Tobacco cessation has made a small contribution to the recent decline in the prevalence of smoking, and some populations have been left out entirely. For example, the prevalence of smoking among seniors has not declined in over a decade. (For more detail, click here) Although the barriers to adopting systems change in tobacco cessation have been studied, little attention has been paid to reimbursement.
A close study of the economics of tobacco treatment can support a reconceptualization of tobacco cessation as a profit center. Clinical guidelines describe an evidence-based intervention that can be provided to every tobacco user at every visit, regardless of their readiness to change. If 19.8 percent of adults in the USA use tobacco, do the math on the fee for service reimbursement to your practice here.
An increasing fraction of care is provided through value-based contracts. Although smoking cessation is among the few preventive services that is cost-effective, that value has been difficult to estimate until now. A recent study shows how to estimate returns for the first year of investment in hiring Tobacco Treatment Specialist for your medical group or ACO. Do the math here. The ROI-Return on Investment Reimbursement for Tobacco Treatment increases for subsequent years making strong business case for insurers, ACOs and any group with a value-based contract.
Measurement of your practice performance is an essential step in any quality improvement program.
Reimbursement is the key driver to align incentives in tobacco cessation. The standards for documentation and coding of tobacco cessation are described.
The EMR setup is essential, but there is no national standard. Advice from the American Lung Association is available here and here.
Management of Tobacco Treatment What are the barriers to effective tobacco cessation programs and how can they be overcome? Learn about systems change and the many ways tobacco cessation treatment pathways can be incorporated into your practice.
Exemplars in Tobacco Treatment. Some clinicians and groups have demonstrated a range of approaches that can be modelled in your practice.
Select the approach to systems change that is best for your organizational culture.
Do the math. Estimate economic returns and model program cost.