~ HealthConnect Blue is now available, P. 25 ~
Summer 2004
from the n e w s
s t o r i e s
HEALTH f r o m
a c r o s s
files t h e
c o u n t r y
Health Savings Accounts looking better for consumers
than basic preventive care, according to a new Institute of Medicine report.
According to USA Today, proponents of health savings accounts — tax-free accounts linked to high-deductible health insurance — were encouraged by new Treasury Department guidelines that say the accounts could be used to cover some preventive services and prescription drug costs. (Note: Arkansas Blue Cross and Blue Shield will begin offering a health savings account, called HSA Blue PPO, in August.)
Medicare Web site to provide comparative data on retail prices of prescription medicines
Kids, parents getting less sleep Children are sleeping less than experts recommend, and many parents are not happy about it, according to a survey of American households by the National Sleep Foundation. The foundation, an independent organization that supports sleep education, announced that its annual survey found that children, from newborns to fifth-graders, are getting one to two hours less sleep every 24 hours than is recommended.
TV linked to shorter attention span in children USA Today recently reported that the more infants and toddlers watch television, the more likely they are to have trouble paying attention and concentrating during their early school years. Although there has been other research on how many hours of TV very young kids watch, this is the first study on how early viewing might affect attention span. The American Academy of Pediatrics recommends no TV for children under the age of 2 and no more than two hours a day of high-quality programming for older kids.
The New York Times recently reported that Medicare will soon publish detailed information comparing the prices of most prescription drugs, shining a bright light on some of the biggest secrets in the health-care industry. Economists and federal officials say the information, intended to help Medicare beneficiaries, also could be immensely useful to other consumers, as well as to private insurers and employers who provide drug coverage to employees and retirees.
Safety, cost concerns rise as obesity surgeries soar According to The Washington Post, the number of overweight Americans resorting to stomach-shrinking surgery is rising so rapidly that health experts and insurance companies increasingly are becoming alarmed about the safety, effectiveness and mounting costs of the operations. While the operations can produce dramatic benefits for very obese people, some hospitals and surgeons may be rushing too quickly to satisfy the surging demand, offering the lucrative procedures without adequate training, experience and support, experts say. To try and resolve some of these issues, the National Institutes of Health has launched a five-year, $15 million research project to gather data about the operations, identify patients most likely to benefit and learn more about how they work.
Lack of understanding contributes to cost of care According to Modern Physician, about half of the nation’s adults, or approximately 90 million men and women, have difficulty understanding or acting on health information they encounter every day, making them far more likely to rely on expensive emergency services Blue & You Summer 2004
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), BasicBlue®, 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: 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, healthcare professionals and other persons interested in health care and wellness.
Blue & You Summer 2004
INSIDE THIS ISSUE
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~Summer 2004~
From the Health files .................................. 2 Teaching teens healthy habits ....................... 4 Teens need checkups, too ............................ 4 Sleep: vital for a healthy teen........................ 5 Epidemic of teen obesity.............................. 6 Recognizing eating disorders ........................ 7 Preparing for peer pressure ....................... 8-9 Standing up to scoliosis............................. 10 Coping with learning disabilities .................. 11 Skin-care struggles .............................. 12-13 Teen safety issues ............................... 14-15 Anabolic steroids are risky business.............. 16 STDs and teens; Beware of backpacks? ............... 17 A time of change ..................................... 18 Top four customer needs addressed .......... 20-21 “Don’t Start” winners announced ............. 22-23 Blue & You Foundation issues annual call ....... 23 BluesEnroll going strong ............................ 24 Health Advantage is 10! ............................. 24 HealthConnect Blue now available ................ 25 My BlueLine at your service ........................ 26 Introducing Short-Term Blue........................ 27 Measuring up in customer service ................ 28 New ID numbers, no more SSNs .................... 28 The pharmacist is in; ScriptSave ..................... 29 Financial information privacy notice ............. 30 New member discounts .............................. 30 Blue & Your Community ............................. 31 Blue Online ............................................ 32 Vice President of Advertising and Communications: Patrick O’Sullivan Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer: Gio Bruno Contributors: Chip Bayer, Tammi Bradley, Janice Drennan, Damona Fisher and Kathy Luzietti
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Teaching teens healthy habits
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he teenage years can be formidable for both the parent and the child. While parents want to keep their teenagers close to protect them from worldly pitfalls, teenagers are anxious to have control of their own lives. It’s a difficult balancing act for the parent to maintain some authority, yet give their teenager the independence he or she desires. But when it comes to the health of their teenager, parents should exert their influence. This issue of Blue & You gives tips and information on how parents can help their teenagers maintain healthy habits by setting a good example themselves as well as helping their teenager practice healthy behaviors. A teenager who understands and follows good health habits will more than likely keep those healthy habits into adulthood. According to the Centers for Disease Control and Prevention (CDC), the most common causes of death in the United States (in 2000) were tobacco, poor diet and physical inactivity, alcohol consumption, microbial agents (flu, pneumonia, etc.), toxic agents (pollutants), motor vehicle accidents, firearms, sexual behavior and illicit use of drugs. By simply scanning the list above, it’s easy to see how many of those causes of death are preventable. By helping your child learn to choose healthy habits and practice safety measures, you are guiding them
to last a lifetime
toward a long, productive and healthy life. Inside this issue of Blue & You, you will find information on nutrition and weight control, peer pressure, sleep, safety, skin care and much more to help you in your efforts to keep your teen healthy and fit. Parents, along with their child’s physician, can help teenagers understand the importance of choosing a healthy lifestyle that includes good nutrition, proper exercise and the practice of safety measures. The more teens understand about their bodies, health and surroundings, the more they will realize the importance of taking an active role in their own wellness efforts. Keep reading for an abundance of information to help get your teenager on the right track toward a long and healthy life.
Te enagers ne ed checkups, Parents are very conscientious when it comes to
making sure their babies and toddlers have regular checkups and immunizations. Practicing good wellness habits starts early. Remember that although your teenager seems almost grownup, it’s still important that he or she receives regular checkups through the teenage years. Health Advantage recommends these preventive health guidelines for adolescents. Always check with your health benefits plan to see which preventive services are covered and to what extent. All referenced health services may not be covered under a health plan.
to o
Check the terms of your health plan or policy for coverage of services.
PREVENTIVE HEALTH GUIDELINES Screening for Adolescents – Normal Risk
Please note: These guidelines are evidencedbased and provide the basics of preventive care for average patients. These guidelines are for normal risk. Highrisk populations are not addressed. They do not replace clinical judgment. You always should consult your physician for medical advice. Blue & You Summer 2004
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SLEEP: vital for a healthy teen
Many teens today perform an impressive juggling act
every day. They juggle school, sports, clubs, friends and jobs in a spectacular display almost worthy of Ringling Bros. and Barnum & Bailey’s circus. What they may neglect to include in the mix is sleep. With the time commitments necessary to keep all of their activities successfully in the air, there just isn’t enough left over to get a full night’s rest. Unfortunately, doctors and researchers agree that of all the important things on anyone’s list, sleep should be one of the top priorities. Sleep isn’t just the opposite of being awake; it is a function vital to the brain. During sleep the brain passes through a number of stages necessary for health. Sleep is brain food and, as such, is absolutely necessary. For every 90 minutes of sleep, the brain will go through four stages of sleep, from light to deep. The most important of these stages is known as Rapid Eye Movement (REM) sleep. REM sleep has been most closely related to learning and memory in proper brain function. During each cycle of these four stages the amount of REM is increased. So, while a person may only experience 10 minutes of REM sleep in their first hour of sleep, it is in the later hours of sleep, the seventh, eighth, or ninth hour of sleep, where they will get the majority of REM sleep. People who sleep only five to seven hours a night will disproportionately deprive themselves of REM sleep. This is why it is impossible to “catch up” on the benefits of lost sleep during the week by sleeping late or taking Blue & You Summer 2004
naps on the weekend. It would be far more beneficial to tack on an additional two hours of sleep per night. Most teens need nine hours of sleep nightly to foster optimum brain function. Unfortunately, they rarely average that much sleep, and it’s not entirely their fault. Recent studies have shown that many teens have trouble going to sleep early because their brains naturally work on later schedules. There are, however, some simple things that can help in developing proper sleep habits. • Have a regular bedtime and stick to it. • Try to stay on schedule even on the weekend. (Don’t go to sleep more than an hour or wake up more than two to three hours later than usual). • Don’t nap during the day. • Leave some time to unwind before bed. • Don’t exercise right before bed. • Avoid beverages with caffeine in the late afternoon and evening. • Get into bright light as soon as possible in the morning, but avoid it in the evening. (Bright light signals the brain that it’s time to wake up.) — Sources: kidshealth.org, keepkidshealthy.com and The National Sleep Foundation
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Too much food,
When compared to teenagers from 14 other industrialized countries, U.S. teens are more likely to be overweight, according to a study by two agencies of the U.S. Department of Health and Human Services (with input from other countries) that appeared in a recent issue of The Archives of Pediatrics & Adolescent Medicine. In the United States (according to the study): • 10.8 percent of 13-year-old girls and 12.6 percent of 13-year-old boys are likely to be overweight, and • 15.1 percent of 15-year-old girls and 13.9 percent of 15-year-old boys are likely to be overweight. In Arkansas, obesity also is on the rise among adults. In 1991, 12.7 percent of the population was
considered obese, but by 2001, that had increased 81 percent to 23 percent. For Arkansas teens, the news is not much better. Approximately 11 percent of students in the ninth through 12th grades are considered obese, and 34 percent of those same students describe themselves as overweight. Being overweight or obese puts teenagers at risk for diabetes type 2, hypertension, sleep apnea and other chronic health problems. Additionally, the Arkansas Department of Health statistics show that Arkansas ranks fourth highest in the nation for obese high school girls, third lowest in the nation for participation in physical activity and 11th overall for obese high school students. The percentage of children and teenagers who are overweight has tripled in the past 30 years, according to the Centers for Disease Control and Prevention
too little exercise Obesity epidemic threatens teen health (CDC). One-third of overweight students are so heavy they probably will have serious health problems later in life. For the first time, recent studies by the U.S. Agriculture Department now link obesity to soft drink consumption. The studies show that many students drink soda pops instead of eating healthy meals, and then eat more food later because they are still hungry. And if that isn’t enough, there’s one more thing nudging kids toward the top of the scale: the extinction of gym class. The CDC recently reported that from 19911997 daily participation in physical education dropped from 42 percent to 29 percent, and that almost half of all teens and young adults ages 12 to 21 get no vigorous exercise on a regular basis.
