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In 1997, the Robert Wood Johnson Foundation launched the four year Addressing Tobacco in Managed Care (ATMC) initiative designed to promote the implementation of evidence based tobacco interventions in managed care settings. As part of this initiative, a baseline survey of managed health care plans was conducted in 1997-98 for the primary purpose of assessing the extent to which health plans were developing, implementing, and evaluating evidence based tobacco cessation and prevention programs. A questionnaire was mailed to all health plans in the American Association of Health Plans' database of member and non-member plans and 323 (60%) of health plans responded. The methods used to conduct the 1997-98 ATMC survey are reported more fully elsewhere.1 The results of the survey indicated, among other things, wide variation in the approaches taken by health plans to design and provide covered benefits for tobacco control programs. Owing to the high level of interest in identifying barriers to enhanced tobacco control programs, a qualitative approach (that is, focus groups) was adopted as a way to gain insight into the decision making process of health plans for these programs.
Highlights gleaned from the focus groups are presented here. A more detailed report is being prepared for future publication.
Data from the 1997-98 ATMC survey was used to categorise respondent health plans by the level and scope of tobacco related benefits and services provided to their members. For example, health plans were categorised as “maximum” providers of tobacco related benefits and services if they had established tobacco programs in place and provided coverage for pharmaceutical agents used to treat nicotine addiction. Health plans were categorised as “moderate” providers of tobacco related benefits and services if they had some programs in place but provided little or no coverage for tobacco related pharmaceuticals. Likewise, health plans were …
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