1. Partnering with the Michigan Tobacco Quitline Michigan Purchasers Health Alliance 17 September 2015

2. Agenda Partnerships MI Department of Community Health National Jewish Health Overview of Michigan Quitline Outcomes and ROI How to partner with NJH and MDCH

3. Quitline National Jewish Health, the leading respiratory center in the US, has provided Quitline services since 2002 serving over 1,000,000 callers Partnered with Michigan since 2011 – Provided services to over 35,000 in Michigan

4. MDCH Mission: To protect, preserve, and promote the health and safety of the people of Michigan with particular attention to providing for the needs of vulnerable and under-served populations. NJH Health Initiatives Mission: To save lives by treating the #1 and #2 causes of preventative illness and death – tobacco use and obesity – using coaching supported by technology.

5. The CDC states: Tobacco cessation is the single most cost effective benefit an employer can provide.

6. M ichigan Tobacco Quitline Evidence-based behavior change program Program 24/7 Personalized Coaching (5 calls) Includes OTC medications English, Spanish, and Arabic- speaking coaches (Translation Services) Nicotine Replacement Therapy (NRT) Website Text Messages Email Support Mobile App Educational Materials

7. The Michigan Tobacco Quitline Evidence-based protocols* meet ACA definition of comprehensive tobacco cessation benefit.  ACA requires coverage of preventative health services recommended with an “A” or “B” grade by the U.S. Preventative Services Task Force (USPSTF) – includes tobacco, a grade “A”.  Quitline counseling can more than double a smoker’s chance of quitting. 1  Quitline counseling combined with medication can more than triple the chances of quitting. 1 1 Fiore MC, et al. Treating Tobacco Use and Dependence: 2008 Update – Clinical Practice Guideline, US Public Health Service, May 2008, http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdfhttp://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf QuitLogix

8. ACA: Tobacco Coverage ACA Since 2010, most insurers are required to provide tobacco cessation coverage May 2014 Guidance issued by the U.S. Departments of Health and Human Services, Labor and Treasury stating… To comply with ACA, cessation benefits should include:  Screening for tobacco use.  Two quit attempts per year, consisting of: Four sessions of telephone, individual and group cessation counseling lasting at least 10 minutes each per quit attempt; and,  All medications approved by the FDA as safe and effective for smoking cessation, for 90 days per quit attempt, when prescribed by a health care provider.  No cost-sharing or prior authorization for any of these treatments.

9. Michigan Partnerships Why offer a Quitline?  Create a healthy culture  Meet requirements for ACA “reasonable alternative”.  On average smokers miss 2.5 more days of work per year than non-smokers 1  Four 10-minute smoking breaks = one month less work each year 2  ROI calculations for tobacco quitlines are between 2.0 and 3.6  Pay an average of $2,289 in worker’s comp for smokers vs. $176 for non-smokers 3 1 Halpern M, Shikiar R, Rentz A, Khan Z. Impact of smoking status on workplace absenteeism and productivity. Tob Control. 2001: 10(3):233-8. 2 American’s for NonSmokers’ Rights. Business costs in smoked-filled environments. Retrieved fform http://nosmoke.org/document.php?ID=209http://nosmoke.org/document.php?ID=209 3 Musich S, Napier D, Edington D. The association of health risks with worker’s compensation costs. JOEM. 2001:43 (6):534-541.

10. Michigan Tobacco Collaborative Why partner with the Michigan Quitline? Meets ACA criteria Quitline provides evidence-based services Quitline is well recognized by providers and tobacco-users Use of the advertising campaigns for 800-QUIT-NOW It is easy to partner with Quitline Quitline is very cost-effective

11. Quitline Outcomes 6-Month 30-day Responder Quit Rates

12. Return on Investment 12 Sources: Moriarty J, Branda M. Olsen Kerry, et al. J Occup Environ Med. 2012 March. Baicker, Cutler, Song. Health Affairs, 2010:29 ROI = 2.29 Return on Investment Program Costs:20 x $222= $4,440 Quit Rates:42% x 20 = Between 8 and 9 quitters Cost of a Smoker:$1,623 Medical Cost Savings:9 x 1,623 = $14,607 Savings – Cost:$14,607 - $4,440 = $10,167

13. “Paying for an employee’s tobacco cessation treatment provides more return on investment than any other adult treatment or prevention benefit.” – National Business Group on Health

14. Michigan Partnerships The Michigan Tobacco Collaborative  Contract directly with NJH to cover employees and dependents  Costs include:  One time Setup Fee: $500.00  Annual Maintenance Fee: $500.00  Program fees  Per Enrollment: $168.00 (no PEPM fees)  NRT:  4-weeks of patches: $54.00  4-weeks of gum: $60.00  4-weeks of lozenges: $64.00  Comprehensive Monthly Reports: Included in enrollment fee

16. Karen Brown | brownk34@michigan.gov | 517.335.8803brownk34@michigan.gov Cindy Haugland| hauglandc@njhealth.org | 303.728.6506hauglandc@njhealth.org Thank you!