Enhancing Tobacco Dependence Treatment for Kentucky Medicaid Recipients 2018-2020 - 50/50

Tobacco dependence treatment is highly cost-effective in Medicaid populations. Tobacco dependence is a chronic, relapsing condition; yet we have few tobacco treatment specialists in Kentucky who serve Medicaid recipients. It is essential that both patients and providers use evidence-based strategies to treat tobacco dependence in order to achieve the best outcomes. Further, current treatment strategies requiring recipients to opt-in demonstrate low tobacco treatment utilization. Working with state partners (July 2018]June 2020), we propose to expand BREATHE's novel accredited online tobacco treatment specialist training to target Medicaid providers and disparate populations. Our long-]term plan is to conduct a pilot study to determine if changing the current opt-]in tobacco treatment strategy to an opt-out approach is feasible and enhances tobacco treatment utilization and outcomes with Medicaid recipients. Scope of Work The University of Kentucky College of Nursing BREATHE group shall provide the following professional services. A. Characterize Kentucky Medicaid providers who have current training and/or certification in treating tobacco dependence (e.g., UK CE Central trainings, LEADS trainings). 1. Describe these providers by type (primary care physician, pharmacist, nurse practitioner, physician assistant, social worker, and other providers for high prevalence tobacco use groups such as mental health/substance use, obstetrics and HIV/AIDS clinics). 2. Update the map of providers by geographic location annually and use it to identify areas most in need of training and/or certification in treating tobacco dependence. B. Develop a multi]pronged approach to reach KY Medicaid providers with the goal of characterizing gaps in tobacco treatment approaches, infrastructure and brainstorming potential solutions 1. Develop supplemental training content based on prior evaluation of needs assessment and focus groups. 2. Develop continuing education modules for Medicaid providers who treat special populations. 3. Develop continuing education credits for the providers who have completed BREATHE's tobacco treatment specialist training. C. Continue to explore and evaluate the facilitators and barriers to treatment services with key informants from MCOfs and their healthcare providers.