2003 - Winter by Arkansas Blue Cross and Blue Shield

~ benefits & claims questions? my blueline, P. 18 ~

A healthier you? Itâ&#x20AC;&#x2122;s YOUR call!

Winter 2003

from the n e w s

s t o r i e s

HEALTH f r o m

Blue Cross and Blue Shield Association to partner with Harvard Medical School to evaluate efforts to keep health care affordable The Blue Cross and Blue Shield Association (BCBSA) and Harvard Medical School are working together to monitor and evaluate local Blue Plan initiatives to keep health care affordable. The recent announcement was part of BlueWorks, a campaign to shed light on the best practices within the Blues system to keep health care affordable and encourage adoption of the most effective practices. The BlueWorksHarvard partnership is the first resource of its kind to share ideas about what works and shine a light on efforts to expand affordability throughout the U.S. health care system. BlueWorks will publish quarterly reports, beginning January 2004, to identify and provide reviews of innovative Blue plan initiatives that demonstrate promise in keeping health care affordable.

Schools to study health disparities A new initiative to study exactly why African Americans and Hispanics have higher rates of diseases, particularly breast cancer, was announced recently by the U.S. Health and Human Services Department. The University of Chicago and the University of Illinois at Chicago will be among eight centers nationwide designated as Centers for Population Health and Health Disparities.

Obesity increases at alarming rates from teens to 20s The percentage of people who are obese doubles from the teen years to the mid-20s, accor ding to the results of a study by researchers at the University of North Carolina in Chapel Hill and published in a recent edition of USA Today. The researchers attributed the rapid weight gain to busy lifestyles and bad habits. Researchers found that of those studied, 27 percent were overweight, and 22 percent were

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obese by their 20s. About 11 percent were obese at the start of the research project and stayed that way while another 11 percent became obese during the same time. Study participants were weighed and measured at various ages from 13 to 20, and weighed and measured again at ages 19 to 26. Young African-Americans were found to have the highest obesity rates; Asians had the lowest rates.

More people with insurance using emergency rooms for treatment According to the Center for Studying Health System Change (a Washington, D.C.-based think tank), people with insurance are using emergency rooms more often, even for nonurgent care. This new study found that emergency room visits jumped to an average total of 107.7 million in 2000 and 2001, up 16.3 percent from 1996 and 1997. Most of the increase came from insured patients. Unnecessary use of the emergency room results in increased health care costs.

Walking for better health during the WalkingWorks Capitol Hill Challenge More than a dozen members of Congress and nearly 2,000 federal employees signed up to participate in the Capitol Hill Challenge this summer, committing to walk at least 10,000 steps a day for a least five days a week during a six-week period. Blue Cross and Blue Shield Plans and the Congressional Fitness Caucus launched the Capitol Hill Challenge in June 2003. This is one of the many wellness activities scheduled throughout the United States as part of the Blue Systemâ&#x20AC;&#x2122;s WalkingWorks program, which is designed to encourage people to integrate more walking into their daily routine, live healthier lives and reduce the likelihood of costly health problems in the future. The programâ&#x20AC;&#x2122;s unique approach combines health promotion with consumer education. Blue & You Winter 2003

Customer Service Numbers Little Rock Toll-free Number (501) Number

Category

State/Public School Employees 378-2364 1-800-482-8416 e-mail: publicschoolemployees@arkbluecross.com stateemployees@arkbluecross.com Medi-Pak (Medicare supplement)

378-3062 1-800-338-2312

Medicare (for beneficiaries only): Part A (hospital benefits) Part B (physician benefits)

1-877-356-2368 1-800-482-5525

UniqueCare, UniqueCare Blue, Blue Select®, BlueCare PPO & PPO Plus (individual products), BlueCare Dental 378-2010 1-800-238-8379 Group Services

378-3070

BlueCard®

378-2127 1-800-880-0918

Federal Employee Program (FEP)

312-7931 1-800-482-6655

Health Advantage

378-2363 1-800-843-1329

BlueAdvantage Administrators

378-3600 1-800-522-9878

Pharmacy Customer Service (AdvancePCS): Arkansas Blue Cross and Blue Shield Health Advantage BlueAdvantage Administrators Specialty Rx

1-800-421-1112

1-800-863-5561 1-800-863-5567 1-888-293-3748 1-866-295-2779

For information about obtaining coverage, call: Category

Little Rock Toll-free Number (501) Number

Medi-Pak (Medicare supplement)

378-2937 1-800-392-2583

BasicBlue®, BlueCare PPO & PPO Plus (individual products) 378-2937 1-800-392-2583

Regional Office locations are: Central, Little Rock; Northeast, Jonesboro; Northwest, Fayetteville; South Central, Hot Springs; Southeast, Pine Bluff; Southwest, Texarkana; and West Central, Fort Smith. Customers who live in these regions may contact the regional offices or call the appropriate toll-free telephone numbers above.

Web sites:

www.ArkansasBlueCross.com www.HealthAdvantage-hmo.com www.BlueAdvantageArkansas.com www.BlueAndYouFoundationArkansas.org www.BlueAnnEwe-ark.com is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health care professionals and other persons interested in health care and wellness.

Blue & You Winter 2003

INSIDE THIS ISSUE

~Winter 2003~

From the Health files ................................... 2 Living healthier is up to you ..................... 4-5 Choose good food ..................................... 6-7 Shopping list for you .................................... 8 Moderate exercise is helpful ....................... 8 Bigger but not better .............................. 9-10 Keys to keeping kids fit ........................ 10-11 Checklist for checkups .............................. 12 Stressed out? ............................................. 13 Take your medicine .................................... 14 Breast health steps, FYI on Pap tests ........ 15 Wash those hands ...................................... 16 Foundation awards grants ......................... 17 My BlueLine at your service ...................... 18 Coverage guidelines for FluMist ................ 18 The pharmacist is in .................................. 19 Les Wyatt named to Board ......................... 19 Away From Home Care program replaced .. 20 Breast biopsy referral process improved ... 20 Protecting your identity ............................. 20 Proton Pump Inhibitor changes .................. 20 BlueAnn Health Club .................................. 21 Taking on Rhode Island .............................. 21 New Internet resource ............................... 22 Blue & Your Community ............................. 23 Blue On-Line .............................................. 24 Vice President of Advertising and Communications: Patrick O’Sullivan Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer: Gio Bruno Contributors: Tammi Bradley, Janice Drennan, Damona Fisher and Kathy Luzietti

E at Right. Exercise. Living Y

ou’ve heard it over and over again — you can help maintain good health by eating a balanced diet and participating in regular physical activity. And there’s no doubt (as evidenced by the health problems of Arkansans) that it bears repeating. According to the Arkansas Department of Health Center for Health Statistics (Arkansas Behavioral Risk Factors Surveillance System 2001 survey), 31 percent of Arkansans do not participate in any regular physical activity and 60 percent of Arkansans are overweight. No one can make you eat right, and no one can make you exercise. It takes discipline and commitment to a healthier lifestyle. It’s up to you.

