State Medicaid Grant: Striving to Quit
Wisconsin received a five-year, $9.2 million grant from the federal CMS to help Medicaid recipients quit smoking. The project, called Striving to Quit, was designed to test the effects of incentives on engagement in smoking cessation treatment and quitting behavior among adult BadgerCare (Medicaid) members who smoke. It included two distinct evidence-based approaches to smoking cessation.
Results: Small Investment, Big Reward
The first focused on linking adult BadgerCare Plus members to the Wisconsin Tobacco Quit Line (WTQL). Participants received up to five proactive coaching calls (plus additional calls initiated by the participant).
Several participants in the study were homeless:
The second focused on linking adult BadgerCare Plus members who are pregnant with intensive cessation counseling and support via First Breath (FB), a smoking cessation program of the Wisconsin Women’s Health Foundation (WWHF), and additional postpartum services. Postpartum services included four home visits and five support phone calls up to 6 months after delivery.
In each of the focus areas, WTQL and FB, half of the enrolled members received financial incentives for participating in counseling services and for quitting. The WTQL component of Striving to Quit served up to 2,000 members who smoked. Members could enroll via WTQL referral from participating clinics in South Central and Northeastern Wisconsin. Additionally, members who resided in participant counties also called the WTQL to enroll.
FB enrolled 1,250 pregnant members who smoked and lived in 17 counties throughout the state. This grant offered a tremendous opportunity to improve the health of thousands of Wisconsin residents with low incomes and discover whether financial incentives increase rates of smoking cessation among BadgerCare Plus members.
The grant ran from September 2011 through Sept. 2016, funded by CMS in a grant to the Wisconsin Department of Health Services. The Principal Investigator was UW-CTRI Research Director Dr. Tim Baker.
- Fraser DL, Fiore MC, Kobinsky K, Adsit R, Smith SS, Johnson ML, Baker TB. (2017). A Randomized Trial of Incentives for Smoking Treatment in Medicaid Members. American Journal of Preventive Medicine. 53(6):754-763.
- Baker TB, Fraser DL, Kobinsky K, Adsit R, Smith SS, Khalil L, Alaniz KM, Sullivan TE, Johnson ML, Fiore MC. (2018). A Randomized Controlled Trial of Financial Incentives to Low Income Pregnant Women to Engage in Smoking Cessation Treatment: Effects on Post-Birth Abstinence. Journal of Consulting and Clinical Psychology. 86(5): 464–473.
- Mundt MP, Baker TB, Fraser DL, Smith SS, Piper ME, Fiore MC. (2019) Paying Low-Income Smokers to Quit? The Cost-Effectiveness of Incentivizing Tobacco Quit Line Engagement for Medicaid Recipients who Smoke. Value in Health. 22(2):177-184.
- Mundt MP, Baker TB, Piper ME, Smith SS, Fraser DL, Fiore ME. (2020) Financial Incentives to Medicaid Smokers for Engaging Tobacco Quit Line Treatment: Maximising Return on Investment. Tobacco Control. 29:320-325.
- Mundt MP, Fiore MC, Piper ME, Adsit RT, Kobinsky KH, Alaniz KM, Baker TB. (2021) Cost-Effectiveness of Stop Smoking Incentives for Medicaid-Enrolled Pregnant Women. Preventive Medicine.