Increasing consumer demand among medicaid enrollees for tobacco dependence treatment: The Wisconsin "medicaid covers it" campaign

Purpose. Smoking prevalence among Medicaid enrollees is higher than among the general population, but use of evidence-based cessation treatment is low. We evaluated whether a communications campaign improved cessation treatment utilization. Design. Quasi-experimental. Setting. Wisconsin. Subjects. Enrollees in the Wisconsin Family Medicaid program. The average monthly enrollment during the study period was approximately 170,000 individuals. Intervention. Print materials for clinicians and consumers distributed to 13 health maintenance organizations (HMOs) serving Wisconsin Medicaid HMO enrollees. Measures. Wisconsin Medicaid pharmacy claims data for smoking cessation medications were analyzed before and after a targeted communications campaign. HMO enrollees were the intervention group. Fee-for-service enrollees were a quasi-experimental comparison group. Quit Line utilization data were also analyzed. Analysis. Pharmacotherapy claims and number of registered Quit Line callers were compared precampaign and postcampaign. Results. Precampaign, cessation pharmacotherapy claims declined for the intervention group and increased slightly for the comparison group (t=2.29, p=.03). Postcampaign, claims increased in both groups. However, the rate of increase in the intervention group was significantly greater than in the comparison group (t=-2.2, p = .04). A statistically significant increase was also seen in the average monthly number of Medicaid enrollees that registered for Quit Line services postcampaign compared to precampaign (F [1,22] = 7.19, p = .01). Conclusion. This natural experiment demonstrated statistically significant improvements in both pharmacotherapy claims and Quit Line registrations among Medicaid enrollees. These findings may help inform other states' efforts to improve cessation treatment utilization.