Eat healthy So, first things first. Start with a healthy diet, which means eating a wide variety of foods including bread (or cereal, rice or pasta), vegetables, fruit, milk (or yogurt or cheese) and meat (or poultry, fish, dry beans, eggs or nuts). (See related article on Page 6 for more information on choosing food that’s good for you). Remember to … 1. Eat breakfast every day. People who eat breakfast are less likely to overeat later in the day. A healthy breakfast also gives you energy and helps you think and learn. 2. Choose whole grains more often. Try whole wheat breads and

pastas, oatmeal and brown rice. 3. Eat a variety of different colored vegetables each day. Different colored vegetables have different nutrients. Choose dark, leafy greens such as kale, collards, and mustard greens, and reds and oranges such as carrots, sweet potatoes, red peppers and tomatoes. 4. Choose fresh or canned fruit more often than fruit juice. Fruit juice has little or no fiber. 5. Use fats and oils sparingly. Olive, canola, and peanut oils, avocados, nuts and nut butters, olives, and fish provide heart-healthy fat as well as vitamins and minerals. 6. Eat sweets sparingly. Limit foods and beverages that are high in added sugars. 7. Have low-fat, low-sugar snacks on hand at home, at work, or on the go, to combat hunger and prevent overeating. 8. Eat three meals every day instead of skipping meals or eating a snack instead of a meal Are you a busy mom? Busy dad? Just busy? For those with hectic schedules, mornings can be tough, and sometimes breakfast is ignored. To make breakfast easy, here are some quick breakfast ideas: low-fat yogurt sprinkled with low-fat granola; oatmeal with low-fat or fat-free milk, or a soy-based beverage; whole wheat toast with thinly spread peanut butter; fruit smoothie made with frozen fruit, low-fat yogurt and juice; or a low-sugar cereal with a soy-based beverage. Need a mid-morning snack to get you going? How about low-fat or fat-free yogurt, rice cakes, dried fruit, nuts, fresh fruit or air-popped popcorn sprinkled with a few spices? Learning to eat healthy is a lifelong commitment. It takes willpower. Just remember to make a healthy eating plan, buy healthy foods and get started. Do it for yourself and your family.

Exercise The bad news first. Physical inactivity contributes to 300,000 preventable deaths in the United States each year. Behavior patterns that could be changed cause approximately 40 percent of deaths in the United States. Physically inactive people are twice as likely to develop heart disease than active people. Nearly half of Blue & You Winter 2003

healthier — It’s up to you.

all Americans report that they are not active at all. notice some of the benefits of your exercise program. Now for the good news … significant health benefits Forget the old saying … “no pain, no gain.” If it are gained by simply including a moderate amount of hurts, stop. Stop exercising if you feel abnormally out of physical activity (30 minutes of brisk walking, raking breath, dizzy or feel faint or nauseated. leaves, etc.) in your life. So what is the best exercise? It’s the one you will do. Regular exercise is important for your overall Walking is considhealth. Talk to your doctor about ered a good choice how much exercise is right because it’s free, y diet h t l a for you. A good goal for easy and safe. e h or a f s e l u most people is to exercise The benefits r ds. o o Simple f f o y four to six times per week for of regular exercise variet ght. i a e t w a E y h . 30 minutes or more. However, include reducing 1 lt in a hea a , t t n a i f a remember that any amount of your risk of heart n M i 2. et low . i l d o r a e t e exercise is better than no disease, high s s e d chol 3. Choo n a t s t a i f exercise at all. blood pressure, u rated les, fr u b t a a t s e g e Start out slowly. If you osteoporosis, v lenty of p t a E have been inactive for years, diabetes and . 4 n. . o s i n t i a a r r e g running the Little Rock Maraobesity. d o and y in m l n o s r thon might be a little much. Exercise keeps a n. e sug o s i t U a . r e 5 d Begin with a 10-minute period of joints, tenalt in mo ages in r e v e light exercise or a brisk walk dons and b 6. Use s c coholi l a k n every day, gradually increasing ligaments i r 7. D . n o i t how hard you exercise and how flexible so it’s a oder m long. To sneak some exercise into easier to move around your day, take the stairs instead of and reduces some of the effects of aging. Exercise the elevator, go for a walk during your coffee break or contributes to your mental well-being, helps treat lunch break, walk to work, do housework at a faster depression and relieves stress and anxiety. Exercise pace, or rake leaves and work in your yard. increases your energy and endurance and helps you To make sure you don’t suffer burnout, choose an sleep better. And, best of all, it helps you maintain a exercise you like to do. And just because your husband is normal weight by increasing your metabolism (the rate a runner doesn’t mean you are. Maybe swimming would you burn calories). be better for you if you have arthritic joints. Find something that suits you both mentally and physi— Sources: Arkansas Department of Health, The cally. Sometimes having a partner makes President’s Council on Physical Fitness and Sports, the exercise more fun. Remember to vary your Centers for Disease Control and Prevention and the U.S. routine. You will be less likely to get bored Department of Agriculture/Department of Health and or injured if you change your Human Services routine. Walk one day. Swim the next. Don’t work out right after lunch or when it is too cold or hot outside. Don’t get discouraged; it can take weeks or months before you Blue & You Winter 2003

Choose food that’s good

“B utter is bad for you — oops, it’s not as bad as margarine. High-protein, low-carbohydrate diets are bad for you — no, wait; they may be good for you.” When you hear so many conflicting reports on diet and nutrition, how do you decide what is best for you? Most people agree that following your mother’s advice to eat your vegetables is the right path to follow. We all know that eating a bag of chips while watching a football game on television is bad. Beyond that, it gets confusing. Technology can be your friend when it comes to nutrition dilemmas. Several Web sites offer tools that analyze, compare and rate the nutritional value of foods. You can see exactly what’s in that Big Mac and fries you had for lunch yesterday — fat, protein, calories, etc., and even check how individual foods rate on the “goodness” scale. One of those sites is NutritionData.com. A recent search for the most nutritional breakfast cereal brought up a list of five-star (top-rated) cereals: • Kellogg’s All-Bran with Extra Fiber • Kellogg’s All-Bran Original • General Mills’ Fiber One • Maypo, cooked with water, without salt • Maypo, dry General Mills’ highly touted Whole Grain Total also ranked high at 4.8. A search for the foods lowest in fat from Krispy Kreme returned one item: Krispy Kreme beverage: raspberry. NutritionData.com uses the U.S. Department of Agriculture (USDA) National Nutrient Database for Standard Reference in addition to listings provided by restaurants and food manufacturers. You can search the USDA database yourself at http:// www.nal.usda.gov/fnic/cgibin/nut_search.pl. You’ll find nutrient tables (vitamins, minerals, lipids (fat), proteins, etc.) for everything from raw broccoli to fastfood taco salad.

Read the label Get into the habit of reading food labels when you go to the grocery store. For help interpreting those labels, go to the U.S. Food and Drug Administration (FDA) Web site at http://vm.cfsan.fda.gov/~dms/ foodlab.html. The FDA advises that consumers pay attention to the serving size, which determines the amount of each nutrient and its percent of daily value (%DV) based on FDA recommendations for a 2,000calorie diet. One package or can of food usually contains more than one serving, and the serving size must appear on the label. The %DV column on the label shows you the percent of the recommended daily amount of a nutrient in one serving. The items listed first on the food label (calories, fat, saturated fat, cholesterol, sodium) are the ones Americans generally intake in adequate or excessive amounts. These may increase your risk of certain chronic diseases, such as heart disease, some cancers and high blood pressure. Americans often don’t get enough dietary fiber, vitamin A, vitamin C, calcium and iron in their diets. Eating enough of these nutrients can improve your health and help reduce the risk of some diseases and conditions.

Figure in fiber The FDA recommends that you intake a minimum of 25 grams of fiber per day. Most Americans are not getting that much. You can get 25 grams by eating two bowls of Total cereal, one pear, two apples or three slices of whole-grain bread. Fiber is found only in plant foods, such as whole grains, fruits, nuts, vegetables, beans and seeds. Although mixed reports of recent years have confused consumers, you can count on fiber to help in the prevention of several diseases and conditions. A high-fiber diet that is low in fat with adequate portions of fruits, vegetables and whole grains may help prevent cancer, heart disease and digestive disorders. Food labels will tell you how much of the percent daily value for fiber is in the food product. If the package Blue & You Winter 2003

for your health says the product is high in, rich in or excellent source of, it provides at least 20 percent of the daily value (5 grams per serving). If it says good source, it contains at least 10 percent of the daily value (2.5 grams per serving).

Food pyramid The USDA food pyramid is still a valid guide for daily food intake. Start with plenty of breads, cereals, rice and pasta (six to 11 servings); vegetables (three to five servings); and fruits (two to four servings). Add two to three servings from the dairy group and two to three servings from the meat group. Remember to go easy on fats, oils, and sweets, the foods in the small tip of the pyramid. For more information, visit the food pyramid Web site at http://www.nal.usda.gov:8001/py/pmap.htm.

