Our view: This would cut costs

As the New York Times reported last week, Massachusetts made a big cut in smoking rates among its tobacco-using Medicaid clients. The key was making anti-tobacco treatment -- prescription drugs and counseling -- available at virtually no cost to clients in the program. In the two-and-a-half years since that change, about one of every six tobacco-using Medicaid clients in Massachusetts quit smoking.

Fewer smokers means health costs will go down, especially in the Medicaid program. Poor people, such as those on Medicaid, smoke at much higher rates than the public at large, so they're more likely to have costly health problems that are covered at public expense.

In Alaska, Medicaid will pay for nicotine replacement drugs combined with counseling by a doctor or other medical practitioner. That combination approach is far and away the most effective, with a success rate of 20 percent to 40 percent, according to Andrea Thomas, with the Alaska Tobacco Control Alliance.

Alaska is making it easier for Medicaid smokers to get help when they want to quit. Thomas says the state will drop a requirement that Medicaid has to pre-approve each prescription for anti-tobacco drugs.

But not many doctors or Medicaid clients know this help is available, she says. She wants to get the word out that the program will pay for anti-tobacco treatment.

In an ideal world, Thomas would also like to see Medicaid cover a wider range of anti-tobacco counseling. Now, clients have to get that counseling from a doctor or other medical professional -- an expensive and cumbersome arrangement.

Alaska Medicaid spent only $138,000 to help clients quit smoking in FY2009. The money served 705 people, according to deputy state health commissioner Bill Streur -- a cost of about $195 per treatment.

If that modest level of effort stops just a couple of heart attacks, it probably pays for itself.

Until help through Medicaid is more widely known and used, smokers can always call the state-funded Tobacco Quit Line, 888-842-QUIT. The service, which is open to any Alaskan, offers three months of free counseling and free nicotine patches. It's a good place to start for anyone who wants to break their self-destructive tobacco habit, and it's money well-spent to help reduce Alaska's health care bills.

BOTTOM LINE: Here's one way to help "bend the cost curve" in health care.