New BMI results in Arkansas According to initial data released from the Arkansas Center for Health Improvement’s analysis of the 2004 body mass index (BMI) assessments of public school students, approximately 40 percent of students assessed are either overweight or at risk of becoming overweight. The BMI testing is a result of a law that requires the public schools in Arkansas to record their students’ weights and heights and then send the results home to parents. Other initial data indicates that 38 percent of the state’s Caucasian students are either overweight or at risk of becoming overweight. Among African-American students, the number is slightly higher with 43 percent either overweight or at risk. The Hispanic population had the highest number of overweight or at-risk students with 47 percent. The initial data includes assessments from 730 of Arkansas’ 1,139 public schools. The complete data set will be released to the public in late June 2004.
How parents can help If parents are overweight, their teenage child is more likely to be heavy. So what can parents do to stem this tide, and help teenagers become healthy adults? Parents (Obesity, continued on Page 18) Blue & You Summer 2004
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Recognizing eating disorders Anorexia nervosa She isn’t acting like herself lately. Your teenage daughter is having trouble concentrating in school, and she’s always exhausted. She exercises excessively and rarely has time to eat. She looks too thin. If that description matches your teenage daughter, she may have an eating disorder known as anorexia nervosa or more commonly known as anorexia. Anorexia usually occurs in teenage girls and young women. It’s characterized by an intense fear of being fat. Someone with anorexia rarely eats at all, and the small amount of food she may eat becomes an obsession. She may weigh everything before she puts it in her mouth or compulsively count calories. Someone with anorexia wants to become as thin as possible, and no matter how thin she becomes, she still looks in the mirror and sees someone who is fat and needs to lose weight.
Bulimia nervosa A teenage girl with bulimia nervosa (or bulimia) doesn’t avoid eating. Instead, she eats large amounts of food in a couple of hours, then gets rid of it quickly by vomiting or taking laxatives. This is known as “binge and purge” behavior. This eating disorder commonly affects girls, teens and young women. Often, those with bulimia can be hard to spot because their weight may be average or above average.
What causes eating disorders? No one is really sure what causes eating disorders. Most girls who develop an eating disorder are between 11 and 14 years of age. At this point in their lives, many girls feel they don’t have much control over anything, so they resort to controlling the one thing they can — their own bodies. And even though it is normal, and healthy, for girls to gain some weight during puberty, some girls respond by becoming very fearful of this weight. Some girls may be more likely to develop eating disorders depending on their sports activities. Gymnasts, ice skaters, runners and ballerinas may feel pressure to lose weight. In their quest to make their bodies perfect, they may develop an eating disorder. Although it is unusual, teenage boys also may develop an eating disorder. For example, some sports Blue & You Summer 2004
(like wrestling) have specific weight categories, and participants may develop an eating disorder in response to the pressure of meeting the demands of their chosen sport. It’s easy to see why teens may be prone to developing eating disorders. Just turn on the television or flip through a fashion magazine. Some supermodels and actresses are often extremely thin, far below what their natural weight should be.
Effects of eating disorders The effects of eating disorders can be devastating, and in some cases, life-threatening. When a girl weighs 15 percent less than the normal weight for her height, she may not have enough body fat to keep her organs and other body parts healthy. Someone with anorexia can damage her heart, liver and kidneys by not eating enough. Her body slows everything down as if it were starving, causing a drop in blood pressure, pulse and breathing rate. Anorexia can stop girls from menstruating; and their hair may fall out, fingernails may break off and a soft hair called lanugo may grow all over the skin — all very unattractive qualities. People with bulimia often suffer from constant stomach pain or may have damage to the stomach and kidneys. The constant purging can lead to “chipmunk cheeks” which occur when the salivary glands are permanently expanded, and the constant purging can lead to heart problems and even death.
Treatment With the help of professionals, teenagers with anorexia or bulimia can get well and learn to eat normally again. Along with health-care professionals, parents and other family members can help the patient see that her normal body shape is perfectly fine, and that she doesn’t have to be thin to make herself and others happy. — Source: KidsHealth.org, The Nemours Foundation
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Preparing for
peer pressure P eer pressure is more than a phase. Even as adults, we feel pressure in various situations. Just think (and remember) how much more difficult it is for teenagers to refuse to follow the crowd. Whether peer pressure leads to riskier behaviors (smoking cigarettes or drinking alcohol) or just irritating trends (low-cut jeans or pink hair), it is a powerful reality. Studies show that teenagers do value the opinions of their parents, and parents do have tremendous influence over their children, especially teenagers. Parents should not feel powerless in the face of peer pressure. Make sure your opinions are well known to your child, and maintain your expectations. Pick your battles with your teenager. Keep your standards as far as grades and behavior are concerned. Don’t nag about the state of her room or the length of his hair. Save your energy. Know your teen’s friends, and know your teen’s friends’ parents. Regular communication between parents goes a long way in creating a safe environment for all the teens in a social circle. Parents can help each other keep track of the
teens’ activities without making the kids feel they are being watched. Respect your teen’s privacy. Many parents have trouble with this one because they believe whatever their teen does is their business. However, you are dealing with a young adult, and some privacy becomes their right. If there is a problem, you may want to invade your teen’s privacy to get to the heart of the problem. But the best modus operandi is — let them be. Your teen’s room and telephone calls should be private, and they don’t have to share every thought they have with you. You also can help your teen combat peer pressure by talking to them about how to avoid undesirable situations or people who break the rules. Teens who are not in situations where they feel pressure to do negative actions are far less likely to do them. Remind your teenager that there is strength in numbers. Tell them to bring like-minded friends to situations where they anticipate stressful peer pressure. Let your teenager know that it is OK to seek an adult’s advice. If you are not there to help, maybe there is another parent or maybe a school counselor to offer advice or intervene. And, remember to nurture your child’s self-esteem. Strong self-esteem helps teenagers make decisions and follow them, even if their friends do not think some choices are “cool.” Always be generous with praise, and avoid criticism that takes the form of ridicule or shame.
Smoking Many teenagers begin smoking because they have friends or older siblings who smoke. Teens may think it makes them look older or look at it as a way to get through parties or other difficult social situations. Teenage girls may think of it as a way to keep their weight under control. Sometimes teens begin smoking because one or both parents smoke. They get the message that smoking is an acceptable habit. Others smoke because it isn’t accepted in their families, and it shows they are making their own decisions. Whatever the reason teens start smoking (and 90 percent of adult smokers started as teenagers), it’s never easy to stop. Explain to your teenager why smoking is bad for him or her, and how to say “no” to an offer of a cigarette. If a friend offers them a cigarette, there’s no need to get in an argument … just a simple “no” or “I don’t like it” or “I want to stay in shape for soccer” is enough. Remind your teenager about the “ugly” side effects of smoking. For example, smokers stink. The smell of tobacco lingers in hair and on breath. And, smoking is expensive. Buying one pack of cigarettes per day costs between $4 and $6 depending on where you live. Smoking causes teeth to turn yellow and causes the skin Blue & You Summer 2004
to age prematurely. If your teen is an athlete, he or she would find it difficult to compete if smoking became a habit. Smokers have a rapid heartbeat, decreased circulation and shortness of breath. Smokers are more likely to miss a big game because they get more colds, flu, bronchitis and pneumonia. And, worst of all, smoking causes cancer. Teenagers should realize approximately three out of every four teenagers do not smoke. Everyone doesn’t do it.
Alcohol & Drugs More than likely, teenagers know the facts about alcohol and have been exposed to their parents’ attitudes and beliefs about substance abuse. Teach your teen various approaches to dealing with offers of alcohol or drugs. • Teens must ask questions. If an unknown substance is offered, ask what it is and where the person got it. • Teens can explain their refusal to accept alcohol or drugs by simple explanations such as “I’m going to see a movie later” or “I don’t want to have a hangover.” • Tell your teenagers to offer alternatives to suggestions of drinking or taking drugs such as going to get pizza or renting a movie. • Remind your teenager to leave situations that make him or her uncomfortable. Make sure your teenager has money for transportation or access to a telephone where he or she can reach you or another responsible adult. • Tell your teenager that he or she must NEVER accept a ride from someone who has been drinking or taking drugs. Some parents find that offering to pick up their teen if they are in an uncomfortable situation — no questions asked — encourages kids to be honest and call when they need help. Teenagers who have problems with self-control or who have low self-esteem are more likely to abuse alcohol or drugs. Additionally, teens who do not connect well with their families or who feel they are different also may be at risk. Parents can do plenty to help their teen make the right decision when it counts. Be a good role model. Blue & You Summer 2004
Strong self-esteem helps teenagers make decisions and follow them, even if their friends do not think some choices are “cool.”