Organic: worth the extra cost? Food labeled organic in U.S. stores and restaurants must meet USDA standards. Organic food is produced without using most conventional pesticides, fertilizers made with synthetic ingredients or sewage sludge, bioengineering or ionizing radiation. Organic meat, poultry, eggs and dairy products come from animals that are given no antibiotics or growth hormones. The price at the grocery store is usually higher than comparable nonorganic foods. Before a product can be labeled organic, a government-approved inspector ensures that the farm where the food is raised is following all the rules necessary to meet organic standards. Companies that handle or process organic food before it gets to your local supermarket or restaurant must be certified too. Whether organically produced food is safer or more nutritious than conventionally produced food is a controversial issue. Organic food differs from conventionally produced food in the way it is grown, handled and processed — but usually not in its nutritional value. Consumers buy organic foods for multiple reasons, including: • To limit exposure to chemicals for themselves, their children and farm workers; • To improve water quality by reducing pesticide and fertilizer runoff; Blue & You Winter 2003

• To protect soil from erosion and depletion of its nutrients by conventional farming of single-plant, row crops; • To support small farmers, who use labor-intensive methods, such as weeding by hand, thereby saving energy needed to run large farms and to produce the chemicals conventional farmers use. Some people say organic foods just taste better. The USDA has developed strict labeling rules to help consumers know the exact organic content of the food they buy. The USDA Organic seal tells you that a product is at least 95 percent organic. For vegetables or pieces of fruit, look for the word organic and a small sticker version of the USDA Organic seal on the food item. The designation may be on a sign above the produce display. The word organic and the seal also may appear on packages of meat, cartons of milk or eggs, cheese and other single-ingredient foods. Labeling is a little more complicated when it comes to foods with more than one ingredient. Look for these designations on the package: • 100% organic with USDA seal: Product is made with 100 percent organic ingredients. • Organic with USDA seal: Product contains 95 to 100 percent organic ingredients. • Made with organic …: Product is made with at least 70 percent organic ingredients. Products with less than 70 percent organic ingredients may list specific organically produced ingredients on the side panel of the package but may not make any organic claims on the front of the package. The bottom line is that Americans need to pay more attention to what they are eating if they want to feel better and live longer. You might call it responsible eating. — Sources: http:// www.NutritionData.com, U.S. Food and Drug Administration, USDA Nutrient Data Laboratory, USDA National Organic Program

Stock your kitchen with healthy food choices

o help yourself (and your family) make healthy eating decisions, start with shopping for quick, low-fat food items to fill your pantry and refrigerator. If there are no chips in the house, you won’t be tempted. We’ll make it easy for you … here’s your shopping list! • Fat-free or low-fat milk, yogurt, cheese and cottage cheese • Light or diet margarine • Eggs/Egg substitutes • Sandwich breads, bagels, pita bread, English muffins • Soft corn tortillas, lowfat flour tortillas • Low-fat, low sodium crackers • Plain cereal, dry or cooked

• Rice, pasta • White meat chicken or turkey (remove skin) • Fish and shellfish (not battered) • Beef: round, sirloin, chuck, loin and extra lean ground beef • Pork: leg, shoulder, tenderloin • Dry beans and peas • Fresh, frozen or canned fruits in light syrup or juice • Fresh, frozen or no-salt added canned vegetables • Low-fat or nonfat salad dressings • Mustard and ketchup • Jam, jelly or honey • Herbs and spices • Salsa — Source: The National Heart, Lung and Blood Institute

Moderate exercise is helpful W

omen who want to lose weight can benefit as much from a moderate physical activity as from an intense workout, according to a new study sponsored by the National Heart, Lung and Blood Institute (part of the National Institutes of Health). According to the study, overweight women who participated in either a moderate or intense workout during the week (usually brisk walking) all lost a significant amount of weight and improved their cardiorespiratory fitness. In the study, there was no significant difference among the women in relation to the type of workout they participated in during the week. Because so many studies have concluded that moderate exercise is beneficial, the Centers for Disease Control

and Prevention recently released a broader definition of physical activity through a state-based survey. The survey provides a more comprehensive picture of the daily lifestyles of Americans and includes physical activity measures such as gardening, vacuuming and brisk walking to do errands, as well as more traditional forms of exercise. For more information about the survey, visit www.cdc.gov/ mmwr, and for more information about physical activity recommendations, visit www.cdc.gov/ nccdph/dnpa.

Blue & You Winter 2003

B igger but not better

Why are Americans gaining so much weight?

mericans love fast food, and it shows. We have super-sized our way to obesity. Both adults and children have become a part of this alarming trend, so much so that many experts now view the situation as a public health concern. The Surgeon General recently called for a broad approach to avoid and reduce obesity. He challenged people to work together through communication and education to help Americans balance healthy eating with exercise, and he called for research and evaluation to improve the publicâ&#x20AC;&#x2122;s understanding of the causes, prevention and treatment of obesity. According to data from the Centers for Disease Control and Prevention, the epidemic just keeps growing. Recent research shows that more than 30 percent of adults are considered obese. Thatâ&#x20AC;&#x2122;s an 8 percent increase from 1994. There also are more extremely obese adults, 4.7 percent of the population today compared to 2.9 percent in 1994. The percentage of overweight American adults increased to 64.5 from 55.9 in 1994. Researchers from the Centers for Disease Control and Prevention used body mass index (BMI) to identify obesity. Overweight was defined as having a BMI of 25 or higher. A BMI of 30 or greater is considered obese, and extreme obesity means having a BMI of 40 or more. The BMI is determined by a mathematical formula involving weight and height. According to the research, there are several factors contributing to the epidemic including increase in portion sizes, consumption of high-fat fast foods and increasingly sedentary lives. The reasons include behavior (simply eating too much and not getting enough exercise), environment (home, work, school, or community can create barriers to an active lifestyle), and genetics (heredity plays a large role in determining how susceptible people are to being overweight or obese). Although behavior and environment are the main contributors to weight problems, they all offer the greatest opportunities for prevention and treatment. They are factors that can be controlled. According to the National Institutes of Health Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults, all adults (18 and older) who have a BMI of 25 or more are considered Blue & You Winter 2003

at risk for premature death and disability as a consequence of being overweight or obese. These health risks increase as the severity of the obesity increases. Economists point out that rising obesity rates are more about workplace and food trends than laziness or gluttony. According to a research paper from the National Bureau for Economic Research, the rise in the number of working women has contributed to the rise in obesity. Women get heavier because they sit at their computers all day and, so the reasoning goes, their families get fat because they are eating less home cooking and more fast food. Recently, two RAND Corp. economists claimed the rise in obesity rates is 60 percent due to sedentary jobs and 40 percent due to cheap, plentiful food (a sign of an affluent society). Although the government (at all levels) is now looking for ways to stem the obesity epidemic, efforts have not always panned out. Healthy People 2000, a project uniting federal, state and nonprofit organizations, failed to reduce obesity rates in a single state between 1990 and 2000. Whatever the reason for the rise in the number of overweight and obese Americans, it will ultimately be up to each person, and each parent, to make sure their families are eating right and getting plenty of exercise.

The fat facts â&#x20AC;˘ Poor diet and inactivity may lead to obesity. People who are overweight and obese are at an increased risk for (Bigger, continued on Page 10)

10 (Bigger, continued from Page 9)

high blood pressure, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems and some types of cancer. • More than 60 percent of adults in the United States are overweight or obese.

Cost of obesity In 2000, the cost of obesity in the United States was more than $117 billion. Poor nutrition and physical inactivity account for approximately 300,000 premature deaths in the United States each year.

