Medicare Tobacco Cessation Follows Lead of Many Private Insurers

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The Centers for Medicare and Medicaid (CMS) announced March 23 that it will begin covering the cost for tobacco cessation for some beneficiaries, following the lead of many private insurers who know that reducing risks can save both lives and dollars.

The Centers for Medicare and Medicaid (CMS) announced March 23 that it will begin covering the cost for tobacco cessation for some beneficiaries, following the lead of many private insurers who know that reducing risks can save both lives and dollars.

“By providing this coverage, CMS is responding to a high priority behavior risk in a very positive way,” said Gregg Lehman, president and CEO of Gordian Health Solutions. “We applaud this approach to ending the single highest cause of death and disease in our nation.”

Gordian, based in Nashville, Tenn., is a nationally recognized leader in population health management, working with insurers and businesses to improve the health of members through its full line of health management programs and services. Gordian’s tobacco cessation program, “Breaking Free from Tobacco,” has seen successful deployment by large public and private sector employee groups such as the Commonwealth of Virginia’s employee wellness program.

“We’ve had great success with this program with a diverse population of adults of all ages,” said Bridgit Mitchell, DrPH, vice president of Continental Health Promotion, a division of Gordian Health Solutions. “Smoking cessation has health benefits for anyone, no matter what their age.” This year alone, 25 percent of the more than 1300 employees participating in the CommonHealth Breaking Free From Tobacco program reported they remained tobacco-free one year after program completion.

Gordian’s Breaking Free program uses a proven mix of counseling and nicotine replacement therapy to guide participants through the cessation process. Participants receive individual telephone support from a health coordinator, who helps them set reasonable goals. Whether the participant is ready to quit or just beginning to think about it, the personalized program helps guide tobacco users through the steps to quit for life.

The Centers for Disease Control and Prevention (CDC) has estimated that 9.3 percent of Americans age 65 and older smoke cigarettes. About 440,000 people die annually from smoking related disease, with 300,000 of those deaths in those 65 and older.

Beyond the benefit of better health through tobacco cessation, the new move may also help Medicare cut through the issue of rising costs. Researchers estimate that smoking accounts for about 10 percent of the total costs of the Medicare program,

"Covering smoking and tobacco use cessation counseling for seniors has great potential to save and improve lives for millions of seniors,” said CMS Administrator Mark B. McClellan, MD, PhD, as he announced the new benefit. “This is another step in turning Medicare into a prevention-oriented health program."

The new benefit is available only to those who already have an illness caused or complicated by tobacco use, including heart disease, cerebrovascular disease, lung disease, weak bones, blood clots, and cataracts – the diseases that account for the bulk of Medicare spending today. It also applies to beneficiaries who take any of the many medications whose effectiveness is complicated by tobacco use--including insulin and medicines for high blood pressure, blood clots and depression.

Medicare has added several new significant preventive benefits in 2005: cardiovascular screening blood tests and diabetes screening tests for all Medicare beneficiaries and the “Welcome to Medicare” prevention physical for new Medicare Part B enrollees. CMS has also developed a guide for preventive services for physicians, providers, suppliers and other health care professionals and they have established a preventive services website.

Medicare’s new focus on prevention follows an overall trend by private insurers to adopt health management strategies to both improve enrollee health and lower costs. According to a study release March 18 by the National Business Group on Health and Watson Wyatt, the number of employers adopting lifestyle behavior change through a health plan doubled to 40 percent this year.

“Increasingly, both private and public insurers are recognizing that reducing health risk behavior makes sense,” Lehmann said. “Reducing the risk for disease is the logical next step in changing health care from a system that just treats disease to one that promotes a healthier lifestyle.”

About Gordian Health Solutions, Inc.

Based in Nashville, Tennessee, Gordian offers a comprehensive suite of products and services such as population health risk analysis, telephonic counseling, online products, health education hotlines, on-site health education/fitness center management and lifestyle and disease management programs. Gordian works with employers, health plans and hospitals to identify, control and manage health risk factors and their associated costs. Through targeted and tailored programs, and sophisticated tracking, monitoring and reporting capabilities, Gordian works with clients to measure program progress and cost savings. For more information about Gordian Heath Solutions, visit

This press release was distributed through eMediawire by Human Resources Marketer (HR Marketer: on behalf of the company listed above.

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Karla Hurter
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