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Educate yourself about alcohol and drug abuse. Build your teen’s self-esteem. Teach your teen to manage stress in healthy ways such as by talking to an adult or engaging in a healthy activity (such as walking). And, above all, love your teenager unconditionally. — Sources: KidsHealth.org, The Nemours Foundation, U.S. Department of Health and Human Services/Center for Substance Abuse and Prevention and the American Cancer Society
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Standing up to scoliosis
veryone’s spine curves a little — it’s necessary to move and walk correctly. However, three out of every 100 people have a condition known as scoliosis, in which the spine (or backbone) curves too much. Scoliosis is a musculoskeletal disorder in which there is a sideways curvature of the spine. The curve, generally S- or C-shaped, also can occur back-to-front or topto-bottom. Scoliosis is not a disease — it is a descriptive term. There are many forms of scoliosis. Four of the most common forms are: congenital scoliosis (a rare form that develops in infancy because of a congenital malformation); neuromuscular scoliosis (occurs due to weakness of the spinal muscles or neurologic problems); degenerative scoliosis (develops later in life as joints degenerate causing a bend in the back) and the most common form, idiopathic scoliosis (develops during adolescence). Scoliosis does not result from carrying heavy things, athletic involvement, sleeping/standing postures or minor differences in leg length. More than 80 percent of all scoliosis cases are idiopathic, meaning there is no known cause. Most idiopathic scoliosis develops in children between 10 and 18 years, when the growth rate of the body is the fastest. Scoliosis with significant curvature of the spine is much more prevalent in girls than in boys. Additionally, girls are eight times more likely to need treatment for scoliosis, as they tend to have curves that are much more likely to progress. Still, the majority of all cases of scoliosis do not require treatment. Because idiopathic scoliosis can develop slowly, it may not be noticed until a youngster is 10 to 14 years old. The most common physical symptoms are: • One shoulder is higher than the other; • One shoulder blade sticks out more than the other; • One side of the rib cage appears higher than the other; • One hip appears higher or more prominent than the other, or • The waist appears uneven. To verify that a child actually has scoliosis, a health professional might conduct a simple physical examination called the forward-bending test. During this painless examination, the
child bends forward with knees straight and fingertips touching the floor, while the spine is checked for abnormal curvature. (Almost half of the public schools in the United States are required to test for scoliosis.) If scoliosis is suspected, an X-ray may be performed to confirm the diagnosis. After the X-ray, if necessary, a measurement called the Cobb angle is used to determine the curvature of the spine in degrees. A scoliosis of 10 to 15 degrees means that nothing needs to be done, except for regular checkups until maturation and growth are complete. If the curve is 20 to 40 degrees, the orthopedist will generally suggest a back brace. A Cobb angle of 40 or 50 degrees or more may mean that surgery is necessary. Nearly one in five teens with scoliosis needs to wear a back brace, which acts as a holding device to keep the spine from developing more of a curve. A brace won’t ever make the spine straight, but it can prevent the curve from increasing more than five or 10 degrees. Fortunately, braces are becoming more sophisticated and more comfortable all the time. In cases where surgery is necessary, an orthopedic surgeon removes tiny pieces of bone from the patient’s pelvis and inserts them in between the vertebrae in the spine to provide stability and to prevent further side-toside curving of the spine. The surgeon also adds a metal rod, hooks and wire to keep the spine straight until the bits of bone join. The patient can resume most activities within six weeks and even contact sports within a year. It’s important to remember that with proper treatment almost every teen with scoliosis can enjoy an active, normal life. They can participate in sports, work after-school jobs and for the most part, do whatever teenagers without scoliosis can do! Teens with scoliosis want to be treated the same as other teens because they are like all other teens. — Sources: Scoliosis Research Society, National Institute of Arthritis and Musculoskeletal and Skin Diseases, KidsHealth.org, scoliosis.com and Spine-health.com
Blue & You Summer 2004
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earning disabilities affect one in 10 children. Most of these conditions remain with them throughout adolescence and adulthood. If diagnosed early, most of them are treatable, making it possible for a normal lifestyle. If left alone, these conditions can cause a range of problems and have a “snowball” effect. For example, a child who does not learn addition in elementary school cannot learn algebra in high school. This can lead to frustration and emotional problems such as low selfesteem. Many children with learning disabilities begin to misbehave in school because they would rather be thought of as “bad” than “dumb.” It is important to understand that people with learning disabilities typically have a normal range of intelligence. They are not “dumb.” Rather, learning disabilities are caused by a difficulty within the nervous system that affects receiving, processing or communicating information. The problem can be as much physiological as it is psychological. Or, in laymen’s terms, they are just “wired” differently. The typical signs of most learning disabilities include: • Difficulty understanding and following instructions. • Trouble remembering what someone has just said. • Failure to master reading, spelling, writing or math skills. • Difficulty distinguishing right from left. • A tendency to reverse letters, words or numbers. • A lack of coordination in walking, sports or small activities. • Easily misplacing items.
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The presence of one of these signs is not necessarily an indication of a learning disability. However, with more than one of these signs a comprehensive evaluation by an expert may be recommended to determine if a learning disability is the problem. Two of the most common learning disabilities among children and teens are dyslexia and attention deficit hyperactivity disorder (ADHD).
Dyslexia A person with this particular learning disorder has trouble processing or understanding words or numbers. Dyslexia (which gets its name from two Greek words: dys, meaning impaired, and lexis, meaning language or words) is a condition that often runs in families. Approximately 100 years ago, doctors first identified the problem and believed it was caused by poor vision. Now,
Helping teens cope with learning disabilities researchers know dyslexia occurs because of the way the brain is formed, which affects the way information is processed. A common misconception is that a person with dyslexia reverses letters and numbers. Actually, this happens as a normal part of development and is no more frequent in people with dyslexia than in others. Researchers have found that the real problem is recognizing phonemes, which are the basic sounds of speech. People with dyslexia often have trouble associating a letter with the sound it makes. Also, people with dyslexia may mix up the letters in words and, for example, read the word “won” as “now.” They also may blend words together. (Learning disabilities, continued on Page 19)
Blue & You Summer 2004
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een years are trying times when it comes to skin care. The choices that teenagers make about skin care can improve their health today and prevent serious problems later in life.
Treatment Advances Reduce Acne Agony Nearly 85 percent of 12- to 24-year-olds face the acne battle, but the degree of severity varies from person to person. Acne should be taken seriously because of the physical and emotional scarring it can cause. Acne results from the action of hormones on the skin’s oil (sebaceous) glands. These glands are connected to canals called follicles, each of which contains a fine hair and opens onto the surface of the skin through a pore. A variety of lesions may appear on the skin after hormones cause sebaceous glands to produce excess, pore-clogging sebum, an oily substance that normally empties onto the surface of skin through pores. The basic acne lesion, called a comedo (KOM-e-do), is an enlarged and plugged follicle. Bacteria that normally live on the skin grow in the plugged follicle. If the lesion stays beneath the skin, it is a closed comedo and forms a white bump called a whitehead. If it reaches the skin surface and opens, it is called a blackhead because it looks black; but the black color is not caused by dirt. More serious lesions may form and become inflamed, infected and painful. Several myths are related to acne: • Certain foods, such as chocolate or french fries, often receive blame as a cause of acne; but foods have little relationship to acne in most people. • Acne is not caused by uncleanliness. In fact, frequent and vigorous scrubbing worsens acne. • Stress does not cause acne. Changing hormone levels in females, associated with the menstrual cycle, can cause an acne flareup. Environmental factors, such as air pollution and high humidity, also may exacerbate acne. Over-the-counter medications may work for mild acne, but those with severe cases should seek help from a family practitioner, pediatrician or dermatologist. Early treatment helps prevent scars, and newer prescription medications are highly effective. Treatment options include:
Teens’ skin-care struggles • Over-the-counter medications (benzoyl peroxide, resorcinol, salicylic acid and sulfur): Benzoyl peroxide kills bacteria and may reduce oil production. Resorcinol, salicylic acid and sulfur help break down blackheads and whiteheads. • Topical prescription medications (antibiotics, benzoyl peroxide, tretinoin, adapalene, azelaic acid): Antibiotics and azelaic acid stop or slow the growth of bacteria and reduce inflammation. Tretinoin, a retinoid, stops development of new comedones by unplugging follicles so that other topical medicines can enter them. The retinoid-like drugs tazarotene and adapalene decrease comedo formation. With use of these prescription drugs, acne may look worse for the first four to eight weeks of treatment. Stinging, burning, redness, peeling, scaling and discoloration may result and discourage the user, who often stops using the medication before it starts improving the acne problem. The side effects usually decrease or go away after this initial period, and the treatment becomes highly effective. Teenagers need to be encouraged to stick with the treatment plan long enough to give the medication time to work. • Oral prescription medications: A physician may prescribe oral antibiotics in severe cases of acne. Topical medicines are usually combined with this treatment. A physician also may prescribe the powerful oral retinoid isotretinoin (Accutane), which reduces the size of oil glands and, as a result, the growth of bacteria. Dermatologists often prescribe this drug for those who have severe nodules and cysts. The acne usually goes away or is significantly reduced in 90 percent of patients after 15 to 20 weeks of treatment with isotretinoin. It usually prevents scarring. A physician must monitor patients who are taking isotretinoin for possible serious side effects. It can cause birth defects, so females who might become pregnant should not use it or use two effective forms of birth control for a Blue & You Summer 2004
can have serious consequences month before treatment, during treatment, and a month following treatment. Proper skin care can lessen the severity of acne outbreaks and decrease their frequency: • Clean skin gently; don’t scrub. Wash with mild soap twice daily and pat dry. • Follow cleansing with one of the recommended topical medications. • Avoid touching or rubbing the areas where acne most often occurs (face, neck, back, chest, shoulders). Tight collars, bike helmets and even pressure from a backpack can worsen acne. • Don’t pick, squeeze or pinch blemishes. • Shave carefully and avoid nicking blemishes. • Avoid sunlight. Many acne medications make a person more sensitive to sunlight. • Choose cosmetics labeled noncomedogenic and look for oil-free cosmetics and hair products.
