Medicaid Coverage and Utilization of Covered Tobacco-Cessation Treatments

The Arkansas Experience

While many state Medicaid programs provide some coverage for tobacco-cessation treatments, little is understood about their utilization by Medicaid enrollees. This study specifically examined the utilization of tobacco-cessation treatments under Arkansas Medicaid.

Utilization of tobacco-cessation treatment was assessed using Arkansas Medicaid administrative claims. Specifically, researchers conducted monthly measures and examined the data by: number of pharmacy claims for each covered pharmacotherapy; number of medical calls for counseling services; and number of unique enrollees who received each type of covered tobacco-cessation treatment.

Key Findings:

  • A total of 12,673 enrolled received some tobacco-cessation treatments between October 1, 2003 and June 30, 2008.
  • Seventy-seven percent of the enrollees receiving some tobacco-cessation treatment had received pharmacotherapies only.
  • As coverage expanded, an initial increase of utilization of tobacco-cessation mediations occurred. However, it declined rapidly after three months.
  • When the smoking cessation aid Varenicline was added, utilization increased, but then decreased quickly after six months.
  • Counseling services appeared inconsistent with policy changes.

This study shows that low awareness of coverage and low perceived effectiveness may be contributing factors to low utilization of tobacco-cessation treatment. More efforts may be needed to ensure increase utilization of covered tobacco-cessation treatment among Medicaid enrollees.