A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue Capture

A recent paper identified significant gaps in billing for tobacco-cessation services for a multihospital health system. Underbilling can reflect poor billing practices, low rates of tobacco-cessation counseling, or a combination of both. The study design was applied to 2 academic medical centers. De...

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Main Authors: Edward Anselm, MD, Derek J. Baughman, MD, Marcus Rauhut, MS, Taylor Martin, DO, MPH, Ishan Mahajan, Allison B. McCoy, PhD
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:AJPM Focus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773065425000677
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author Edward Anselm, MD
Derek J. Baughman, MD
Marcus Rauhut, MS
Taylor Martin, DO, MPH
Ishan Mahajan
Allison B. McCoy, PhD
author_facet Edward Anselm, MD
Derek J. Baughman, MD
Marcus Rauhut, MS
Taylor Martin, DO, MPH
Ishan Mahajan
Allison B. McCoy, PhD
author_sort Edward Anselm, MD
collection DOAJ
description A recent paper identified significant gaps in billing for tobacco-cessation services for a multihospital health system. Underbilling can reflect poor billing practices, low rates of tobacco-cessation counseling, or a combination of both. The study design was applied to 2 academic medical centers. Deidentified data from the electronic medical records systems were used to identify adult tobacco users and their insurance coverage for patients who had visits to primary care clinics. The proportion of office visits where cessation services were billed was calculated. An economic evaluation of the missed counseling opportunities was based on insurance type and a fee-for-service-payment model. Billing of cessation services is consistently below 2% across the medical centers studied, suggesting substantial opportunities to improve quality and increase revenue. The prevalence of tobacco use in the patient populations studied was significantly lower than reported for that state by the Centers for Disease Control and Prevention.
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spelling doaj-art-7ebfc238fa1a4118b59b9192b2ef31182025-08-20T03:51:19ZengElsevierAJPM Focus2773-06542025-10-014510037910.1016/j.focus.2025.100379A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue CaptureEdward Anselm, MD0Derek J. Baughman, MD1Marcus Rauhut, MS2Taylor Martin, DO, MPH3Ishan Mahajan4Allison B. McCoy, PhD5Icahn School of Medicine at Mount Sinai, New York, New York; Address correspondence to: Edward Anselm, MD, Fort Myers, FL, 33919.Department of Biomedical Informatics, Vanderbilt University Medical Center, Vanderbilt University School of Medicine, Nashville, TennesseeWellSpan Health, Research & Development, York, PennsylvaniaClinical Informatics, UCLA Health, Los Angeles, CaliforniaDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Vanderbilt University School of Medicine, Nashville, TennesseeDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Vanderbilt University School of Medicine, Nashville, TennesseeA recent paper identified significant gaps in billing for tobacco-cessation services for a multihospital health system. Underbilling can reflect poor billing practices, low rates of tobacco-cessation counseling, or a combination of both. The study design was applied to 2 academic medical centers. Deidentified data from the electronic medical records systems were used to identify adult tobacco users and their insurance coverage for patients who had visits to primary care clinics. The proportion of office visits where cessation services were billed was calculated. An economic evaluation of the missed counseling opportunities was based on insurance type and a fee-for-service-payment model. Billing of cessation services is consistently below 2% across the medical centers studied, suggesting substantial opportunities to improve quality and increase revenue. The prevalence of tobacco use in the patient populations studied was significantly lower than reported for that state by the Centers for Disease Control and Prevention.http://www.sciencedirect.com/science/article/pii/S2773065425000677Tobacco cessationcounselingeconomic evaluation
spellingShingle Edward Anselm, MD
Derek J. Baughman, MD
Marcus Rauhut, MS
Taylor Martin, DO, MPH
Ishan Mahajan
Allison B. McCoy, PhD
A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue Capture
AJPM Focus
Tobacco cessation
counseling
economic evaluation
title A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue Capture
title_full A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue Capture
title_fullStr A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue Capture
title_full_unstemmed A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue Capture
title_short A Multi-Institutional Evaluation of Billing for Tobacco-Cessation Services: Opportunities to Improve Quality and Enhance Revenue Capture
title_sort multi institutional evaluation of billing for tobacco cessation services opportunities to improve quality and enhance revenue capture
topic Tobacco cessation
counseling
economic evaluation
url http://www.sciencedirect.com/science/article/pii/S2773065425000677
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