Sunlight/Sunlamp Exposure = Skin Damage Another skin problem most teenagers don’t even realize they have is ultraviolet (UV) light exposure, which can lead to the serious health problem of skin cancer later in life. In fact, melanoma, the most serious form of skin cancer, is the most common cancer among 25- to 30year-olds. Skin cancer usually results from UV exposure from the sun (or sunlamps) before the age of 18. Skin doesn’t have to be badly sunburned to be damaged, and damage accumulates with each exposure. There is no safe tan. Tanned skin is damaged skin. Tanning salons and sunlamps are not safer than the sun and may cause even more damage than sunlight. Tanning booths emit both UVA and UVB rays. UVB rays cause sunburn, but UVA rays penetrate deeper into the skin. Recent studies have shown that the exposure to UVB rays in tanning beds is about equal to exposure to sunlight, but exposure to UVA rays is 10 to 15 times higher. These high UVA levels correspond to an overall Blue & You Summer 2004
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UV “index” of 13, whereas the average index on a hot summer day is 8.5. An index above 6 is considered high. In spite of the risks, teenagers continue to tan. The American Academy of Dermatology (AAD) surveyed more than 10,000 young people (ages 12 to 18) from 50 states recently and found that only 34.4 percent of them used sunscreen. The AAD found that 83 percent of the teens surveyed had experienced at least one sunburn in the previous year. Of those, 36 percent had experienced three or more sunburns during that period. Recent research indicates that UV radiation damages skin cells in two ways. First, it damages cells, and they follow a natural repair mechanism that causes them to “commit suicide.” That’s why the skin peels after a burn. Some damaged cells do not die, however, because their repair mechanism is impaired. As normal cells die and abnormal ones survive natural cleanup, genetic damage accumulates. Prevention of skin damage from UV exposure is simple: • Avoid midday sun when exposure is more intense. • Seek shade. On the beach, an umbrella or tent is helpful. • Use sunscreen of SPF 15 or higher with both UVA and UVB protection. Apply generously about 30 minutes before sun exposure and reapply every two hours or more frequently if you are sweating or getting wet. Sunlight can damage unprotected skin in as little as 15 minutes. Skin might not show damage for up to 12 hours after exposure. Remember that clouds filter but do not block UV rays, so use protection even on cloudy days. • Cover up with clothing made of tightly woven fabric. • Wear a hat when you’re in the sun. The best choice is a hat that shades the face, scalp, ears and neck. Teenagers often wear baseball caps, which are not as protective but better than no hat at all. • Wear sunglasses that block UV rays. Look for a rating close to 100 percent for both UVA and UVB rays. — Sources: National Center for Chronic Disease Prevention and Health Promotion, National Institute of Arthritis and Muscokeletal and Skin Diseases, American Academy of Dermatology Public Resources and U.S. Food and Drug Administration
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Your teen:
he teenage years are a time of exploration and T new experiences — cars, concerts, chat rooms and cell phones. But the distance between 12 and 20 years doesn’t have to be a catastrophe. Teaching your teens some safety basics (and reinforcing the lessons) is an important way to help them through the transition to adulthood. Safe practices apply to every facet of life. Here are just a few to THINK about.
Safe Surfing Instant messaging is the 21st Century telephone call for many teens, and the Internet is the primary substitute for encyclopedias these days. But it’s important to remember that there are good and bad aspects of the Internet. Chat rooms can be fun, but they can be dangerous as well, because the users are anonymous. Chat rooms sometimes can attract people who are interested in more than just chatting. Information about family, friends, addresses and other things can be shared innocently and then used maliciously. On the Internet, it’s hard to tell if someone wants personal information in order to send you advertisements, or if their intentions are of a darker nature (e.g. to initiate illegal/indecent relationships or to harm a person’s or family’s well-being). Here are some guidelines to use while surfing the net to stay safe: • Keep all private information private — never give out full name, home address, telephone number, Social Security numbers, passwords, etc. • Think carefully when creating an e-mail address or screen name. • In chat rooms, use a nickname different from your screen name. • Consider setting up private chat rooms for friends. • Keep online friendships online; no face-to-face meetings. • If you don’t recognize the sender of a document that asks to be downloaded, don’t open it. It could contain a computer virus. THINK. Use common sense to remain in control on the Internet.
the object
The Wheel Deal Many things cause auto accidents including weather, reckless driving, speeding, drinking and drug use, and road rage. With teenagers, driver mistakes, speeding, multiple passengers, nighttime driving, and low seat belt use cause most motor vehicle accidents and injury, according to the Insurance Institute for Highway Safety. Driver-education programs are a great way to help teenagers learn driving skills. Learning the rules of the road, practicing driving, remembering to be safe and using good judgment will make driving more enjoyable because your teen is protecting himself or herself and others. Some driving “Dos and Don’ts” include: • Drive a safe, sensible vehicle; always wear a seat belt. • Take along only as many passengers as there are seat belts in the car. • Obey all speed limits and rules of the road. • Make sure the intersection is clear when the light turns green. • Obey curfews and allow enough time to reach a destination. • Don’t blast the radio; it could interfere with sounds that need to be heard. • Don’t drink and drive; don’t ride with anyone who has been drinking. Don’t take drugs and drive; don’t ride with anyone who has been using drugs. Remember that some over-the-counter medications can make you drowsy, so check the labels. • Don’t talk on a cell phone, put on makeup, comb hair or eat while driving. Pull off the road to a safe spot and park, if it is necessary, to make a telephone call. • Don’t allow friends or other uninsured drivers to drive the car. THINK. Don’t drive like you own the road; drive like you own the car. There aren’t any “do overs” when it comes to vehicle crashes.
Piercing Problems and Tattoo Troubles Body art has become popular for lots of people, including teens. Body piercing and tattoos have become a form of self-expression. But is it safe? Are they a good idea? What should your teen be aware of if he or she should decide to do it? Blue & You Summer 2004
of your protection Body piercing is a puncture made in your body by a needle. A piece of jewelry then is inserted into the puncture. Most commonly pierced body parts seem to be the ears, nostrils and the belly button. But people also pierce their lips, eyebrows, tongues, cheeks and “other” places. A tattoo also is a puncture, a wound, made deep in the skin (not the skin’s surface or epidermis), that is filled with ink to make a design — and is made to be permanent. Tattoos are done manually or with a tattoo machine and may take hours to do. Parents, talk about this subject with your teen. Teens, if you are considering getting a piercing or a timeless tattoo, do your homework and talk it over with a parent. • Many places won’t allow people under 18 to get a piercing or a tattoo without parental consent. • Find out what risks are involved and how best to protect yourself from infections and other complications. Infection is a common complication of mouth and nose piercings because millions of bacteria live there. Tongue piercings can damage teeth over time. Tongue, cheek and lip piercings can cause gum problems. • People with certain types of heart disease might have a higher risk of developing a heart infection after body piercing. If you have allergies, diabetes, skin or immune system disorders, or infections, or if you’re pregnant, ask your doctor before getting a piercing or tattoo. If you’re prone to keloids (overgrowth of scar tissue), it’s probably best to avoid piercings and tattoos. • Make sure your immunizations are up to date (especially hepatitis and tetanus). • Make sure the piercing or tattoo shop is safe and sanitary. Most states don’t regulate these shops (call your local health department). Make sure the staff takes proper precautions against infection and other health hazards. Check out the shop’s procedures (autoclave sterilizing machines and instruments in sealed packets) before you pierce. • Make sure the tattoo artist is a licensed practitioner, and be sure the studio follows the Occupational Safety and Health Administration’s Universal Precautions. Healing times may vary for piercings and tattoos. If all goes well, you should be fine after a body piercing except for some temporary symptoms, including some pain and swelling at the pierced area. But be aware that Blue & You Summer 2004
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several things can go wrong in some cases, including chronic infection, prolonged bleeding, scarring, hepatitis B and C, tetanus, skin allergies, abscesses or boils, inflammation or nerve damage. Take care of the skin around your new piercing; keep it clean, but do not use hydrogen peroxide. Don’t tug at it. Seek medical attention if you develop infection or the area does not heal. For tattoos, keep the bandage on the area for up to 24 hours; don’t touch it or pick at any scabs that may form. Use antibiotic ointment on the tattoo but not petroleum jelly. Try not to get a tattoo wet until it fully heals and stay out of the sun. Use an ice pack if you see redness or swelling around the tattoo. Even after it’s healed, a tattoo is more susceptible to the sun’s rays, so it’s a good idea to always keep it protected from direct sunlight. Tattoos can hurt. Getting a tattoo involves being stuck multiple times with a needle. You probably will bleed a little. Remember, a new tattoo is a wound and it is at risk for infections and disease. Some people are allergic to the tattoo ink. If you already have eczema, you may have flare-ups as a result of the tattoo. Even though there are new techniques available to “remove” tattoos, such as laser procedures, completely obliterating a tattoo may be difficult and is not always guaranteed. You may not be able to donate blood within a year after a piercing or a tattoo because both procedures can transmit blood-borne diseases, such as HIV, hepatitis B and C. If for any reason, you don’t feel comfortable about the shop or studio, or anything looks out of the ordinary … leave. THINK. Impulsive purchasing does not apply here. Getting and maintaining a body piercing or tattoo requires some responsibility. — Source: KidsHealth.org, The Nemours Foundation
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Anabolic steroids are risky business
In today’s sports-crazed society where athletes are
paid more than the president of the United States … it’s almost easy to understand why impressionable teenagers might do anything do get that competitive edge when it comes to their favorite sport. Professional athletes seem to have it all — fame, money, admiration — just for being able to pitch faster, hit harder or kick farther. Teenagers with big dreams of playing a professional sport may not be happy with being a good athlete — they may want to be the best and also may feel pressure to excel from outside influences. Pressure combined with desire may lead some teenagers to an unfortunate conclusion — anabolic steroids are the answer to making their dreams come true. Most professional athletes are naturally gifted athletes that have worked hard at their chosen sport. Athletic performance has more to do with skill and hard work rather than popping a pill or chugging a “super drink.” Recent evidence suggests that steroid abuse among adolescents is on the rise. The 1999 Monitoring the Future Study, funded by the National Institute on Drug Abuse, estimated that 2.7 percent of eighth and 10th graders, and 2.9 percent of 12th graders, had taken anabolic steroids at least once. That is a significant increase from one year earlier when 2 percent of 10th grade students claimed to have taken anabolic steroids at least once. Steroids (sometimes referred to as roids, juice, hype, gym candy or pumpers) are the same or similar to certain hormones in the body. The body produces steroids naturally to support such functions as fighting stress and promoting growth. Steroids can be taken in the form of pills, powders or injections. Anabolic steroids are artificially produced hormones that are the same or similar to androgens, the male-type sex hormones in the body. The most powerful androgen is testosterone. Athletes sometimes take anabolic steroids because of their testosterone-like effects such as increasing muscle mass and strength. Another group of anabolic steroids, known as steroidal supplements, contains dehydroepiandrosterone (DHEA) and/or androstenedione (andro). Steroidal supplements often are sold
at health food stores or gyms. The effects of steroidal supplements aren’t well known, but it’s believed that, when taken in large doses, they cause effects similar to stronger anabolic steroids. Very little is known about the long-term effects on the body by these substances. Anabolic steroids have become popular because they may improve endurance, strength and muscle mass. Research has shown that they do not improve skill, agility or performance.
