents, 24 (39%) were prescribed pharmacotherapy
and 41 (66%) were interested in using smoking cessation
treatment. There were eight who had quit smoking. Of the remaining
54 smokers, 31 (57%) were unaware that Medicaid would cover
pharmacotherapy. Of 24 participants who received a prescription for
pharmacotherapy, 13 (54%) were able to fill the prescription at no cost
using the Medicaid benefit.

Conclusion. The majority of respondents were interested in using
smoking cessation treatment, yet three main barriers existed to using
Medicaid smoking cessation benefits: physicians not prescribing
treatment to patients, patients not aware of Medicaid coverage, and
inadequate pharmacy filling. Improved physician and patient awareness
of Medicaid coverage will facilitate more patients receiving
smoking cessation therapy and ultimately quitting smoking.
KS J Med 2017;10(4):88-91.