Overview

Smoking has a well-documented, negative impact on health, and prevention and cessation programs can lower medical costs within three or four years. Group Health Cooperative (GHC), an integrated health system and health plan in Seattle, made tobacco cessation a priority in 1992. It started by developing a clinical pathway to identify smokers throughout the system and engage them in cessation programs. Later, GHC created a telephone-based behavioral counseling program, Free & Clear. Tobacco status is treated as a vital sign to be documented and charted by medical staff. The program's quit rate runs 25 to 30 percent. But calculating the cost benefit of smoking cessation programs is a murky undertaking. If health providers, insurers, and other payers invest in tobacco programs, they do not reap immediate financial savings for delaying the onset of smoking-generated health conditions. At best, their payback is avoiding higher medical costs down the road. Despite the long-term savings from avoided medical costs, larger employer groups typically are the only payers that reward this commitment to quality. For more information, see the Fund report under Related Resources.

This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Fund-sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied organizations' experiences in ways that may aid their own efforts to become high performers. The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund's case studies series is not an endorsement by the Fund for receipt of health care from the institution.