Policy Brief IV: Best Practice Recommendations for Managed Care Organizations

It is advised that healthcare providers ask all adults about tobacco use, advise them to quit, and assist with the use of cessation medications and counseling. However, our previous work demonstrates these recommendations are not being met for most Kentucky Medicaid recipients. Although use of tobacco-related diagnosis codes is high, use of tobacco cessation counseling codes is very low and widely variable across the state.

This Policy Brief summarizes current practices used by two Kentucky Managed Care Organizations (MCOs) to identify Medicaid member tobacco users and engage them in tobacco treatment. We created a summary workflow used by MCOs and described common themes to expand and enhance tobacco treatment. Best practice recommendations for MCOs are described in the following categories: 1) identifying all Medicaid recipients who use tobacco; 2) reaching those who use tobacco; 3) connecting tobacco users with evidence-based treatment; and 4) evaluating services to determine effectiveness and identify gaps.