Dangers Anabolic steroids cause many problems. The less serious side effects include acne, oily hair, purple or red spots on the body, swelling of the legs or feet and persistent bad breath. The most serious side effects include: • Premature balding. • Dizziness. • Mood swings including anger, aggression and depression. • Hallucinations. • Paranoia. • Nausea, trembling and vomiting. • High blood pressure. • Greater chance of injuring muscles and tendons. • Aching joints. • Jaundice; liver damage. • Urinary problems. • Shortening of final adult height. • Increased risk of developing heart disease, stroke and some types of cancer. Specific risks for females include increased facial hair, development of masculine traits (such as deepening of the voice and loss of feminine body characteristics) and menstrual cycle changes. Specific risks for males include testicular shrinkage, pain when urinating, breast development, impotence and sterility. Teens may tell themselves they only will use steroids (Steroids, continued on Page 18) Blue & You Summer 2004
Are teens at risk for STDs? W
hen compared to adults, adolescents (10- to 19year-olds) are at a higher risk for contracting sexually transmitted diseases (STDs). Why? One reason is that teenagers are more likely to have multiple sexual partners rather than a single, long-term relationship. The higher occurrence of STDs also reflects the barriers teens face when it comes to prevention services — lack of insurance or other ability to pay, embarrassment, lack of transportation, discomfort with facilities or services designed for adults and concerns about confidentiality. It’s estimated that one in five people in the United States has an STD, and 25 percent of all new cases are in teens. STDs are diseases (or types of infections) easily spread from person to person, and are usually passed
BEWARE D oes your teenager struggle to get his backpack on or off? Does he or she have back pain, numbness or weakness? Does your teenager lean forward to carry his or backpack? If you answered yes to any of the above questions, his or her backpack may be too heavy. Most doctors and therapists recommend that teens should carry no more than 10 to 15 percent of their body weight in their backpacks. When a backpack is too heavy, teens may arch their backs or lean forward to compensate for the weight of the backpack. This stresses the muscles in the neck and back, increasing the risk of fatigue and injury. Additionally, using only one strap causes asymmetry of Blue & You Summer 2004
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through intimate sexual contact. It’s often impossible to tell if someone has an STD just by looking at him or her. Just as with many other diseases, prevention is the key. It’s much easier to prevent STDs than cure them. The only way to completely prevent STDs is to abstain from all types of sexual intercourse. If teens do engage in sexual activity, they must use a latex condom every time. Talk to your teenager about STDs. If your teenager is engaging in sexual activity, he or she must have regular checkups. If your teenager thinks he or she may have an STD, it’s important to seek medical attention immediately. STDs can lead to long-term problems (such as infertility) if left untreated. — Sources: KidsHealth.org, The Nemours Foundation and the Centers for Disease Control and Prevention
OF BACKPACKS? the spine and affects the spine’s natural shock absorption abilities. The safest backpacks offer two wide, padded straps for both shoulders, a padded waist belt or chest belt to distribute weight more evenly across the body, numerous compartments to distribute the load and is not wider than the teen’s torso. Limiting the weight of the backpack is key to preventing injuries. To limit the weight, make sure your teen is using his locker to store books and other items instead of carrying them throughout the day, and make sure your teen is not toting unnecessary items such as laptops, CD players, etc. If your teen continually complains about back pain, consult his or her physician for advice. — Source: KidsHealth.org, The Nemours Foundation
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A time of change
A
dolescence is a time of change, and the most important thing for parents to remember, and share with their young teenager, is that everyone is different. When the body reaches a certain age, the brain releases a special hormone that starts the changes of puberty. Usually, puberty starts sometime between the ages of 8 and 13 in girls and 10 to 15 for boys. Some kids may start puberty earlier or later. That is completely normal. During puberty, both boys and girls grow taller and reach their adult height. Teens usually gain weight, and there are changes in their overall body shape — girls get curvier and boys get wider shoulders. During puberty, their bodies began to develop adult characteristics, and teenagers become more aware of the opposite sex. Acne also is a sign of puberty, but it usually disappears by the end of adolescence.
There’s nothing anyone can do to speed up development; however, it’s important that teenagers eat healthy foods, get plenty of exercise and plenty of rest. Talk to your doctor if your 13year-old daughter or 15-year-old son hasn’t shown any signs of puberty. Most of the time, everything is fine, but the doctor can determine if there is a problem. Although teens may progress through puberty at different rates — your daughter may be the tallest girl in class or your son’s friends may need to shave — eventually, everyone catches up. That’s what makes each person special — everyone has qualities that make them unique, inside and out. — Source: KidsHealth.org, The Nemours Foundation
(Obesity, continued from Page 6)
must set a good example by eating healthy themselves, and keep healthy snacks on hand. If your child is overweight, criticism won’t help; however, encouragement and modeling healthy behaviors will.
Step 1 Teenagers must pull themselves away from the computer and television and get moving. Encourage your teen to skateboard and rollerblade; join school teams or local sports clubs; walk the family dog; swim; or wash the car.
Step 2 The other half of the “get healthy” equation is eating healthy foods, and eating only when hungry. When you
are fortunate enough to have your busy teenager at home, offer well-balanced meals that include vegetables, fruits, milk products including yogurt and cheese, breads and meat (including fish, beans, eggs and nuts). Why should teenagers care about their health? There are plenty of reasons, including feeling good, looking good, getting stronger, and doing better in school and other activities. Living healthy must become a lifelong habit, and parents can help by encouraging their teens along the way. — Sources: 2001 MacNeil-Lehrer Productions: NewsHour, Centers for Disease Control and Prevention and the National Institutes of Health
(Steroids, continued from Page 16)
for a season or a school year, but steroids can be addictive. Teens who use steroids also are at risk for using other drugs, such as alcohol or cocaine. There have been very few studies conducted concerning treatment for anabolic steroid abuse. If your teenager is using anabolic steroids, consult your physician for the best treatment options.
Anabolic steroids are controversial in sports because of all of the risks associated with them. Most are illegal and banned by professional sports organizations and medical associations. When it comes to improving athletic performance, encourage your teen to do it the smart and healthy way: eat the right foods, practice and train. — Sources: KidsHealth.org, The Nemours Foundation; MayoClinic.com; and the National Institute on Drug Abuse Blue & You Spring 2004
(Learning disabilities, continued from Page 11)
Text may appear to them as the following:
Thew ord sare n otsp aced cor rect ly. We spell wrds xatly az tha snd to us. Sometimesallthelettersarepushedtogether.
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There is no simple way to test for dyslexia, however, certain problems may be observed: • Difficulty rhyming words. • Difficulty with directions. • Poor reading skills despite normal intelligence. • Difficulty remembering the right names for things. Even though dealing with dyslexia is tough, help is available. Students who have been diagnosed with the condition are entitled to extra help from the public school system. It also is important to make sure they receive appropriate emotional support because they can experience high frustration at not being able to keep up with other students.
ADHD ADHD is a disorder that affects the brain and can cause people to behave differently than their peers. ADHD occurs in approximately 3 to 5 percent of schoolage children. People with ADHD exhibit two primary symptoms: 1) They have trouble focusing on tasks or subjects; and 2) They may act impulsively (without thinking) and often get into trouble. There are actually three subtypes of ADHD: • The first is referred to as simply Attention Deficit Disorder (ADD). People with this subtype have trouble paying attention, staying organized and following instructions, and are often losing or forgetting things.
• The second subtype involves hyperactivity and impulsive behavior such as fidgeting, interrupting others, difficulty waiting for a turn or feelings of restlessness. • The third subtype (and the most common) involves a combination of the two. Doctors and researchers have been unable to isolate a single specific cause for ADHD but have been able to determine there may be a genetic link in some cases. Teens who have ADHD also may have other problems such as depression, anxiety or other learning disabilities like dyslexia. They also may be at greater risk for smoking and drug use, especially if their condition goes untreated. Most doctors agree that a multimodal approach is best when treating ADHD. This means treating the problem from a variety of ways, which includes medication (most often Ritalin), cognitive-behavioral therapy, social skills training, parent education and modifications to the child’s education program. With ADHD, as with most learning disabilities, it is possible to have productive and successful lives, especially when the condition is diagnosed and treated. — Sources: The Attention Deficit Disorder Association, American Academy of Child & Adolescent Psychiatry, The International Dyslexia Association and KidsHealth.org
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“Blue comes through” in responding
You talk. We listen.
You, our members, tell us that four things are very important to you when it comes to being satisfied customers. You want: 1. More affordable health insurance options. 2. More information about your benefits and staying healthy. 3. Your claims paid quickly and accurately. 4. Any problems resolved quickly and conveniently. Here are some of the ways that “Blue comes through” in meeting these needs.
