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 * About
 * Blog
 * Collab
 * 
 * 

 * What is 6|18?
 * 6|18 in Action
   * 6|18 State Spotlights
   * Prevention Activities by State
 * General Tools
 * Resource by Conditions
   * Control Asthma
   * Reduce Tobacco Use
   * Prevent Type 2 Diabetes
   * Prevent Unintended Pregnancy
   * Improve Antibiotic Use
   * Control High Blood Pressure
   * All Resources

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 * What is 6|18?
 * 6|18 in Action
   * 6|18 State Spotlights
   * Prevention Activities by State
 * General Tools
 * Resource by Conditions
   * Control Asthma
   * Reduce Tobacco Use
   * Prevent Type 2 Diabetes
   * Prevent Unintended Pregnancy
   * Improve Antibiotic Use
   * Control High Blood Pressure
   * All Resources
 * About
 * Blog
 * Collab
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COLORADO: INCREASING THE USE OF MEDICAID TOBACCO CESSATION BENEFITS

June 2018 | 6|18 Initiative State Spotlight

Colorado’s Departments of Public Health and Environment (CDPHE) and Health Care
Policy and Financing (Medicaid) partnered under the Centers for Disease Control
and Prevention’s (CDC) 6|18 Initiative to enhance Medicaid enrollees’ access to
and use of covered tobacco cessation benefits. The state’s efforts resulted in
notable achievements, including Medicaid policy changes to expand access to
tobacco cessation medications and services, and communications efforts to
increase provider and consumer use of benefits.

Colorado’s participation in the 6|18 Initiative also strengthened ongoing
collaboration between its Medicaid and public health departments through the
development of two new staff positions to serve as interagency liaisons.

COLORADO KEY FACTS

 * State population: 5.6 million
 * Medicaid population: 1.3 million
 * Medicaid enrollees in managed care: 10.5 percent
 * Medicaid enrollees who smoke: 30.1 percent

COLORADO’S 6|18 ACCOMPLISHMENTS

 * Removed Medicaid copays for all Food and Drug Administration (FDA)-approved
   tobacco cessation medications.
 * Enacted regulatory changes to allow pharmacists and home visiting nurses to
   deliver and bill for cessation services.
 * Educated providers about how to support Medicaid patients’ cessation efforts.
 * Conducted consumer awareness media campaign about covered Medicaid benefits.


6|18 PROJECT ACTIVITIES

In 2016 and 2017, Colorado’s Medicaid and public health agencies partnered under
CDC’s 6|18 initiative to:

 * Remove copays for Medicaid tobacco cessation benefits, such as nicotine
   replacement therapies;
 * Educate and engage providers through training, education, and resources;
 * Raise consumer awareness through a three-year media campaign;
 * Expand the types of provider eligible to deliver cessation services; and
 * Enhance collaboration between between the state’s Medicaid and public health
   agencies.

Specific activities undertaken by the partners include:

DOWNLOAD SPOTLIGHT »

 


1. REMOVING COPAYS FOR MEDICAID TOBACCO CESSATION BENEFITS

Reducing out-of-pocket costs for evidence-based cessation treatments has been
demonstrated to increase the number of individuals who quit tobacco. In
response, in 2015, Colorado removed prior authorization for initial prescription
fills of short-acting nicotine replacement therapies (NRT), but Medicaid
enrollees still faced copays and prior authorization for NRT refills and other
FDA-approved cessation medications. In November 2017, the state eliminated
copays for all seven FDA-approved cessation medications. After removing these
copays, Colorado was able to cover all preventive services recommended by the
U.S. Preventive Services Task Force without cost sharing, qualifying the state
for a one percentage point increase in its Federal Medical Assistance
Percentage. Medicaid and public health officials will build on this success to
remove prior authorization requirements for additional tobacco cessation
medications.


2. EDUCATING AND ENGAGING PROVIDERS

CDPHE provided training, education, and resources to providers to engage
Medicaid patients about tobacco cessation, including:

 * Developing a toolkit for use in clinical settings with information about
   covered cessation benefits.
 * Hosting regular online provider training webinars.
 * Working with local public health agencies to identify and address gaps in
   providers’ cessation approaches.


3. RAISING CONSUMER AWARENESS

Colorado worked to increase consumer awareness of Medicaid-covered tobacco
cessation services through a three-year media campaign focused on specific
Medicaid subpopulations. This campaign was funded by Colorado Amendment 35 state
tobacco tax revenue. Strategies included:

 * Print materials: Developing print media to highlight Colorado’s Medicaid
   cessation benefit and encourage consumers to talk with their providers about
   quitting. CDPHE made the materials available to providers and community-based
   organizations that serve Medicaid enrollees identified as tobacco users.
 * Online and mobile outreach: Running statewide online and mobile ads in
   English and Spanish. Ads, including on Facebook and Google, targeted
   consumers likely to be tobacco users. This strategy resulted in 9.9 million
   impressions and above-average click rates.
 * Radio ads: Creating regional and internet radio ads featuring testimonials
   from Medicaid providers. This strategy was based on research suggesting that
   ads featuring trusted community members are especially effective.


4. EXPANDING PROVIDER TYPES ELIGIBLE TO DELIVER CESSATION SERVICES

Colorado worked to expand its list of providers who could offer cessation
services. Using multi-disciplinary providers increases access to cessation
services and creates meaningful linkages on the effects of tobacco use in all
areas of patients’ lives. Activities focused on two main provider types:

 * Pharmacists: Colorado’s governor signed a collaborative pharmacy agreement
   bill (Rule 17) giving pharmacists the authority to screen and assess
   patients’ tobacco dependence, dispense cessation medication, and provide
   counseling on medications and cessation strategies. Following the bill’s
   passage, state agencies and other stakeholders developed a medication
   protocol and accreditation program for pharmacists.
 * Home visiting nurses: Colorado expanded billable services under its Nurse
   Home Visiting Program, enabling nurses to bill medical services, such as
   tobacco cessation counseling for new mothers, separately from case
   management.


5. ENHANCING COLLABORATION BETWEEN PUBLIC HEALTH AND MEDICAID

Colorado created and funded two new positions to function as liaisons between
the state’s Medicaid and public health agencies. Liaisons are responsible for
interagency collaboration and strategy alignment, serving as points of contact
to strengthen Medicaid-public health communication. Working together, liaisons
led the agencies in developing a new data-sharing agreement for program
evaluation

STATE SPOTLIGHTS: MEDICAID-PUBLIC HEALTH COLLABORATION IN CDC’S 6|18 INITIATIVE

This profile is part of a series, developed by the Center for Health Care
Strategies and made possible by the Robert Wood Johnson Foundation, that
showcases how state Medicaid and public health departments are using the Centers
for Disease Control and Prevention’s (CDC) 6|18 Initiative to accelerate the
adoption of evidence-based prevention efforts focused on improving health
outcomes and controlling health care costs. The CDC’s 6|18 Initiative links
proven prevention activities to health coverage and delivery with a focus on six
high-burden, high-cost health conditions — tobacco use, high blood pressure,
inappropriate antibiotic use, asthma, unintended pregnancies, and diabetes.

©2024 Center for Health Care Strategies. All Rights Reserved.  Privacy Policy.

 Implementing CDC’s 6|18 Initiative: A Resource Center is a Center for Health
Care Strategies (CHCS) website developed with support from the Robert Wood
Johnson Foundation. The views expressed here do not necessarily reflect the
views of the Foundation.

CHCS is partnering with the Centers for Disease Control and Prevention (CDC) on
CDC’s 6|18 initiative.  CDC does not endorse any particular product, service, or
enterprise.




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