, 2010). Insurance Sodium orthovanadate coverage and provider reimbursement for tobacco use treatment in medical settings have increased significantly in the past decade (McMenamin, Halpin, & Shade, 2008). However, the expansion of insurance coverage and reimbursement opportunities has largely excluded dentists and dental patients. For example, in New York State where medical providers can receive Medicaid reimbursement for smoking cessation counseling, dentists are excluded (New York State Department of Health, 2009). Recognizing the importance of dentistry in tobacco control efforts, Healthy People 2020 includes as a key objective increased tobacco use screening and counseling in dental settings (USDHHS, 2010). Yet the current reimbursement structure does not support expansion of dental providers�� role in this arena.

The purpose of this study was to interview dental insurers to assess attitudes toward tobacco use treatment in dental practice, pros and cons of offering dental provider reimbursement, and barriers to instituting a tobacco use treatment-related payment policy for dental providers. Methods Study Subjects and Recruitment A targeted sampling method was used to identify executives of dental insurance programs who had knowledge of both current reimbursement policies related to preventive care and of the factors influencing their organizations�� reimbursement policies. Dental insurers and consultants to dental insurers were recruited from the National Association of Dental Plans (NADP) clinical workgroup. The NADP is a large national trade association that represents more than 80% of dental insurance companies.

(NADP, 2011). Twelve NADP members of the workgroup, representing dental insurance executives and consultants, were contacted via e-mail and phone to inform them of the study. Those who expressed interest in participating were then contacted by investigators at the University of Chicago, who provided a detailed overview of the study, obtained consent, and conducted the interviews by phone. No monetary compensation was offered. Nine of the 12 workgroup members agreed to participate. Following preliminary analysis of the first nine interviews, we determined that there were themes specific to tobacco cessation that had not yet been fully explored. A purposeful sampling approach was then used to identify and interview three additional participants having greater experience or expertise in preventive health services or tobacco cessation activities in dentistry. In the final analysis, the interview with the dental consultant was excluded because of a lack of specific knowledge Dacomitinib about reimbursement policies for preventive services.