1. New, More Affordable Plans Whatever your budget or your coverage needs, we have a plan for you. In addition to our full menu of traditional major medical, PPO, HMO and POS plans, we’ve introduced several new health plans that make health care even more affordable: • BasicBlue® for individuals and families provides essential coverage at a more affordable cost. This plan provides a $1 million lifetime maximum benefit for covered services. BasicBlue does not require covered individuals to choose physicians, specialists and hospitals from a predetermined list. They have the freedom to use any health-care provider. • Group BasicBlue® provides similar group coverage for employees at a much lower cost to employers. • MyChoice Blue offers all the advantages of traditional PPO plans, and each employee may choose the plan that best fits his or her needs, making it truly “my choice.” With MyChoice Blue, employers can offer each employee (whether they have two or 200) the opportunity to select from one of four benefit plans. • Open Access Point of Service is an innovative plan from Health Advantage that is a hybrid of traditional HMO coverage and POS benefits. The member pays a copayment for preventive and routine services from his or her primary care physician. For services provided by in-network specialty physicians and hospitals (without the need for a referral), the member pays applicable deductible, copayments and coinsurance. The member also has the option of using out-of-network providers, receiving the lower level of out-of-network benefit coverage.
• Short-Term Blue is for individuals and their families who are temporarily uninsured and want one to six months of protection against catastrophic events such as severe or unexpected illnesses, diseases or accidents, with up to $1 million in benefits per person. • MyHRA Blue is a consumer-driven health plan that centers around qualified Health Reimbursement Arrangements (HRA) and Flexible Spending Arrangements (FSA) as defined by the IRS. The plan gives employees more control over how their health-care dollars are spent; more flexibility in managing out-of-pocket costs; more choice in network and non-network providers; and the ability to roll over eligible, unused dollars into the next year for future healthcare expenses while covered by the plan. Web-based tools help guide the member to make the best use of healthcare dollars.
2. Information on Benefits & Health • Web site tools available on our Web sites (www.ArkansasBlueCross.com, www.HealthAdvantagehmo.com and www.BlueAdvantageArkansas.com) provide a variety of information resources, including: — My Blueprint: Personal Benefits and Claims Tracker, a secure, self-service center, which allows you to: ◊ Check the status of your claims and review your claims history ◊ Check eligibility for you and your covered spouse and children ◊ Review primary care physician history ◊ Order a replacement ID card — Pharmacy benefits information, a customized Web section that enables you to: ◊ Look up your specific drug coverage ◊ Check your prescription claims history ◊ Locate a pharmacy ◊ Access a drug information center ◊ Check drug-to-drug interactions — Provider directories, lists of physicians, dentists, hospitals, pharmacies and facilities participating in our networks and serving our members. — Coverage policies, a database of policies to help inform members and their physicians why certain medical procedures may or may not be covered under our health plans. — Wellness discounts, a list of health clubs and fitness equipment companies that offer discounts to our members. Blue & You Spring 2004
to “Top Four” customer needs • Blue & You magazine is a quarterly publication mailed to members’ homes, containing articles on staying healthy and benefit information. • Understanding Your Health Care Costs is a booklet and video about what drives health-care costs up and what you can do to help hold costs down. To read the booklet online or view the video, go to www.ArkansasBlueCross.com or www.HealthAdvantage-hmo.com, click on “Members,” then click on “Understanding Your Health Care Costs.” • Brand Name or Generic Drugs? What you don’t know can cost you is a special, 16-page booklet to help Arkansans understand how and why using generic drugs is the smart choice (and why generic drugs cost less than brand-name drugs). The booklet is available on our Web sites to print. • Health Education Programs, available free to members, provide information and links to local, regional and national resources to help members manage disease and prevent complications of illness. Programs are available for diabetes, respiratory health, low back pain and cardiovascular health. Additionally, we offer Special Delivery, which educates expectant mothers about pre-term births. • Blue & Youth Health Program uses a big blue sheep, BlueAnn Ewe, to teach school-aged children the importance of practicing healthy habits. Through an elementary classroom presentation, a middle-school mentoring program (High School Heroes), a health “club” for kids, animated musical television messages and a wild and woolly Web site for kids (www.BlueAnnEwe-ark.com), the Blue & Youth programs have taken healthy lessons to more than 575,000 Arkansas youth in the past eight years.
3. Paying Claims Quickly & Accurately • Fast turnaround — After we receive your medical claims from your doctor or hospital, we process your claims in an average of six days. So, for most of the claims processed, you receive your explanation of payments within 10 days after we receive the claim. • High accuracy rate — For the 12 months of 2003, we achieved a dollar accuracy rate of 99.2 percent in paying
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your claims. This is impressive when you consider that we process more than 8 million claims a year. • Investment in technology — Arkansas Blue Cross has invested in technology that facilitates the electronic submission of claims from providers. As a result, more than 80 percent of all claims are submitted electronically, speeding up the process. Arkansas Blue Cross now gives doctors and hospitals free access to the Advanced Health Information Network (AHIN), giving them access to eligibility, claims, claim-status and related data. A unique feature allows direct claim submission as well as online, real-time correction of erroneous claims.
4. Resolving Any Problems Whether you prefer picking up the telephone, checking a Web site or visiting face-to-face, Arkansas Blue Cross and its family of companies are working to make customer service easy and convenient: • My BlueLine, our self-service Interactive Voice Response System, recognizes speech patterns to help answer questions when customers call customer service telephone lines. By simply speaking a response to the questions asked by the automated system, customers can get questions answered quickly and easily with no buttons to push. My BlueLine is available 24 hours a day, seven days a week. It can help customers who have questions about benefits, status of claims and premium payments, and help customers order a new ID card, provider directory or claim form. And if you prefer to speak directly to one of our 200 customer service representatives, you can do so at any time during normal business hours. • My Blueprint, our online service center, lets you check your own claims and get answers 24 hours a day, seven days a week in a customized, secure Web environment. • Personal service, close to home, is available for customers who prefer face-to-face interaction (rather than a telephone call or Web contact) by visiting any of our seven convenient locations in Arkansas. Our offices, located in Fayetteville, Fort Smith, Hot Springs, Little Rock, Jonesboro, Pine Bluff and Texarkana, offer sales, customer service, medical management and provider relations services to members in all areas of the state. These are some of the ways Arkansas Blue Cross and its affiliated companies are meeting the needs of our customers. When you need answers, Blue comes through … for you.
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Winners Announced for 2004 “Don’t Start” Smoking Coloring Contest
Katelynn Horsman, age 6, a first-grader at Bergman
Elementary School in Bergman, was named the grandprize winner in the third annual “Don’t Start” Smoking Coloring Contest. The contest was sponsored by Arkansas Blue Cross and Blue Shield, KASN-TV/UPN Channel 38 and KLRT-TV/FOX Channel 16, in partnership with the American Lung Association of Arkansas and the Arkansas Department of Education. The “Don’t Start” Smoking Coloring Contest gave students in public, private and home schools in kindergarten through fifth grade an opportunity to write and illustrate a story about why it’s important to never begin the dangerous habit of smoking. The contest helped students “draw their way” to prizes and an opportunity to have their story transformed into a television Public Service Announcement (PSA) to be broadcast in Arkansas in the summer and fall of 2004. Almost 12,000 entries were received statewide. The object of the program was to get kids thinking about why they should not use tobacco products and what they can do because they aren’t sick from smoking. Kids used storyboard sheets to write a story and draw pictures depicting their story. They were encouraged to draw animals, people, cartoon characters or anything their creative minds could think of to tell their story. In addition to the storyboards, teachers received a seven-minute educational video and Teacher’s Packet to help build a curriculum around the “Don’t Start” Contest. Sharon K. Allen, president and chief operating officer of Arkansas Blue Cross, told students, along with their family members, parents, teachers, counselors and principals at the “Don’t Start” celebration party, “Learning at an early age about how the choices you make now can affect your health in the future is part of what our mission is all about at Arkansas Blue Cross. We want you to be healthy. As you all have shown in your storyboards, there is nothing healthy about smoking. We hope the ‘Don’t Start’ Smoking Contest was a fun learning opportunity for you. Someday, chances are good you will be asked or tempted by someone to try a cigarette or
2004 “Don’t Start” Smoking Contest Finalists Kindergarten First-Place Finalist — Scott Turpen, age 5, Patterson Grammar School in Fordyce Second-Place Finalist — Trenton Allred, age 5, Gandy Elementary School in White Hall Third-Place Finalist — Kéara Alyssa Calvin, age 6, Central Arkansas Christian Academy in Sherwood First Grade First-Place Finalist & Grand-Prize Winner— Katelynn Horsman, age 6, Bergman Elementary School Second-Place Finalist — Keegan Hines, age 7, Baker Elementary School in Little Rock Third-Place Finalist — Austin Tywater, age 6, Patterson Grammar Elementary School in Fordyce Second Grade First-Place Finalist — Alex Burroughs, age 8, Southside Elementary School in Damascus Second-Place Finalist — Dulce Laguna, age 7, Jones Elementary in Springdale Third-Place Finalist — Lindsey Walker, age 7, Westside Elementary School in Cabot Third Grade First-Place Finalist — Kimmi Hanners, age 8, Holly Harshman Elementary School in Mena Second-Place Finalist — Blanca Lerma, age 10, College Hill Elementary School in Texarkana Third-Place Finalist — Layne King, age 8, Gosnell Elementary School Fourth Grade First-Place Finalist — Kayla Schluterman, age 9, Greenwood Elementary School Second-Place Finalist — Anna Engler, age 9, Heber Springs Elementary School Third-Place Finalist — Courtney Daniel, age 10, Searcy McRae Elementary School in Searcy Fifth Grade First-Place Finalist — Taylor Dodd, age 10, Cavanaugh Middle School in Fort Smith Second-Place Finalist — Maggie Rubben, age 10, Lake Hamilton Intermediate School in Hot Springs Third-Place Finalist — Molly Elizabeth Roberts, age 10, Jefferson Elementary School in Little Rock
(Winners, continued on Page 23) Blue & You Spring 2004
Blue & You Foundation issues call for grant applications T he Blue & You Foundation for a Healthier Arkansas has issued its third annual call for grant applications to fund 2005 health programs, which support services to improve the health of Arkansans. The foundation anticipates awarding up to $1 million in grants annually to non-profit 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. The foundation also intends to devote a portion of this year’s grant funding to programs that effectively address maternal and child health issues, as well as childhood obesity. The deadline for applications is Aug. 13, 2004. Information about applying for a grant is found on the foundation Web site at www.BlueAndYouFoundationArkansas.org, or may be requested by writing to Blue & You Foundation, 601 S. Gaines Street, Little Rock, AR 72201. The grant applications will be reviewed in the fall and grants awarded in December for 2005 programs. “We have a health-care crisis in Arkansas that must be addressed,” said Robert L. Shoptaw, chief executive officer of Arkansas Blue Cross and Blue Shield and chairman of the foundation’s board of directors. “The
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poor health status of our citizens ranks 47th in the nation and contributes to rising medical costs. By providing funding and working together with other organizations, we hope to establish or expand a number of diverse health-care projects that will benefit all Arkansans over the long term.” The foundation awarded its second round of grants, totaling $1,001,235, in 2003 to fund 14 programs statewide during 2004. Recipients of 2004 grants included the American Lung Association of Arkansas; Arkansas Center for Addictions, Research, Education and Services (CARES); Arkansas Center for Birth Defects Research and Prevention; Bess Chisum Stephens YWCA; Crowley’s Ridge Development Council, Inc.; Delta Memorial Hospital; Focus, Inc.; Guadalupe Prenatal Clinic; Interfaith Clinic; KIDS FIRST/UAMS Department of Pediatrics; Kiwanis Activities, Inc.; Northwest Arkansas Radiation Therapy Institute (NARTI); Safe Jonesboro Coalition; and the University of Arkansas, Division of Agriculture, Cooperative Extension Service. The foundation is an independent licensee of the Blue Cross and Blue Shield Association and serves the state of Arkansas. The foundation is a 501(c)(3) organization.
