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The Medi-Cal Incentives to Quit Smoking Project: Impact of Statewide Outreach Through Health Channels.

Abstract：

INTRODUCTION:Little is known about how incentives may encourage low income smokers to call for quitline services. This study evaluates the impact of outreach through health channels on California Medicaid (Medi-Cal) quitline caller characteristics, trends, and reach. STUDY DESIGN:Longitudinal study. SETTING/PARTICIPANTS:Medi-Cal quitline callers. INTERVENTION:Statewide outreach was conducted with health providers, Medi-Cal plans (all-household mailings with tracking codes), and public health organizations (March 2012-July 2015). For incentives, Medi-Cal callers could ask for a $20 gift card; in September 2013, callers were offered free nicotine patches. MAIN OUTCOME MEASURES:Caller characteristics were compared with chi-square analyses, joinpoint analysis of call trends was performed accounting for Medi-Cal population growth, referral source among Medi-Cal and non-Medi-Cal callers was documented, and the annual percentage of the population reached who called the Helpline was calculated. Analyses were conducted 2016-2018. RESULTS:Total Medi-Cal callers were 92,900, a 70% increase from prior annual averages: 12.4% asked for the financial incentive, 17.3% reported the mailing code, and 73.3% received nicotine patches while offered. Among the two thirds of callers who completed counseling, 15.5% asked for the financial incentive, and 13.6% reported the mailing code. A joinpoint analysis showed call trends increased 23% above expected for the Medi-Cal population growth after mailings to providers and members began, and decreased after outreach ended. Annual reach increased from 2.3% (95% CI=2.1, 2.6) in 2011 to peak at 4.5% (95% CI=3.6, 5.3) in 2014. Among subgroups with higher reach rates, some also had higher rates of asking for the financial incentive (African Americans, American Indian), reporting the tracking code (whites), or both (aged 45-64 years). Medi-Cal callers were more likely than non-Medi-Cal callers to report providers (32.3% vs 23.8%) and plans (19.7% vs 1.4%) as their referral source, and less likely to cite media (20.2% vs 44.4%, p<0.001). CONCLUSIONS:Statewide outreach through health channels incentivizing Medi-Cal members increased the utilization and reach of quitline services. SUPPLEMENT INFORMATION:This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.

journal_name

Am J Prev Med

journal_title

American journal of preventive medicine

authors

Tong EK,Stewart SL,Schillinger D,Vijayaraghavan M,Dove MS,Epperson AE,Vela C,Kratochvil S,Anderson CM,Kirby CA,Zhu SH,Safier J,Sloss G,Kohatsu ND

doi

10.1016/j.amepre.2018.07.031

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

S159-S169

issue

6 Suppl 2

eissn

0749-3797

issn

1873-2607

pii

S0749-3797(18)32167-6

journal_volume

pub_type

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The Medi-Cal Incentives to Quit Smoking Project: Impact of Statewide Outreach Through Health Channels.