Populations at Risk Across the Lifespan: Program Evaluations
Tennessee Health Plan Tobacco Cessation Coverage
Article first published online: 14 NOV 2013
© 2013 Wiley Periodicals, Inc.
Public Health Nursing
Volume 31, Issue 1, pages 28–35, January/February 2014
How to Cite
Kolade, F. M. (2014), Tennessee Health Plan Tobacco Cessation Coverage. Public Health Nursing, 31: 28–35. doi: 10.1111/phn.12089
- Issue published online: 6 JAN 2014
- Article first published online: 14 NOV 2013
- managed care;
- public health;
- smoking cessation;
To evaluate the smoking cessation coverage available from public and private Tennessee health plans.
Design and Sample
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.
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.
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.
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.