(Winners, continued from Page 22)
other tobacco product. I hope you will remember what you’ve learned through this program, stand firm, and just say, ‘no.’ We’re proud to have been a sponsor of this worthwhile project for the third year, and I’m proud of the commitment you all have made to stay smoke-free.” “Studies have shown that when the arts are incorporated into a message, it is retained for a much longer period of time by the students,” said Karen Lackey, executive director of the American Lung Association of Arkansas. “This anti-tobacco program is unique and provides thousands of kids an opportunity to get involved in the fight against tobacco in a meaningful way. Our goal is to have a future generation of healthier adults free of tobacco-related lung disease.” “Engraining the harm of smoking in the minds of our Blue & You Spring 2004
youth is imperative. Doing it in a fun and creative way is to be commended,” said Chuck Spohn, vice president and general manager of Clear Channel Communications. “I am proud of the efforts of the American Lung Association of Arkansas, Arkansas Blue Cross and FOX16/ UPN38 for providing this educational and informational challenge to our youth.” Students could enter the contest as individuals, or teachers could have their students participate in the contest as a class project.
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On a roll: BluesEnroll going strong
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fter almost one year in operation, BluesEnroll now has more than 30,000 members enrolled. BluesEnroll, a Web-based enrollment method for group employers with Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas insurance, was designed to reduce paperwork and make the process of enrollment and membership maintenance much more efficient. Currently, BluesEnroll is available to groups with 50 or more employees. With online enrollment, group members are able to complete initial and open enrollment as well as life status changes (new baby, divorce, etc.) quickly and easily. Information only has to be entered one time, and electronic data transfer assures that information is received quickly with less chance of paperwork being lost in the mail or misrouted. Members have two options for online enrollment. Members can enter enrollment information online (using a secure ID and password) and have the information approved by the group administrator. The other option is that group members can provide enrollment information to the group administrator, and the group administrator will submit the information online. The group administrator will determine the appropriate enrollment method. BluesEnroll allows employers to spend less time on paperwork and reduce the cost of human resources management functions. With BluesEnroll, new-hire processing and open enrollment is much easier. Donna Greenwood of Murphy Motors in El Dorado said, “BluesEnroll is the best thing that ever happened to
me. It is wonderful. It is so easy! Enrollment and change functions are simple and quick. I recommend BluesEnroll to anybody and everybody.” According to Sherri Brown of Lawrence Health Services in Walnut Ridge, “I have found BluesEnroll to be very user friendly. It is so convenient to add employees without having to make copies of forms to keep for my files, and I know they will be added fast. Terminations also are very easily entered. Thanks to Arkansas Blue Cross for filling my needs.” And Alicia Adams of Bank of the Ozarks in Little Rock said, “This is so handy and easy to use. I don’t know why anybody wouldn’t want to use BluesEnroll.” The value of the BluesEnroll product is evident in the number of groups that renew with the Arkansas Blue Cross family of companies. Since implementation of BluesEnroll began, very few groups have left the Arkansas Blue Cross family of companies and changed carriers, and not one single group has asked to return to the paper process. Groups interested in more information on BluesEnroll or groups that would like to be included in the online enrollment process should contact their sales representative. BluesEnroll will customize online enrollment for each group based on its benefit package and location. Arkansas Blue Cross and its family of companies hope to have 50,000 members enrolled through BluesEnroll by the end of 2004.
Health Advantage: Serving Arkansas for 10 years H MO Partners, Inc. was formed in 1994 with the merger of the state’s two leading health maintenance organizations (HMOs). On April 21, 1994, Health Advantage, an HMO founded in 1986 by Baptist Medical System HMO joined forces with Arkansas Blue Cross and Blue Shield’s HMO Arkansas (founded in 1984). The company, which does business as Health Advantage, is the state’s largest and oldest HMO and the only statewide HMO that is both state-certified and federally qualified. HMO Partners, Inc. is half-owned by USAble Corporation and half-owned by Baptist Medical System HMO, Inc. Baptist Medical System HMO, Inc., is half-owned by Baptist
Health and half-owned by a group of Arkansas physicians. For the past 10 years, Health Advantage has been serving Arkansans by providing organizations, families and individuals in each community served with the best value, predictable service and high satisfaction. Health Advantage products and services aim to create high customer value, confidence, peace of mind and an improved quality of life. Health Advantage serves more than 146,000 members and has a statewide network of more than 5,200 providers and 89 hospitals. Blue & You Summer 2004
Health Advantage members: HealthConnect Blue now available H
ealth Advantage members* now have access to HealthConnect Blue, a complimentary, confidential health information service. HealthConnect Blue puts members in touch with Health Coaches by telephone and health information online — to help members make more informed decisions about their health. HealthConnect Blue is designed for members who have everyday health concerns and questions or who have ongoing (chronic) health conditions such as diabetes, lung or breathing problems and heart conditions. Members can call a toll-free telephone number to speak with a Health Coach to get the support and health information they need 24 hours a day, seven days a week. Health Coaches are specially trained health professionals such as nurses, respiratory therapists and dietitians. Members may call as often as they like at no cost. Members also can access free health information online by using the HealthConnect Blue link at www.HealthAdvantage-hmo.com. “When it comes to dealing with health problems, most people benefit from information to help them learn more about their conditions,” said Clement Fox, M.D., medical director of Health Advantage. “Many want support to help them take an active role in making the choices that are right for them. As always, we encourage members to talk with their physicians to discuss all of their health-care needs. Members who participate in HealthConnect Blue may find that the information and support they receive helps them make informed decisions concerning their health care while strengthening their relationship with their physician.” HealthConnect Blue provides the following services: • A Health Coach to talk to anytime, day or night, 24 hours a day, 7 days a week A Health Coach is available anytime to discuss immediate or everyday concerns. Health Coaches provide health information and support so members can work more effectively with their doctors. Health Coaches do not provide medical advice. Members with urgent needs that require immediate medical attention are (as always) urged to call their physician, contact their local 911 or emergency service, or go to a nearby emergency room, as the need requires.
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• Personalized follow-up calls with a Health Coach about a chronic condition or other health concerns A Health Coach can help provide a better understanding of how to manage members’ conditions and other topics that are important to them, as well as discuss how they might prepare for the next visit with their health-care provider. • Free educational materials mailed to members’ home If a member needs tips on lowering cholesterol, information about a low-salt diet, a heart condition, lung condition or diabetes, Health Coaches with HealthConnect Blue can send him or her information from nationally recognized sources on a wide variety of topics. Videotapes are available on specific topics such as breast cancer, prostate cancer and low back pain. • Internet access to valuable health information Members may access HealthConnect Blue online by going to the HealthConnect Blue link at www.HealthAdvantage-hmo.com. “By working together with their health-care provider and Health Coach, we believe HealthConnect Blue will better prepare our members to manage their health and make informed, confident health-care decisions,” said Dr. Fox. *Includes all Health Advantage commercial HMO members statewide, Blue Choice PPO, Open Access PPO and Fort Smith Choice Health Advantage members. School and state employees covered by Health Advantage will receive the service later in 2004.
GET
MORE TEEN INFO!
Health Advantage members interested in learning more about the subjects covered in this issue of Blue & You can go to the HealthConnect Blue link in the Healthwise KnowledgeBase at www.HealthAdvantagehmo.com for in-depth articles on the following subjects: • Obesity • Sleep Problems, Age 12 and Older • Back Problems and Injuries • Acne • Skin Problems, Age 12 and Older • And much more to help you and your teen.
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My BlueLine never sleeps, so you can rest easy
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t Arkansas Blue Cross and Blue Shield, we want to make sure that you 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 your convenience in mind, makes your personal health insurance information available with a simple telephone call. Many customers asked for telephone self-service — now it’s here. If you are 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 has been a tremendous help to us and our customers,” said Betty Chadduck, manager of Customer Service for Health Advantage. “Approximately 20 percent of the calls that come in are being handled by My BlueLine. This gives our customers access to information immediately, seven days a week, 24 hours a day. And, of course, the customers always have the option of speaking to a customer service representative during business hours. We have received many positive comments from callers. If a customer has suggestions for improvement of the system, we will consider them also.” Just a few of the customers comments have been: “I called after hours to check on the status of my son’s • Check your eligibility claim and was very • Check your benefits impressed with how • Check the status of easy it was to use.” your claims “The menu options • Check the status of on My BlueLine are your premium very good.” payment My BlueLine is an • Order a new ID card interactive voice • Order a provider response (IVR) system directory that recognizes speech • Order a claim form 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 prompt you with a question, and all you have to do is simply respond to the question.
