ments from 2011 to 2021. Eligible non- hospital-based pediatricians with at least a 20-percent Medicaid patient volume could receive up to $42,500 during the same period. Health professionals in the Medi-
care incentive program can earn up to $44,000 over five years for meeting meaningful use criteria from 2011 to 2016. Eligible Medicare physicians in a health professional shortage area can re- ceive a 10-percent increase in incentives. Stage 1 meaningful use core mea-
sures require physicians to record the smoking status for more than 50 percent of patients 13 years or older. In Stage 2, the requirement increases to recording smoking status for more than 80 percent of patients 13 or older. To achieve meaningful use, physicians also must report on six clinical quality measures, several of which involve to- bacco cessation. In Stage 1, physicians can choose a clinical quality measure requiring them to advise smokers and tobacco users to quit, discuss smoking and tobacco cessation medications, and discuss smoking and tobacco cessation strategies. In Stage 2, physicians can opt for a clinical quality measure requiring them to record the percentage of pa- tients older than 18 screened for tobacco use at least once in two years and who received cessation counseling. For more information about the Medi-
care and Medicaid meaningful use EHR program, visit the TMA EHR Incentive Program Resource Center at www.tex
med.org/EHRIncentive. TMA has additional resources to arm physicians with tools to promote good health among their patients. (See “POEP Podcast Fights Tobacco,” page 44.) The TMA Tobacco Cessation Counsel- ing Calculator helps physicians estimate how many patients would benefit from tobacco cessation treatment and deter- mine the potential revenue they could earn by billing for such services. Using the calculator is easy. Physicians or staff members enter contracted fee amounts for each of the codes listed and then en- ter the number of patients to whom they provide cessation treatment. To access the calculator, visit
www.texmed.org/ tobacco_calculator.
The Texas Department of State Health
Services (DSHS) offers a clinical toolkit for treating tobacco dependence. The toolkit, online at
www.dshs.state.tx.us /tobacco/
toolkit.shtm, allows physicians and staff members to develop a system that helps ensure they ask every patient at every clinic visit about tobacco use — and document that they did it.
Saving lives saves money Ultimately, the EHR tobacco cessation protocol project could reduce tobacco- related deaths, Dr. Angelocci says. DSHS says more than 24,000 Texans die annu- ally from a smoking-related illness such as cancer or cardiovascular and respira- tory disease.
The American Cancer Society es- timates a $2,000 reduction over four years in health care costs for every smok- er who quits. TMA’s legislative agenda stresses that a healthy and wealthy Texas depends on a sound health care system with robust medical care and effective public health components. The association calls for the state to invest in evidence-based wellness and public health programs that reduce tobacco use. TMA’s recommendations to the Texas
Legislature include supporting funding for evidence-based interventions that reduce tobacco use, especially in youth, such as education in schools and the Texas Tobacco Quitline. To read TMA’s full legislative agenda, visit www.tex
med.org/advocacy.
Fiscal year 2012 funding for the Quitline totaled $848,648, says DSHS Assistant Press Officer Christine Mann. Last year, the Cancer Prevention and Re- search Institute of Texas (CPRIT) award- ed a three-year $950,000 prevention grant to DSHS to fund Quitline services. In 2012, DSHS also received funding for Quitline services from the Centers for Disease Control and Prevention (CDC) that provides an additional $1,157,363 annually for 2013 and 2014. Ms. Mann says DSHS asked the leg-
islature to maintain the core funding of $848,648 for the Quitline and asked the Legislative Budget Board for about $1.5 million over the next two years to ex- pand Quitline services. According to Ms. Mann, about 27 per- cent of Quitline clients surveyed seven months postenrollment said they were tobacco-free. A 2006 Texas study by the Center for Health Research at Kaiser Per- manente found that every Texan who quits smoking saves $8,127 in medical costs and lost productivity within the first five years. Assuming 27 percent of the 12,113 clients enrolled in Quitline counseling in 2011 successfully quit us- ing tobacco, the state would potentially save about $26.5 million, Ms. Mann says.
Moving forward DSHS awarded $300,000 in initial fund- ing for the e-tobacco protocol project through December 2011. CPRIT gave UT-Austin a $266,920 grant through Au- gust of this year to fund the project.
March 2013 TEXAS MEDICINE 43
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