How to lose the weight According to the Surgeon General, losing just 10 percent of your body weight can improve your health. The Surgeon General also recommends that gradual weight loss is the best way to go — losing just 1 to 2 pounds per week is recommended. Additionally, the Surgeon General recommends physical activity for at least 30 minutes per day most days of the week (60 minutes for children) and limiting TV watching to two hours per day. Americans should eat sensible portions based on the Dietary Guidelines for Americans (www.health.gov/dietaryguidelines). The Centers for Disease Control and Prevention’s Division of Nutrition and Physical Activity recommends that the easiest and safest way to lose weight is to reduce calories and increase physical activity. Government research and recommendations can provide the facts based on science so that people can make informed choices about appropriate weight loss. The fact is that the majority of people who are attempting weight loss are not using the correct methods to maintain or achieve positive results. For more information about eating right and exercising, see related articles beginning on Page 4. — Sources: Centers for Disease Control and Prevention, The Robert Wood Johnson Foundation, U.S. Surgeon General, National Institutes of Health, The President’s Council of Physical Fitness and Sports and the American Heart Association

More exercise and a are keys to keeping I

n 1972, approximately 12 percent of America’s youth were considered overweight. Today, in 2003, 13 percent of children ages 6 to 11 and 14 percent of adolescents ages 12 to 19 are considered overweight. African-American, Hispanic-American and NativeAmerican children and adolescents have particularly high obesity rates (30.9 percent, 30.4 percent and 38.5 percent respectively). There are numerous health risks associated with childhood obesity: Diabetes — Type 2 diabetes in children has increased dramatically in the last 20 years. The parallel increase in obesity is reported to be the most significant factor for the increase in diabetes. Sleep disorders — Apnea, hypopnea and excessive nighttime arousals have been associated with obesity. Hypertension — High blood pressure is nine times more prevalent among obese children. Approximately 20-30 percent of obese children have high blood pressure. Menstrual abnormalities — Early menarche is observed in obese girls. Late or absent menstruation also is associated with obesity. Orthopedic complications — When children are growing, bone and cartilage are in the process of development and are not strong enough to bear excess weight. Obesity can cause numerous orthopedic complications. In a study of Blount’s Disease (severe bowing of the legs), approximately 80 percent of patients were obese. Eating disorders (anorexia nervosa, bulimia, binge eating) — Everywhere you look, there is an emphasis on weight in American society. There are numerous weight-loss products on the market, and most people have dieted at one time or another. In a recent study of elementary school students (third through sixth grade), 70 percent believed they were fat, 45 percent wanted to be thinner and 37 percent had tried to lose weight. Blue & You Winter 2003

healthy diet kids FIT Psychosocial effects and stigma — Obesity may cause inappropriate expectations and adverse socialization because the child looks older for their age. Overweight children and adolescents often receive negative feedback from their peers and parents. Why are children more overweight that ever before? Genetics, overeating and lack of physical activity can all contribute to obesity. Experts believe there are two main reasons for the alarming rate in childhood obesity: the food the children eat and their lack of exercise. Only about one-half of the young people in the United States (ages 12 to 21) regularly participate in vigorous physical activity. Approximately 14 percent report little or no physical activity. Because families are so busy, many times moms and dads turn to fast food to feed their children. Fast foods are usually high in fat and sugar. Additionally, fast foods put children at risk for nutritional deficiencies that contribute to a lack of energy, mood swings, sleep difficulties, poor school performance and more illnesses. Children also get less exercise than they used to get. The average American child spends 24 hours a week watching television. And that doesn’t include time spent playing video games, watching movies or working on the computer. For children who are overweight, there are things parents can do to help them trim down. It is up to the parent to help children make healthy choices. Additionally, by modeling healthy habits themselves, parents set powerful examples for their children. Children whose parents are overweight are more likely to become overweight adults themselves.

Focus on healthy choices Do not limit the amount of food your child eats. Limiting food can lead to eating disorders and cause other health problems. Instead, focus on replacing unhealthy food choices with healthy food choices. Instead of chips, offer grapes as a snack. Instead of a

Blue & You Winter 2003

candy bar, offer yogurt or a banana. Keep healthier food choices visible — a bowl of fruit on the counter or carrot sticks in the refrigerator. When families do eat out, choose the smaller portions (no super sizing) and choose grilled items rather than fried.

Get children moving Children need more physical activity. With plenty of physical activity, children will lose weight or avoid the weight gain in the first place. Choose activities that are fun and be sensitive to the child’s needs. Do not pick activities that may be difficult. Plan fun family outings such as bike rides, swimming and hikes. Take a family walk after dinner; play tag and hopscotch; set up a volleyball net in the backyard; shoot the basketball; and play Frisbee. Instead of focusing on losing weight, focus on increasing physical activity and making healthier food choices. Develop healthy habits now to last a lifetime. — Sources: University of New Hampshire Cooperative Extension Program, American Dietetic Association, American Obesity Association, The President’s Council on Physical Fitness and Sports and The American Academy of Child and Adolescent Psychiatry

Checklist for Checkups ——

racticing good disease prevention starts before birth and lasts a lifetime. Parents can help make sure their kids get off to a good, healthy start by ensuring they receive their immunizations, proper health screenings and well-child checkups. Health Advantage recommends the preventive health guidelines below for children from birth through adolescence. Always check your health benefits plan to see which preventive PREVENTIVE HEALTH 2003 GUIDELINES services are covered and to what Screening for Children – Normal Risk extent. All referenced health services may not be covered under a health Infancy Early Childhood Middle Childhood Adolescence plan. Check the terms of your AGE 2-3d 1m 2m 4m 6m 9m 12m 15m 18m 24m 3y 4y 5y 6y 8y 10y 12y 14y 16y 18y 9-21y health plan or policy for coverage History & Physical Exam, Hearing & Vision, of services. Annually Immunization Status Hemoglobin Electrophoresis

At birth

Ophthalmic Antibiotics

At birth

Phenylalanine

After 24 hours After 24 hours Infant by history and exam

T4/TSH Hearing Urinalysis Blood Pressure Height & Weight or BMI Head Circumference Anemia Screen

Once in age range

Vision for Amblyopia & Strabismus Tuberculosis

Once in age range High-Risk Populations

Lead Risk Assessment Chlamydia (sexually active females) Pap with pelvic (sexually active every 1-3 years) Active screen for Problem Drinking & Tobacco use

If sexually active If sexually active

Annually

Parents also can set a good example for their children by practicing healthy lifestyles themselves and teaching their children healthy habits — good nutrition, exercise, dental hygiene, safety, proper sleep, and avoiding tobacco, alcohol and drug abuse — to stay ahead of illness and disease. Please Note: These guidelines are evidence-based and provide the basics of preventive care for average patients. These guidelines are for normal risk. High-risk populations are not addressed. They do not replace clinical judgment. You should always consult your physician for medical advice.

Blue & You Winter 2003

W hether you are worried about the war or the weather, you are probably stressed out and anxious about something. It’s inevitable that you will experience some form of stress in your life. An important thing to keep in mind when dealing with stress is that stress, in itself, cannot directly affect you — it’s how you choose to respond to it. One thing is certain, if not properly managed, stress can have a harmful effect on your physical, as well as mental, health. Many things determine why individuals respond differently to stress. Sometimes there are biological or genetic reasons that cause them to be more vulnerable to stress. Age, personality, isolation and ethnic differences also can play a role in how an individual reacts to stress. Whatever the reason, people usually have their own way of dealing with it. Some turn to unhealthy habits like eating junk food, smoking, alcohol abuse or a sedentary lifestyle while others seem to be able to “roll with the punches.”

• Diabetes • Intensified arthritic/muscular aches and pains • Sleep disturbances • Sexual and reproductive dysfunction • Loss of concentration and memory • Skin conditions Any physical or psychological conditions that are out of the ordinary, such as cardiac symptoms, significant pain, severe anxiety or depression, should be discussed with a physician or psychologist. Stress, when appropriate and controllable, can stimulate interest and motivate individuals to greater achievements. On the other hand, a lack of stress can cause boredom and depression.

out?

