Call it Quits Referral Program - Center for Prevention

Call it Quits Referral Program

This message funded by Blue Cross and Blue Shield of Minnesota,
an independent licensee of the Blue Cross and Blue Shield Association.

Agenda

• Why should we do this?
• What is the Referral Program?
• Clinical Practice Guidelines:

The “5 A’s”
• How does it work?
• Patient experience
• Reporting
• The successful clinic

Why?

of smokers
see a physician each year

of smokers
report wanting to quit

AND
Smokers cite a physician’s advice to quit
as an important motivator for
attempting to stop smoking

Source: Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice
Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

What is it?

The Call it Quits Referral Program:
• allows providers to easily refer patients to tobacco

cessation phone counseling services via a single fax
referral form
• launched statewide in October, 2007
• is supported by a collaboration of Minnesota’s major
health plans and ClearWay Minnesota
• has over 1000 clinics registered to date
(medical, dental, public & behavioral health)
• has a 27% overall enrollment rate
• is FREE to all Minnesotans!

Why Phone Counseling?

• Statistics show that fewer than 1 in 20
smokers will be successful in quitting tobacco
and staying quit.1

• With tailored phone-based coaching, greater
than 1 in 3 will be successful in quitting and
staying quit.2

1 According to ACS, only about 4% to 7% of people are able top quit smoking on any given attempt
without medicines or other help. Studies in medical hournals have reported that between about 25%
and 33% of smokers who use medicines can stay smoke-free for over 6 months.

2 Alere Wellbeing performance metrics for Blue Cross and Blue Shield of Minnesota, 2012.
39% quit rate based on a 30 day quit rate at a 6 month follow-up.

Clinical practice guidelines

The 5 A’s

ASK
ADVISE
ASSESS
ASSIST
ARRANGE

#1- ASK about tobacco use

…and document

#2 - ADVISE to quit

“The most
important thing
you can do to
improve your
health is to quit
smoking, and I
can help you.”

#3 - ASSESS willingness to quit

“Are you willing to try to quit at
this time? I can help you.”

#4 - ASSIST in quit attempt

“Interventions lasting just three minutes increase
overall tobacco abstinence rates.”

U.S. Department of Health and Human Services, “Treating Tobacco Use and Dependence, 2008 Update”

Quitline services:
- Free
- Confidential
- Effective
- Available regardless of

insurance coverage

#5 - ARRANGE for follow-up

How the program works

1 Provider 2 Patient fills out referral form, or staff
assesses create EMR order for smoking
tobacco status cessation and obtain verbal consent
& asks if patient
is interested in 3
quitting
Designated staff fax
referral/EMR to
central triage

5 Result of patient outreach 4 Quitline contacts patient
faxed back to provider

Services for Minnesota

Provider
Fax

Referral faxed to single
triage number

Call it Quits Referral Triage

Health Health Health Etc. No Call it Quits Referral
Plan Plan Plan Plan or Triage sorts referral
1 2 3 Program based on health plan
check box

Quitline Quitline Quitline QUITPLAN Referral faxed to
A B C Services appropriate
quitline

Referral Form

Site Information
(pre-populated)

Patient Information

Quitline Outcome

Downloadable Materials

• Provider is sent
personalized
referral form and
patient
takeaways

• Provider
downloads
additional
materials as
desired

Patient experience: components

• A series of individually tailored calls from a
quitline coach

• Unlimited inbound calls to a quitline coach
• Program materials mailed to each participant
• Prescription consultation
• Over-the-counter (OTC) fulfillment available

via direct mail to enrolled participants*

*costs vary depending on the individual’s benefit coverage

Patient experience: first call

• The quitline will:

– confirm contact info
– determine the patient’s tobacco history and

readiness to quit
– describe the program and number of scheduled

phone calls the patient can expect
– explain how to access the support line
– answer quit medication questions

(quit coach cannot prescribe)

• The patient will accept or decline enrollment

More for Less

Clinic Intervention Call it Quits Referral
• 5-10 Minutes
• 3-6 Minutes
– Ask
– Advise – Ask
– Brief Counseling – Advise
– Assess & Assist
• 7 - 10% Quit
(CiQ Referral)

• 4-5 calls
• Free counseling

• 15 - 40% Quit

Reporting

Online reporting is available through a third-party
vendor, Professional Data Analysts (PDA).

• https://www.pdastats.com/CallitQuitsReports/login.aspx
• User name and password required

Sample report

The successful clinic

• Champion

– Resource
– Promoter
– Training new staff

• Process
• Feedback
• Realistic expectations

We can do it!