Implementation of a Comprehensive Tobacco-Cessation Policy in Medicaid Managed Care Plans in California
Implementation of a Comprehensive Tobacco-Cessation Policy in Medicaid Managed Care Plans in California
复制标题
DOI：
10.1016/j.amepre.2020.04.007
复制
发表时间：
2020-10-01
影响因子：
5.5
通讯作者：
Zhu, Shu-Hong
中科院分区：
文献类型：
--
作者：
McMenamin, Sara B.;Yoeun, Sara W.;Zhu, Shu-Hong
简介：2016 年，加州卫生保健服务部向 Medi-Cal 管理式医疗计划发布了 All Plan Letter 16-014，提供有关全面戒烟服务要求的信息。加州大学圣地亚哥分校的研究人员着手 (1) 检查 Medi-Cal 的管理式医疗计划在实施 All Plan Letter 16-014 各部分方面的进展，(2) 了解与实施 All Plan Letter 16-014 相关的各种因素，以及 (3) 提出改进实施的建议。 方法：研究人员对加州 25 项 Medi-Cal 管理式医疗计划中的健康教育者进行了调查，记录了每个人 2018 年的戒烟服务和政策。数据为通过 3 种方法收集了 25 项 Medi-Cal 管理式医疗计划中的 24 项 (96%)，包括：(1) 基于网络的调查，(2) 深入的电话访谈，以及 (3) 收集戒烟相关文件。 结果：管理式医疗计划的全面实施程度较低，只有 1 项计划完全实施了“所有计划函”的所有 20 条规定。平均而言，管理式医疗计划实施了 20 条规定中的 13 条。管理式医疗计划对与美国食品和药物管理局批准的 7 种戒烟药物的覆盖要求相关的条款执行率最高，其中 12 种 (55%) 完全执行了所有相关要求的条款。管理式医疗计划在与数据收集相关的条款方面的实施率最低，只有 4 个计划 (18%) 完全实施了所有 3 项要求。结论：尽管所有计划信函 16-014 成功地在整个管理式医疗计划中创造了更全面和一致的福利，但 95% 的管理式医疗计划尚未完全实施。可能需要卫生保健服务部的进一步指导以及与加州吸烟者帮助热线的整合才能实现全面实施。 (C) 2020 年美国预防医学杂志。由爱思唯尔公司出版。保留所有权利。
Introduction: In 2016, the California Department of Health Care Services issued All Plan Letter 16-014 to the Medi-Cal Managed Care plans to provide information on requirements for comprehensive tobacco-cessation services. Researchers at the University of California, San Diego set out to (1) examine Medi-Cal's Managed Care plans' progress in implementing each section of All Plan Letter 16-014, (2) understand various factors related to implementation of the All Plan Letter, and (3) make recommendations to improve implementation.Methods: Researchers surveyed health educators within California's 25 Medi-Cal Managed Care plans to document each one's smoking-cessation services and policies in 2018. Data were collected for 24 of the 25 Medi-Cal Managed Care plans (96%) through 3 methods, including: (1) a web-based survey, (2) an in-depth phone interview, and (3) collection of smoking cessation-relevant documents.Results: Managed Care plans demonstrate low levels of full implementation, with only 1 fully implementing all 20 provisions of the All Plan Letter. On average, Managed Care plans implemented 13 of the 20 provisions. Managed Care plans had the highest implementation rates for provisions related to requirements for coverage of the 7 U.S. Food and Drug Administration-approved medications for tobacco cessation, in which 12 (55%) fully implemented all related required provisions. Managed Care plans had lowest implementation rates for provisions related to data collection, with only 4 (18%) fully implementing all 3 requirements.Conclusions: Although All Plan Letter 16-014 was successful in creating more comprehensive and consistent benefits across Managed Care plans, 95% of Managed Care plans have not fully implemented it. Further guidance from the Department of Health Care Services and integration with the California Smokers' Helpline may be needed to achieve full implementation. (C) 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.