1. Partners for Better Health 2005: One HMO’s Approach to Tobacco Control Dr. Gail Amundson, M.D., F.A.C.P. Associate Medical Director HealthPartners, Inc. Minneapolis, Minnesota

2. Learning Objectives  Describe the Partners for Better Health (PBH)2005 Tobacco Control Goal, Objectives and Strategies  Learn about successes/challenges in developing a health plan wide tobacco control agenda  Learn about how to work with health plans on this issue

3. HealthPartners Overview  Non-Profit, Consumer Driven  680,000 Members  Mixed Model HMO  HPMG and HPDG Clinics  Regions Hospital/Contracted Hospitals  Contracted medical and dental groups  Range of insurance products

4. Partners for Better Health (PBH) 2005 PBH 2005 DiabetesHeart Health Physical Activity Tobacco Control Healthy Eating Depression

5. PBH 2005 Tobacco Control Goal Reduce the prevalence of tobacco use and reduce childhood and adolescent exposure to tobacco among HealthPartners members and patients Reduce the prevalence of tobacco use and reduce childhood and adolescent exposure to tobacco among HealthPartners members and patients

6. PBH 2005 Tobacco Control Objectives  Reduce prevalence of tobacco use among adults, age 18 years of age and older, from 25% to 15%  Reduce the prevalence of tobacco use among adolescents, 13-17 years of age, to 15% and secondhand smoke exposure to 12%  Reduce secondhand smoke exposure among children, birth through 12 years from 24% to 12%

7. PBH 2005 Tobacco Control Strategies  Identified comprehensive tobacco control strategies:  Tobacco cessation  Tobacco prevention  Public policy  System wide integration (5As)

8. PBH 2005 Tobacco Control Strategies Care Delivery/Health Plan  Outcomes Recognition Program (primary care/specialty)  System-wide integration (5As) - case management, hospitals, OB/GYN, dental, specialty care-Ortho, ENT, Cardio  Performance Data  Corporate, Regions and clinics-tobacco free grounds policy

9. PBH 2005 Tobacco Control Strategies Employer Groups  Increase employers knowledge/use of our tobacco product benefit  Increase worksites with tobacco free policies and cessation referral

10. PBH 2005 Tobacco Control Strategies Community(in partnership):  Increase the cigarette excise tax ($1.00)  Support local and state clean indoor air laws  Keep the tobacco endowment intact

11. Success and Challenges Successes  Health plan wide initiative  Top management support  Willing to step “out of the box” (policy)  Leveraging other goal areas  Collaboration (internal/external)

12. Successes and Challenges Challenges  Resources  Keeping the PBH 2005 Agenda visible  Engaging other departments who have not focused on this issue have not focused on this issue

13. Tobacco Use as a Vital Sign  38,300 have quit smoking since 1997  158,000 more asked about tobacco use  43,700 provided assistance to quit in 2001.  Adult prevalence now 17.9%  N=497,127

14. Tobacco Exposure:A Pediatric Vital Sign  2 nd Hand smoke puts children at risk  For every 1000 children 90 fewer exposed in 2001  138 of every 1000 still exposed to 2 nd hand tobacco  99 avoiding 2 nd hand smoke discussed

15. Working with Health Plans  Health plans are important partners  Identify key champions  Find out what health plans are doing  Tobacco product benefit?  Cessation programming?  Provide appropriate incentives?  Delivery system assessed?