Stressed

How to reduce the stress in your life

• Learn to say “no” when appropriate. You will gain more control of your life. • Develop a positive attitude. Your outlook on life will improve. • Try leaving 15 minutes earlier for appointments or work to avoid the rush. • Wear a smile on your face. Studies have shown that even if it’s “pasted on,” it’s a start to being happier. • Discuss your feelings with someone you trust. • Lay off the caffeine and other stimulants and don’t drink alcohol. • Exercise regularly. • Eat a healthy diet. • Practice relaxation techniques such as deep breathing, muscle relaxation or meditation. • Learn to delegate. • Realize there are things you cannot change. Just remember that stress in your life is here to stay. The best thing that you can do is to eliminate as much of it as you can, and learn to deal with the rest. By doing so, you’ll have an opportunity to lead a much healthier, more enjoyable life.

Stressed

Signs of stress • Anxiety • Constipation or diarrhea • Depression • Fatigue • Headaches • High blood pressure • Insomnia • Problems with relationships • Shortness of breath • Stiff neck • Upset stomach • Weight gain or loss

Results of stress • • • • • •

Heart disease High blood pressure Stroke Susceptibility to disease or illness Digestive problems Weight problems

Blue & You Winter 2003

— Sources: National Institutes of Health, The American Academy of Family Physicians and Nidas Information Services, Inc.

Take your medicine! Study shows poor adherence to doctor’s orders

measly 50 percent of people usually follow their A doctor’s orders when it comes to taking prescription drugs (and the rates are even lower for certain medical conditions). Only 43 percent of patients take their medications as prescribed to treat acute asthma; between 60 and 70 percent of people follow their doctor’s orders when it comes to taking their medication for depression; and only 51 percent of patients take their prescribed dose of medication for high blood pressure. These statistics, reported earlier this year by the World Health Organization, is a perplexing problem in medicine.

This phenomenon is one of the major reasons why drugs in clinical trials prove to be more effective than when they are in the hands of the patients. According to the research, there is no simple explanation on why people do not take their drugs as prescribed. Rich, highly educated people are just as likely to skip their prescribed medication as poor, less-educated people. Adherence to long-term therapy for chronic illnesses in developed countries averages 50 percent. The rate is lower for developing countries. Poor adherence to longterm therapies severely compromises the effectiveness of treatment making this a critical issue in population health both from the perspective of quality of life and health care costs. According to this study by the World Health Organization, in all situations where people must take their own medicine (usually at home), most do not take their medications as prescribed. There are many patient-related reasons for this problem. Some people may just have an inner rebellion to their doctor’s orders. Some simply forget. Some people do

not fill their prescriptions because of the expense. And probably the most likely reason is that people just don’t like the way the drugs make them feel and stop taking them. The patient-related reasons for lack of adherence are many. However, there also are other reasons for the problem of adherence, including the characteristics of the disease itself and the treatment prescribed, socioeconomic factors, and attributes of the health care system. There is no easy answer on how to improve patient adherence to doctor’s orders concerning prescribed medication. Just remember that you should always follow your doctor’s prescribed treatment for your illness, so you can quickly get on the road to recovery.

Currently, there is research under way to find ways to encourage people to adhere to their drug regimen and follow their doctor’s orders. At the National Institutes of Health, there currently are 35 trials under way. For more information about the World Health Organization study, visit www.who.int/chronic_conditions/adherencereport/en. — Sources: World Health Organization, National Institutes and the Wall Street Journal Blue & You Winter 2003

eing female and getting older are the two main risk factors for developing breast cancer. Clearly, these factors cannot be controlled. While there is no cure at this time, practicing good breast health habits is a woman’s best assurance of detecting and beating this disease. Make a promise to yourself to practice good breast health, and create a plan on how to do so. Breast cancer is the leading cause of death in women 40-59. Education and a personal commitment to put the education to work are essential for the early detection and early treatment of breast cancer, which lead to better chances of survival. There are three tried-andtrue steps to follow. As part of the educational process, the number “3” is emphasized when teaching breast health classes. Association with a number often makes things easier to learn. Therefore, remember the number “3” because there are three steps to breast health. Remember the following steps to breast health: 1) Monthly Breast Self-Exams (BSE) — starting at age 20, the monthly exam should be done approximately one week following the start of the menstrual period, and for

women who have reached menopause, the BSE should be done on the same day each month, 2) Annual clinical exams by a physician or nurse practitioner, and 3) Annual mammograms starting at age 40. Women who have a positive family history for breast cancer may be requested by their primary care physician (PCP) or gynecologist to obtain the baseline mammogram in their early thirties and not wait until later. If the PCP or gynecologist is not recommending annual mammograms, then women should request this test. It also is important to know that women can self-refer for screening mammography. However, when the procedure is completed, the facility must have the name of a physician to whom to send the results. These three steps are powerful and offer the best package women have today to protect themselves and to detect breast cancer early enough to have successful outcomes. The sooner a breast health program is begun and consistently followed, the greater the chances of survival. — Sources: American Cancer Society and the Susan G. Komen Foundation

F Y I on Pap tests A Pap test and pelvic examination are an important part of a woman’s routine health care. These tests can detect cancer or abnormalities that may lead to cancer of the cervix. Women should receive a Pap test at least once every three years, beginning about three years after they begin to have sexual intercourse but no later than age 21. If the Pap test shows abnormalities, further tests and/or treatment may be necessary. Blue & You Winter 2003

Approximately 55 million Pap tests are performed each year in the United States. Of those performed, about 3.5 million (6 percent) are abnormal and require medical follow-up. The primary risk factor for cervical cancer is the human papillomavirus (HPV) infection. HPVs are a group of more than 100 viruses. However, although HPV infections are very common, only a very small percentage of women with untreated HPV infections develop cervical cancer. If you have questions about the Pap test, please consult your physician. — Source: National Cancer Institute

Pssst! Want to know a simple way to hold

down your health care costs? It fast. It’s easy. And best of all, it’s cheap! Well, here it is — wash your hands! That’s right, by washing your hands frequently, you can wash away the germs you’ve picked up from other people, your pets and contaminated surfaces. At the same time, you’ll help cut your chances of getting sick. Everyday you pick up germs when you shake hands, stroke your pet or grab the door handle, and then you infect yourself when you touch your eyes, mouth or nose. In fact, that’s how most of us catch colds and pass the virus onto the next person. The next thing you know, everyone around you is getting sick. Good hand washing is your first line of defense against the spread of many illnesses — and not just the common cold. More serious illnesses such as meningitis, bronchiolitis, influenza, hepatitis A and most types of infectious diarrhea can be stopped with the simple act of washing your hands.

How to wash your hands You wash your hands every day, but are you doing it correctly? Here are some simple steps for scrubbing away germs. If you have small children, demonstrate this routine to them — or better yet, wash your hands with them several times a day so they learn a good habit. • Wash your hands in warm water, which kills germs better than cold water. • Use soap and lather up for about 10 to 15 seconds (antibacterial soap isn’t necessary — any soap will do). Make sure you get “in-between” places such as between fingers and under nails (where uninvited germs like to hang out). Don’t forget the wrists! • Rinse and dry well with a clean towel.

Wash your hands often You probably should wash your hands more often than you do now because you can’t see germs with the naked eye or smell them, so you don’t really know where they are hiding. It is especially important to wash your hands before,

W a s h t h o s e h a n d s !

during and after you prepare food; after handling animals or their waste; before you eat and after you use the bathroom; when your hands are dirty; and when someone in your home is sick. Did you know that it is estimated that one out of three people do not wash their hands after using the restroom? So these tips are especially important when you are out in public. Washing your hands regularly is one of the simplest things you can do to help control the rising costs of health care. Because it costs less than a penny, you could say that this penny’s worth of prevention might save you a $50 visit to the doctor.

