Provider Onboarding

INTEGRIS Health Tobacco Freedom Program

Three Steps to Successful Patient Tobacco Treatment

Combined, these evidence-based, brief strategies can improve cessation success rates from 5% to 35%!

1. Brief, 1 - 3 minute, repeated intervention by all clinical staff
   Ask: ID patient as tobacco user - does patient use tobacco; how often; how much?
   Advise: patient to quit & tie it to their health issues
   Assess: if patient is ready to make a quit attempt
2. Assist: Prescribe Appropriate Medication
   Nicotine Replacement Therapy (NRT)
   Medications - Varenicline (Chantix)
   - Bupropion SR 150
3. Arrange: Refer to Counseling
   Master’s level counselors walk the patient through the process
   Five to seven sessions: 30 - 40 minutes each over the phone. (up to ten sessions for pregnant patients)

Additional resources: http://ok.gov/stopswithme/

Tobacco Dependence

Tobacco dependence continues to be the leading cause of preventable death in the US. And current research still shows us that smoking is directly related to many chronic diseases that we spend Billions of health care dollars on every year.

The opportunities for improved health outcomes are significant and Integris Health, the leader in healthcare in the state of Oklahoma, is positioned in the communities we serve throughout the state to make a considerable impact.

Why Treat Tobacco Dependence?

• Tobacco causes premature death of almost half a million Americans each year. Approximately 8.6 million Americans have chronic illnesses related to smoking.
• Lost productivity from premature deaths: $1.556 billion
• Annual medical costs for Oklahoma: $1.162 billion (includes $218 million in Medicaid
• 44% of tobacco users have made at least one quit attempt in the past year

Evidenced-Based Model: The 5 A’s

• Consistently identify and intervene - Ask
• Treatments are effective – Advise to quit
• Assess patient’s tobacco use & readiness to quit
• Assist with appropriate medication
• Arrange for assistance and follow up

Medications combined with counseling is the most effective treatment.

Working with a consistent evidence based protocol and providing the clinical staff with new tools, we have seen positive outcomes. We have received 3014 total fax referral confirmations from the Oklahoma Tobacco Helpline in 16 months! Most recent data from Alere Wellbeing: Of all the referrals made to the Helpline in Oklahoma, 50% of all referrals came from INTEGRIS Health! In addition, 40% of the patients referred have accepted some form of services to help them quit.

Integris Health Tobacco Cessation initiative is a partnership with the Oklahoma Hospital Association. With funding provided by: Oklahoma Tobacco Settlement Endowment Trust and Oklahoma State Department of Health.

Allowable Bill Rates for Medicare

Symptomatic patient:
Billing Code 99406: $13.11
Intermediate: 3-10 minutes Tobacco Cessation Intervention Counseling

Billing Code 99407: $25.55
Intensive: >10 minutes Tobacco Cessation Intervention Counseling
Coinsurance/Deductible is Not Waived
Can still bill E&M visit

Asymptomatic patient:
Billing Code G0436: $13.42
Intermediate: 3-10 minutes Tobacco Cessation Intervention Counseling

Billing Code G0437: $27.12
Intensive: >10 minutes Tobacco Cessation Intervention Counseling
Coinsurance/Deductible is waived
Can still bill an E&M visit

Frequency:
Pt is allowed two cessation attempts per year; Each attempt includes maximum of 4 intermediate or intensive sessions, up to 8 sessions in a 12-month period.