Making Tobacco Use a Vital Sign in Managed Care

In 1996, the National Committee for Quality Assurance (NCQA), Washington, an accrediting organization for managed care plans, issued a "Call for Measures" inviting public participation in revising its Health Plan Employer Data and Information Set (HEDIS).

HEDIS, the most widely used performance measurement system for managed care, had not previously addressed either tobacco use prevention or medical interventions to help smokers quit.

The Center for the Advancement of Health, Washington, gathered expert advice from more than 400 leading tobacco control researchers, epidemiologists, and performance measurement experts as well as representatives of health plans, consumers, and purchasing groups.

Key Results

  • Ultimately, a panel of experts proposed two composite measures:

    • A clinical measure of tobacco use screening and intervention.
    • A survey measure of tobacco use prevalence and intervention.
  • As a result, a survey measure of smoking prevalence and intervention, which highlighted medical advice to quit smoking, was included in a modified form in HEDIS 3.0 and also adopted as a quality measure by The Foundation for Accountability, the consumer-focused equivalent of NCQA.