— Sources: National Center for Infectious Diseases, Centers for Disease Control and Prevention and www.KidsHealth.com Blue & You Winter 2003

Blue & You Foundation awards grants to support health The Blue & You Foundation for a Healthier Arkansas

has announced its second annual grant awards totaling more than $1 million to 14 organizations to be used to support services to improve the health of Arkansans. Arkansas Blue Cross and Blue Shield established the Blue & You Foundation in December 2001 as a charitable foundation to promote better health in Arkansas. The Blue & You Foundation awards grants annually to nonprofit or governmental organizations and programs that positively affect the health of Arkansans. Particular emphasis is given to projects affecting health care delivery, health care policy and health care economics. “This is a step in the process we hope over time will lead to a state of better health in Arkansas,” said Robert L. Shoptaw, chief executive officer of Arkansas Blue Cross and Blue Shield and chairman of the foundation’s board of directors. “Working together for better health is part of our mission at Arkansas Blue Cross. By working with other organizations and agencies who share this commitment, we believe we can have an even bigger impact on the health of Arkansans.” Blue & You Foundation grants awarded for 2004 are: American Lung Association of Arkansas ($132,010) — to support the statewide “Arkansas Asthma Project,” which will provide asthma education programs to help asthmatic children. Arkansas Center for Addictions, Research, Education and Services (CARES) ($90,000) — to support “Building Bridges,” a pilot program targeting families affected by a mother’s substance abuse. Arkansas CARES is a program of the University of Arkansas for Medical Sciences Department of Psychiatry. Arkansas Center for Birth Defects Research and Prevention ($90,000) — to support an educational program to reduce the occurrence of folate-preventable birth defects in Arkansas. Bess Chisum Stephens YWCA ($50,000) — to support EncorePlus, a Central Arkansas program designed to reduce the Arkansas mortality rate of breast and cervical cancer. Crowley’s Ridge Development Council, Inc. ($7,775) — to support “CHOICES,” a program designed to reach kids who have experimented with drug use, in an effort to prevent the progression of the addiction. Delta Memorial Hospital ($95,000) — to launch a women’s health initiative in Southeast Arkansas, entitled Blue & You Winter 2003

“Link to Life,” which will address breast health, osteoporosis, prenatal and infant care. Focus, Inc. ($10,160) — to support the Northeast Arkansas Disability Health Education Conference to improve community-based care delivery to people with retardation, cerebral palsy, seizure disorder or autism. Guadalupe Prenatal Clinic ($50,000) — to support the clinic which provides low-cost prenatal services to increasing numbers of immigrant Hispanic women in Central Arkansas who have limited resources for care. Interfaith Clinic ($25,000) — to support an oral health initiative for the low-income, uninsured and underinsured people of Union County, designed to improve the delivery of dental care services in South Arkansas. KIDS FIRST/UAMS Department of Pediatrics ($119,000) — to support the statewide “Childhood Obesity: Impacting the Arkansas Epidemic” program, which is designed to improve kids’ health through early education and intervention. Kiwanis Activities, Inc. ($75,000) — to support the development of a wellness program through the Joseph Pfeifer Kiwanis Camp for students in the Little Rock School District. Northwest Arkansas Radiation Therapy Institute (NARTI) ($70,750) — to support the Men’s Healthcare Navigator Program for men with cancer. Safe Jonesboro Coalition ($78,824) — to support the coalition’s mission to protect the populations’ most vulnerable citizens, the young and the elderly, by distributing child safety seats and bike helmets, and providing screenings and assessment to prevent falls among the elderly. University of Arkansas, Division of Agriculture, Cooperative Extension Service ($107,716) — to support the “Arkansas Body Walk” program designed to teach healthy behaviors to Arkansas children, grades K-4, to help reduce the incidence of obesity and chronic disease resulting from poor eating habits, substance abuse and lack of physical exercise. The Blue & You Foundation received 77 grant applications requesting more than $6.9 million in support. The Foundation will accept proposals for its 2005 funding cycle any time between Jan. 1 and Aug. 13, 2004. For more information on applying for a grant, visit the Foundation Web site at www.BlueAndYouFoundationArkansas.org.

My BlueLine never sleeps, so you can rest easy

t Arkansas Blue Cross and Blue Shield, we want to make sure that you (our customer) get the information you need when you need it. With My BlueLine, you have access to customer service 24 hours a day, seven days a week. This enhanced benefit, designed specifically with you in mind, makes your personal health insurance information available with a simple telephone call. Additionally, this benefit is a result of many customer requests for telephone self-service. As a customer of Arkansas Blue Cross, Health Advantage or BlueAdvantage Administrators of Arkansas, you can get the answers to your questions anytime, day or night. My BlueLine is an interactive voice response (IVR) system that recognizes speech patterns to help answer questions when you call current customer service telephone lines. When you call a customer service line, My BlueLine will immediately answer the call (no waiting!). My BlueLine will ask questions and all you have to do is simply respond to the question. There are no buttons to push. You can get numerous questions answered quickly and easily anytime (My BlueLine is always at your service). The new system can help you if you have questions about status of claims and premium payments, and help you order a new ID card, provider directory or claim form. Benefit information is available through My BlueLine for Arkansas Blue Cross and Health Advantage customers. When you call, remember to have your ID card on hand. For privacy purposes, the system will ask you questions to verify your identity as the caller — such as your

member ID number as it is listed on your membership card. Also, if Arkansas Blue Cross does not have up-todate information on your home address, there could be a delay or the system may not be able to provide the requested information. In that case, the call will be transferred to a customer service representative during business hours or a voice mailbox (Arkansas Blue Cross and Health Advantage) after regular business hours. During regular business hours, you can request to speak to the next available customer service representative at any time during the telephone call by simply saying “customer service.” For Arkansas Blue Cross and Health Advantage customers who request “customer service” after hours, the call will be forwarded to a voice message mailbox to leave a message, and your call will be returned during regular business hours. If, during your telephone call to My BlueLine, you have trouble understanding what the system is asking, simply say “help” and My BlueLine will rephrase the question to better serve you. My BlueLine is an enhancement to help you get answers to your personal health insurance questions. However, because My BlueLine can’t help customers with all of their needs, Arkansas Blue Cross and its family of companies always will have customer service representatives available during regular business hours. Remember, another self-service option is My BluePrint available through our Web sites.

Coverage guidelines for FluMist E

ffective Jan. 1, 2004, the Arkansas Blue Cross and Blue Shield insurance policies, Health Advantage evidences of coverage and some self-insured group health plans administered by BlueAdvantage Administrators of Arkansas, which provide coverage for the influenza vaccination, will be amended to provide coverage for intranasally administered influenza vaccine, popularly know as “FluMist.” The contracted benefit for FluMist is subject to an annual limitation of $15, the cost of a preservative-free intramuscular injection

of influenza vaccine. For members who use this benefit, please remember that your physician may “balance-bill” you. That means that you will be responsible for any amount in excess of the reimbursement by your health plan. FluMist is a nasal-inhaled flu vaccine. There is no evidence that FluMist has more or less benefit than the injectable flu vaccine. The decision to use this drug is between you and your health care provider. Blue & You Winter 2003

The Phar macist is in Do you have any questions? T

hroughout the years, the American people have been subjected to a constant barrage of advertising (ranging from television ads to newspaper ads) from different pharmaceutical companies urging Americans to consume more medication. As a result, more and more Americans believe that medications are the answer to their physical and mental impairments. We have been subconsciously taught to think this way as more medications become available, and the promotional efforts have become more effective. It is becoming more common for people to contact their physician or pharmacist seeking medication rather than the best resolution for their health problem. Many are even telling physicians what medication they want. These statements should not be interpreted as disrespect for the magnificent advancements made through the research and development of new and improved pharmaceuticals. Medications are chemicals that are foreign to our bodies and, when ingested, should alter our bodily functions producing good results. The right amount, at the right time, used sparingly, is usually

positive and helps correct health problems. Too much too often can produce long-term dependence and sometimes harmful effects. We should all rethink our views on health and medications by: • Restructuring our thinking about our health. • Becoming more selective in our eating habits. • Improving our ability to limit stress in our lives. • Exercising our body in the appropriate manner and duration. • Relaxing, especially before trying to sleep. • Becoming more informed and consciously aware of our health. • Stopping occasionally, breathing deeply and enjoying life. • Tuning up our body and mind through non-chemical intervention. • Taking medication when necessary and properly supervised.

