Exploring the Utilization of Tobacco Cessation Medications Among Female Medicaid Recipients Aged 40-64 in Nevada

BACKGROUND:  Tobacco use continues to be a public health issue that increases the risks of cancer and other chronic diseases observed in Nevada’s population. An estimated 16.9% of Nevada residents self-report as current smokers, similar to the national rate of 18.1% (2014 Behavioral Risk Factor Surveillance System (BRFSS)). In Nevada, almost one-third (30.8%) of people with the lowest household incomes (less than $15,000 per year) report current smoking on the BRFSS along with one-fourth of all African Americans (24.5%). Nevada’s state cancer and tobacco programs have identified the Medicaid population as an appropriate target group in need of tobacco cessation services and the Affordable Care Act requires Nevada Medicaid to cover tobacco cessation medications beginning January 1, 2014. Therefore, exploring Medicaid data on the utilization of cessation medications in this population will provide the program with information to develop additional cessation program strategies and interventions.

METHODS:  Nevada Medicaid insurance claims data are being captured through the Medicaid Data Interface to the state’s Cancer and Screening Tracking (CaST) Data System, which was established to track breast, cervical, and colorectal cancers and screenings among the Medicaid population in Nevada. The accessible Medicaid claim data currently includes exclusively women aged 40-64 that have accessed care from January 1, 2014 to September 22, 2015. Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes are being used to search insurance claims data to Medicaid for cessation medications related entries.

RESULTS:  Exploring Medicaid claims data for the identified codes will result in identifying current tobacco users for this select Medicaid sub-population and will determine current tobacco cessation medication utilization. The results will be stratified by age, race/ethnicity, and geographic region.

CONCLUSIONS:  By using a database with Medicaid claim data, the percentage of women that have nicotine dependence and that are prescribed cessation pharmaceuticals, as well as the rate of women accessing cessation services, can be tracked. Further analysis could be done to examine what demographics within this population have had difficulty obtaining cessation medications. Results from these analyses will be used to inform and aid the tobacco control program’s cessation surveillance and intervention efforts.