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Enhancing Health Through Health Coach-led Tobacco Cessation Program at UPMC: Phase 2 Design

This study highlights the pivotal role of health coaches in an integrated tobacco cessation program at UPMC, focusing on program delivery strategies. The approach aims to change the social norms around tobacco use, increase awareness of quitting benefits, and eliminate barriers to treatment access and cost. The program targets UPMC employees with multi-modal treatment options, pharmacist outreach, and wellness committees. Through Phase 1, significant reductions in smoking rates and healthcare costs were achieved. Phase 2 builds on these successes with enhanced enrollment methods, extended copay waivers, and tailored health coach interventions at critical milestones. Health coaches play a key role in stratification, identification, outreach, engagement, enrollment, intervention, assessment, and reporting within the program model. Enrollment figures show a promising start in Phase 2, with 181 employees already engaged with health coaches during the 90-day period.

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Enhancing Health Through Health Coach-led Tobacco Cessation Program at UPMC: Phase 2 Design

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  1. A Key Role for Health Coaches: Integrated Approaches to Program Delivery Timothy R. Cline, Ph.D., MCC Senior Director of Clinical Training and Development

  2. UPMC Smoke-Free Campus Initiative Phase 1 Objectives • Change the social norm of acceptance of tobacco use. • Increase awareness of benefits of quitting. • Remove barriers of cost and access to treatment. • Motivate smokers to engage in treatment.

  3. Systems Model Employer Target Community UPMC Employees UPMC (26 Business Units) UPMC Health Plan Physicians & Nurses Insurer Care Providers

  4. Insurer: UPMC Health Plan • Designed and coordinated the initiative • Produced an integrated, sustained communications campaign • Onsite education for employees • Education and resources to care providers • Multi-modal treatment options • Pharmacist outreach to copay waiver users

  5. Employer: UPMC • Created wellness committees to implement policy and internal communications • Funded no-cost pharmacotherapy

  6. Care Providers • Nurses -National Nurses Week tie-in -Advised smokers to quit -Disseminated information on smoke-free campus • Physicians • Toolkits • Counseled patients according to CPG • Referred patients via fast fax forms for health coaching • Advised patients on use of pharmacotherapy

  7. Target Community: UPMC Employee Members • ≈ 30,000 employees • 17.1% smokers • 50% professional and clinical • Modal = female > 45 yo

  8. Effects of Phase 1 Smoke-Free Campus Initiative on the System Partners

  9. Insurer: UPMC Health Plan • Able to demonstrate the value of its partnership with UPMC by enhancing the health and productivity of UPMC’s employee population.

  10. Employer: UPMC • Paid $439,088 for medication, up from $16,021 for the same period the year before. • Average savings in claims and productivity per nonsmoking employee is $3,141 per year. • Potential savings of over $2 million annually is possible.

  11. Care Providers • Increased compliance with Clinical Practice Guidelines for community of smokers • Used fast-fax form for convenient referral to health coaching • Copay waiver eliminated cost as a patient compliance issue.

  12. Target Community:UPMC Employee Members • 2,084 employees used copay waiver; 1,869 of them “new starts” • Percentage of employees who smoke dropped from 17.1% to 14.2% • Translates to 870 fewer smokers

  13. Sampling of employee testimonials: • “I am so happy to be smoke free after all these years!” • “After smoking for 30 years, it was great to have the extra incentive to stop.” • “Paying for Chantix was the push I needed… This was perfect. Thank you!” • “I feel 110% better without cigarettes.”

  14. UPMC Smoke-Free Campus: Phase 2 Lessons from Phase 1 That Have Been Used to Design Phase 2

  15. In Phase 2 • Enrollment via health coach provides for baseline data collection and early health coaching engagement • Full course of medication for all, regardless of when during the enrollment period (June 1 to August 31, 2008) medication begins • Early outreach by pharmacists will address medication issues

  16. In Phase 2 (cont.) • Extension of copay waiver to covered spouse, domestic partner, and adult dependents provides social support context for quitting • Health coach calls at 30, 90, and 180 days post-quit date provide for follow-up and outcomes tracking

  17. Health Coaches Have the Key Role in Steps 3 - 7 of the Program Model 1. Stratification 2. Identification 3. Outreach 4. Engagement 5. Enrollment 6. Intervention 7. Assessment 8. Analysis 9. Reporting

  18. Phase 2 Enrollment to Date • As of Day 18 of 90-day enrollment period, 181 employees have enrolled with health coaches.

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