Leslie Wyatt, Ph.D., president of ASU, elected to Board of Directors James Leslie Wyatt, Ph.D., president of Arkansas State University (ASU) in Jonesboro, has been elected to the Board of Directors of Arkansas Blue Cross and Blue Shield. Wyatt is the 10th president of ASU, appointed in 1995, and oversees student welfare, operational policies and procedures, budget and fiscal planning, campus facilities, personnel, tenure and promotion of employees, legal issues, academic programs, and goals to improve the university and its eight campuses. “Dr. Les Wyatt brings to the Arkansas Blue Cross board a rich background in both organizational and community development, which spans multiple decades reflecting his personal commitment to the betterment of Arkansas and its citizens,” said Hayes McClerkin, chairman of the board of Arkansas Blue Cross. Prior to ASU, Wyatt served as vice chancellor for Executive Affairs for the University of Mississippi; as Blue & You Winter 2003

vice chancellor for University Advancement and as dean of the College of Fine Arts for the University of Arkansas at Little Rock; and associate dean of the College of Fine Arts for the University of Texas at Austin. In addition to numerous educational committee memberships and chairmanships, Wyatt serves as director of the Jonesboro Chamber of Commerce and Economic Development and the Jonesboro Industrial Development Corporation. He has served with the Development Committee of the Christian Counseling Center in Jonesboro and the American Arts Alliance, Washington, D.C. Wyatt earned bachelor’s degrees from Abilene Christian University and the University of Texas at Austin (UT), and his master’s degree and doctorate from UT. Wyatt and his wife, Jeanne, a Forrest City native, have three children.

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ince October 2003, members who have been approved for out-of-area coverage (example: students attending out-of-state colleges or universities) can use their Health Advantage ID card with any Blue Cross and Blue Shield participating provider throughout the United States. The toll-free number to locate a BlueCard participating provider is listed on the back of your Health Advantage ID card. Because about 85 percent of physicians and hospitals nationwide participate with Blue Cross and Blue Shield, this will give our members a broader coverage area. The benefits that

Health Advantage improves breast biopsy referral process Health Advantage now allows members who need a breast biopsy to obtain a referral from either a primary care physician or an obstetrician/gynecologist (OB/ GYN). This new policy is a result of requests from both OB/GYN providers and members. OB/GYN physicians now may refer members, who have had a positive mammogram and need a breast biopsy, directly to an in-network breast surgeon. This new referral process applies only to breast biopsy referrals.

Protecting D

your identity

ue to escalating identity theft problems, several states have passed laws restricting the usage of Social Security numbers (SSN), with some effective dates beginning in 2004. Recognizing this as a local concern, during 2004, BlueAdvantage Administrators of Arkansas and Health Advantage will begin the migration away from SSNs as part of the member ID number. Additionally, in 2004, the few employer groups with Arkansas Blue Cross and Blue Shield that use SSNs also will be converting. Watch for more communication in the new year on this subject.

Away From Home Care program replaced members currently have with their group plan will still apply. Claims are subject to review. If you are interested in applying for out-of-area coverage, please contact Customer Service to request an application. You will still be required to renew your membership on an annual basis. Renewals will be sent out at the time your group renews. If you have any questions regarding this change, please call Health Advantage Customer Service at 1-800-843-1329.

Proton Pump Inhibitor Changes Coverage changes for PPI drugs announced

T he recent action regarding the U.S. Food and Drug

Administration approval of Prilosec® 20mg for over-thecounter use as Prilosec® OTC will result in changes of coverage for the Proton Pump Inhibitor (PPI) class of drugs by Arkansas Blue Cross and Blue Shield, Health Advantage and all other pharmacy plans managed by Arkansas Blue Cross. The following changes were implemented on Nov. 15, 2003: • • • • • •

Prevacid® — Covered (third-tier copayment) Protonix® — Covered (third-tier copayment) Prilosec® — Not covered omeprazole — Not covered Aciphex® — Not covered Nexium® — Not covered

Blue & You Winter 2003

Get your kids off to a “lamb-tastic” new year A

s the calendar rolls over to a new year, many people are thinking about turning over a new leaf regarding their lifestyles … especially when it comes to health. Why not get your kids involved and help them learn important health lessons from Arkansas Blue Cross and Blue Shield’s health ambassador, BlueAnn Ewe, a big, blue sheep! The BlueAnn Health Clubs are part of the Arkansas Blue Cross Blue & Youth Health Program, a health education effort designed to improve the well-being of Arkansas citizens, beginning with the young people of the state. The BlueAnn Health Club is a free health club with a two-year membership, designed to provide individual children ages 5 to 10 with opportunities to learn about healthy lifestyles and participate in activities, with the goal of encouraging overall healthy behaviors and involving parents in the process. The club includes incentives and rewards for participating in activities. Members get an ID card and membership certificate, as well as a poster and two birthday cards. Following the initial Membership packet, Health Club members receive

quarterly packets which include a newsletter, activity sheet, special gift and a business reply envelope. Packets contain information and activities on health topics including: nutrition, exercise, safety, hygiene, dental health, emotions and drug/tobacco prevention. The BlueAnn Class Club is the classroom equivalent of the Health Club. This free club is designed for kindergarten, first- and second-grade classrooms. Teachers enroll their classes and utilize the club materials at their discretion. Membership is for one school year and also provides incentives and rewards for practicing healthy behaviors. Class Clubs get three packets of information and activities during the school year. The BlueAnn clubs are a fun way for kids to learn about healthy habits and put their knowledge into practice. Help get your kids off on the right hoof for 2004! If you are a parent or teacher and would like to enroll your kids or students in one of the clubs, please call toll-free 1-800-515-BLUE (2583). It’s fun. It’s free. And you can help your kids be their healthy best with the help of a woolly blue friend.

Arkansas Blue Cross and Blue Shield selected as claims processing contractor for Rhode Island A rkansas Blue Cross and Blue Shield has been awarded the Medicare claims processing contract for Rhode Island by the Centers for Medicare and Medicaid Services (CMS), previously the Health Care Financing Administration. As a result of the contract, Arkansas Blue Cross will process claims for Medicare Part A (hospital care, skilled nursing services and other provider services) and Medicare Part B (physicians, licensed practitioners and suppliers) in Rhode Island. Health care for seniors, the disabled and other Medicare beneficiaries in Rhode Island will not be affected by this change. The headquarters for the Rhode Island Medicare operations will remain in Rhode Island, and Arkansas Blue Cross will hire former employees of Blue Cross and Blue Shield of Rhode Island (BCBSRI), which formerly held the Medicare contract. The transition will take place Feb. 1, 2004. Arkansas Blue Cross will serve approximately Blue & You Winter 2003

170,000 beneficiaries in Rhode Island. Under the new contract, the enterprise will process claims for 125 providers and more than 9,300 physicians, suppliers and licensed practitioners in Rhode Island. Arkansas Blue Cross currently administers Medicare Part A and Part B programs in Arkansas and also administers Part B claims in Louisiana, Oklahoma, New Mexico and eastern Missouri. Arkansas Blue Cross also serves as the data center for contractors who process Medicare Part A claims for Alabama, Alaska, Maine, Maryland, Massachusetts, Mississippi, New Hampshire, North Carolina, Rhode Island and Washington. Arkansas Blue Cross also is the sole national maintenance contractor for the Medicare Part A Fiscal Intermediary Standard System (FISS) located in Florida. The company’s Medicare operations now have 850 employees in six states and handle 47 million claims and $4.3 billion in Medicare payments yearly.

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RESOURCE FOR CLINICAL ASSESSMENTS

(brought to you by the Blue Cross and Blue Shield Association)

he Technology Evaluation Center (TEC) of the Blue Cross and Blue Shield Association (BCBSA) has created a new Internet resource (www.bcbs.com/tec) to provide physicians, consumers and health care organizations with scientific assessments of medical devices, drugs and procedures, and to promote the use of scientific evidence in health care decision-making. It showcases a rolling threeyear inventory of TEC assessments on a variety of topics, including cardiovascular medicine, oncology and diagnostic imaging. The goal of this effort is to help people become more educated health care consumers through better understanding of the current scientific evidence on the effectiveness of treatments and tests. Founded in 1985 by BCBSA, TEC pioneered the development of scientific criteria for assessing medical technologies through comprehensive reviews of clinical evidence. Since its inception, TEC has been recognized nationally for leadership in producing evidence-based

NOW AVAILABLE ON - LINE

technology assessments. TEC’s Medical Advisory Panel, which oversees all TEC assessments, is composed of independent, nationally recognized experts in technology assessment, clinical research and medical specialties. The panel includes representatives recommended by the American College of Physicians, American College of Family Physicians, American Academy of Pediatrics and the American College of Surgeons. The Web resources will be updated as new TEC assessments are reviewed by the Medical Advisory Panel and published by BCBSA. The resource is designed for easy navigation, offering 15 searchable clinical topic areas, keyword searching and access to summaries of assessments in process — those recently reviewed by the Medical Advisory Panel and being prepared for final publication. Visitors also can sign up to receive e-mail alerts when new material is published on the Web site.

(Blue On-Line, continued from Page 24)

• Also, be sure to register on the Web site that corresponds to the company name on your ID card.

Haven’t received a password? You should allow five to 10 business days after registering to receive your password through the U.S. Postal Service. Passwords cannot be released by phone or e-mail because of privacy concerns. You may register again after 10 business days, but you may register only three times before the system locks you out. This precaution makes if difficult for a hacker to break into your account.

Can’t log in? Some people have tried to log in using the member number on their health plan ID card or a Medicare number. Remember that the log-in ID is the combination of letters and numbers given to you during My Blueprint registration. Don’t worry if you have misplaced your log-

in ID. You may retrieve it by entering the information from your member ID card again. Click on the link that says Forgot your log-in ID? The password that My Blueprint generates for you (the one you receive by U.S. Postal Service) is not easy to remember. You will be asked to change your password to something private and easy to remember after you log in the first time using the password you received in the mail. Don’t use passwords that are easy for others to guess, such as password, your name, your spouse’s name or your child’s name. If your password fails to let you in, remember that it is case sensitive. Capital letters must be used only where they appear in your computergenerated password. At the bottom of each menu page in My Blueprint, you’ll see a link called Contact Technical Support. If you have any problems, please fill out the simple on-line form to request help. Blue & You Winter 2003

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rkansas Blue Cross and Blue Shield strives to be a good corporate citizen. Our employees raise money and spend many hours helping those causes near and dear to the hearts of Arkansans. Calling all Kids It was time to start thinking about reading, writing and arithmetic at Clear Channel Communications on July 26 as more than 2,300 kids and their parents attended the Back-to-School Kids’ Expo at the Clear Channel MetroPlex in Little Rock. Parents took advantage of free health screenings for hearing and speech as well as free immunizations. Scholastics Books gave away free books to kids, and Office Depot and School Daze Uniforms Students get a healthy start at Kids’ Expo. were on site to make it easy for some parents to pick up needed school supplies. Kids could board a school bus to get an idea of what it would be like to ride before catching a ride for real. The Stamp Out Smoking program provided information about saying “no” to tobacco. The Little Rock Police and Fire Department also taught kids safety measures. James Kidd of Little Rock won the Arkansas Idol contest and received tickets to Los Angeles to see the final taping of American Idol Junior during the week of August 18. More than 200 kids signed up for BlueAnn’s Health Club, and six teachers signed up their students for the BlueAnn Class Club. Step Right up for JDRF “Diabetes … It’s a Three-Ring Circus” was the theme for the 2003 Walk to Cure Diabetes organized by the Greater Arkansas Chapter of the Juvenile Diabetes Research Foundation. The event was held September 20 in the River Market District of Little Rock with more than 2,500 walkers participating to raise awareness and money to support the work of JDRF in finding a cure for this disease. Family members and friends of children with

Blue & You Winter 2003

diabetes raised more than $285,000 for the cause. Corporate sponsors and neighbors, like Arkansas Blue Cross, joined the carnival-style campaign for a cure, with a 124-member employee team whose participation and fund-raising efforts contributed $9,900 to the bottom line. BlueAnn was on hand to raise spirits, and it was a perfect day to step BlueAnn makes friends with Chloe’s up and step out for Critters at the Juvenile Diabetes a cure! Research Foundation Walk.

Taking Flight for a Cure Have wings … will fly! The 10th annual Susan G. Komen Breast Cancer Foundation’s Arkansas Race For The Cure® on October 4, was a huge success. And the Arkansas Blue Cross Race and Three Miles of Men teams once again helped make the day a memorable one for the more than 37,000 participants who came together to raise awareness and more than $1 million to fund breast cancer research, education, screening and treatment. Playing off the 100th anniversary of aviation, the team was “aiming high for a cure” this year as it gathered on the flight deck at Sixth and Gaines and transformed the block into a “runway to a cure.” Three pink airplanes appeared to take flight down the runway (which was lined with about 80 pink reflectors atop the iron fence) … a skydiver floated overhead in a pink flight suit … encouraging words were offered to racers from a pink air traffic control tower … the Magnificent Blue Notes (the Arkansas Blue Cross band), entertained the race participants with music … the TMM team (dressed in flight-suit style T-shirts) manned a water station and distributed commercial airline-size packages of peanuts. It was a great day of remembrance and celebration.

www.ArkansasBlueCross.com www.HealthAdvantage-hmo.com www.BlueAdvantageArkansas.com www.BlueAndYouFoundationArkansas.org www.BlueAnnEwe-ark.com

t’s that time of year when you might need to review your medical claims to track annual expenses or determine whether it’s time for a checkup. Members of Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas can access their claims history for up to two years on most accounts by visiting My Blueprint, an on-line member self-service center. You’ll find a link to My Blueprint on each Web site’s home page (http://www.ArkansasBlueCross.com, http://www.HealthAdvantage-hmo.com, http://www.BlueAdvantageArkansas.com).

Need to register? It’s easy to register to use My Blueprint. The information from your health plan ID card is all you need to get started. After you enter this information, and My Blueprint verifies your identity, you will receive a log-in ID on screen. You should print this screen and save it because you will need the log-in ID to enter My Blueprint after you receive your password through the U.S. Postal Service.

Worried about privacy? The Arkansas Blue Cross family of companies has chosen this method of password delivery to ensure the privacy of your personal information and to comply with federal privacy regulations. The password is sent to the address we have on record for the policyholder, which is shown to you during registration. If your address is out of date, please call Customer Service to make the necessary changes. You’ll find the number to call on the back of your ID card. If your employer participates in BluesEnroll, our on-line large-group enrollment service, please ask your company’s human resources staff about updating your address. My Blueprint also uses encryption to protect the privacy of your personal information. For more information about encryption and other privacy protection measures, click on the Security and Privacy Policy link at the bottom of each page of My Blueprint.

Already registered? If you have already registered, simply enter your login ID and password to access My Blueprint. If you have lost your log-in ID, you may submit the information from Blue & You Winter 2003

your ID card again to retrieve it. If you have forgotten your password, click on the Forgot your password? link on the log-in page. You’ll be asked to answer the secret questions you selected when you registered to use My Blueprint. Then you’ll be prompted to change your password to something you can easily remember.

Problems registering? If you are having problems registering, you might be experiencing the following issues: • You must be a policyholder or subscriber (group plan member) to register. Dependents and spouses cannot register; but the policyholder or subscriber is allowed to see data for covered dependents or spouses. Exceptions are made when a spouse or dependent has made a written request for protection from personal harm through our Privacy Office. • If you are a new member, you cannot register until the effective date of your policy because your account is not active until that date. • Medicare members who have an Arkansas Blue Cross Medi-Pak policy may register, using the ID number on their Medi-Pak card. Entering a Medicare number on the My Blueprint registration form will return an error message. (Blue On-Line, continued on Page 22)

Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181

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