New voice recognition technology answers your questions 24/7
Get answers to your questions anytime There are no buttons to push. With My BlueLine you can get numerous questions answered quickly and easily anytime. 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 also 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. If Arkansas Blue Cross does not have up-to-date 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. Try it, you’ll like it. 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. During regular business hours, at any time during the telephone call, you can request to speak to the next available customer service representative 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. My BlueLine is a new member benefit 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. And, don’t forget, if you prefer to get your answers on the Web, you have another self-service option by accessing the secure My Blueprint section on our Web sites. Blue & You Summer 2004
Introducing Short-Term Blue … A Temporary Solution for the Temporarily Uninsured I
f you are like many people who find themselves temporarily uninsured and in need of short-term health insurance coverage, Arkansas Blue Cross and Blue Shield has developed a new health insurance plan with you in mind. Short-Term Blue is a new Preferred Provider Organization (PPO) health insurance policy that will be available Aug. 1, 2004. Designed specifically for individuals and their families who are temporarily uninsured, Short-Term Blue provides from one to six months protection against catastrophic events such as severe or unexpected illnesses, diseases or accidents, with up to $1 million in benefits per person. “We are very excited about adding Short-Term Blue to our portfolio of individual products. Not only is this product a perfect match for Arkansans who need affordable coverage on a short-term basis, we also believe it will represent a solution for a percentage of Arkansas’ uninsured population,” said Ron DeBerry, vice president of Statewide Business for Arkansas Blue Cross. With Short-Term Blue: • There are no monthly premiums — you make only one payment for the entire term of the policy. • You’ll have access to more than 5,300 providers (doctors and other health-care professionals) and 89 hospitals that make up Arkansas’ FirstSource PPO network. • Participating providers will file claims for you, so there is less paperwork. • You’ll receive a free ScriptSave Discount Drug Card with savings ranging from 5-30 percent.
Is Short-Term Blue right for you? To be eligible for Short-Term Blue, you must be a permanent resident of Arkansas and between six months and 65 years of age. You are a candidate for Short-Term Blue if you are: • A recent graduate without coverage. • Between jobs or laid off. • Working a part-time or seasonal job. Blue & You Summer 2004
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• A new employee temporarily without coverage. • A student in need of coverage for the summer. • Recently retired and not yet eligible for Medicare. Under a Family Plan, Short-Term Blue also protects your legal spouse, as well as your unmarried children up to age 19.
How Short-Term Blue Works When you apply for Short-Term Blue, you can choose from one to six months of coverage and either a $500 or $1,000 deductible. (If you choose a Family Plan, there is a maximum of two deductibles per family per policy.) After the deductible is met, Short-Term Blue pays 80 percent of the next $10,000 (individual policy coinsurance maximum) of covered services per person or $20,000 (family policy coinsurance maximum) per family. You pay 20 percent. Then Short-Term Blue pays 100 percent of covered charges up to the $1 million lifetime maximum per person.
Covered Benefits Among the services covered under Short-Term Blue are inpatient hospital services, outpatient services, physician services, emergency room services, and diagnostic laboratory and X-ray.
Extending your Coverage If your temporary need for coverage continues beyond your original coverage period, you may reapply for an additional coverage period one time upon underwriting approval. This policy does not provide continuous coverage for any subsequent individual health insurance policies, including any Arkansas Blue Cross policies. This article provides a brief description of the important features of Short-Term Blue. If you would like more information or would like to find out if you are eligible for Short-Term Blue coverage, call 1-800-392-2583 or contact your local insurance agent.
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Measuring UP
in customer service
D uring 2003, Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas scored well in the Member Touchpoint Direct Measures (MTM) program, performing well in all categories. From a possible total of 100 points when combining all categories, the enterprise received 99 points. The MTM program is a measure of overall operational performance. In 2000, Arkansas Blue Cross and its family of companies began using the MTM process to measure operational and service performance for the benefit of our members. The MTM program is a way to measure standards that shape member satisfaction. Arkansas Blue Cross, Health Advantage and BlueAdvantage began collecting new MTM data measures that outlined how well we perform tasks that meet the needs of our members. During 2003, our companies received the following scores on the MTM Performance Report. • In the category of claims timeliness (percentage of claims processed within 30 calendar days), we received a 99.5 percent overall performance rating. • In the category of claims accuracy (frequency), we received a 99.3 percent overall performance rating. For claims accuracy (dollar amount), we received a 99.2 percent overall performance rating • In the category of inquiry timeliness (response within seven days to inquiries including telephone calls, written correspondence, walk-ins, faxed items, e-mails, etc.), we received a 95.8 percent overall performance rating, which exceeds the MTM standard (90 percent).
• In the category of inquiry accuracy, we received a 98.6 percent overall performance rating. • In the category of membership timeliness, we received a 99.7 percent overall performance rating. • In the category of membership accuracy (member level), we received a 98.5 percent overall performance rating. • In the category of membership accuracy (group level), we received a 99.7 percent overall performance rating, which exceeds the MTM standard of 99 percent. • In the category of telephone call blockage, the MTM performance guideline is 8 percent or less of all calls that tried to reach the enterprise but were not accepted (callers receives a busy signal). The standard includes all calls that were attempted during formal business hours but were unable to reach a queue. We had a blockage rate of only 2.2 percent overall. • In the category of abandoned calls, the MTM performance guideline is 5 percent or less of all calls that were placed in a queue but were abandoned (the caller hung up or disconnected the call) prior to reaching the final destination. We had 3.4 percent overall abandonment rate. “We have done exceptionally well in all categories when compared to performance standards, reflecting the commitment of employees working hard every day to provide outstanding service to our members,” said David Bridges, senior vice president of Arkansas Blue Cross Customer Service and president and chief executive officer of Health Advantage.
New ID numbers to take place of Social Security numbers to better serve you Due to escalating identity theft, several states have passed laws restricting the use of Social Security numbers (SSN), with some effective dates beginning this year. Recognizing this as a local concern, BlueAdvantage Administrators of Arkansas and Health Advantage recently began the migration away from SSNs as part of the member ID number. Additionally, the few Arkansas Blue Cross and Blue Shield groups that use SSNs as member ID numbers also will convert to new ID numbers. The conversion process will continue throughout
ID
2004. Members will receive notification and new ID cards in the mail. Members: When you receive the new ID cards with the new ID numbers, make sure to contact each provider that you (and your family members) use and provide them with the new number for future claims filing. You should always carry your health insurance ID card when going to a doctor’s appointment and/or when receiving other medical services. Present the card to the provider to ensure timely and accurate claims processing. Blue & You Summer 2004
The Phar macist is in Do you have any questions? Importing medications — Is it a risk worth taking? Due to the increasing costs of prescription medication, many people may be asking themselves — “Should I order my prescriptions from Canada?” Although this may not be an issue for those with health insurance, it certainly impacts those without health insurance coverage. The issue is important, and the answer is difficult. After giving consideration to all alternatives, my initial response is no. My first recommendation is to discuss this issue openly with your physician and pharmacist. Working together, they should be able to relieve this cost burden to some extent, perhaps considerably. There usually are multiple medication choices for a physician when he or she determines a course of treatment. There are many
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drugs, with expired patents that have been proven to be safe and effective and will satisfy most treatment requirements. Seek these out first. They are usually inexpensive and may be overlooked in the current fastpaced world of advertising and marketing. They account for 45 percent of our current prescription volume at Arkansas Blue Cross and Blue Shield. You are taking a chance with your health when you accept medications that are produced, packaged or dispensed in another part of the world apart from the oversight of the U.S. Food and Drug Administration (FDA). This agency is our only guardian for the initial determination of medication safety and efficacy. When we choose to abandon this FDA oversight, we become vulnerable to an undetermined amount of risk. Please be careful.
Medicare-approved drug discount card available M
edicare beneficiaries may enroll in ScriptSave Premier, a new prescription-drug discount card approved by the Centers for Medicare & Medicaid Services (CMS). The recently enacted Medicare Prescription Drug Improvement and Modernization Act of 2003 establishes government-approved prescription drug discount cards. Arkansas Blue Cross and Blue Shield and ScriptSave are partnering together to offer one of these cards, approved by the Centers for Medicare & Medicaid Services (CMS). We are calling our version of this card ScriptSave Premier. We are pleased to report that we are offering this card to you at no cost.* For a ScriptSave Premier enrollment form, please call ScriptSave Premier toll-free at 1-866-223-9675 or 1-888-339-7322 (TTY Users) 8 a.m. to 4:30 p.m. EST-PST. Please reference group number M1212 when you call. If you’d prefer, go to www.ArkansasBlueCross.com and select the ScriptSave Premier enrollment form link. There are other CMSapproved drug cards that will be available to Medicare beneficiaries. You can learn about those cards by calling 1-800-MEDICARE (1-800-633-4227) or 1-877-486-2048 (TTY Users) or going to CMS’s Web site at www.medicare.gov. The other cards may have an enrollment fee of up to $30. Again, the card we are offering is Blue & You Summer 2004
available to you at no cost.* You can only choose one CMS-approved prescription drug card. Special benefits are available to Medicare beneficiaries who are at 135 percent of the federal poverty level. Medicare beneficiaries meeting that income requirement will receive up to a $600 credit to purchase prescription drugs and will have any enrollment fee waived. If you think you qualify for these benefits, please call ScriptSave Premier toll-free at 1-866-223-9675 or 1-888-339-7322 (TTY Users) 8 a.m. to 4:30 p.m. EST-PST to request a special enrollment form. You may also want to contact CMS to determine if you would prefer a CMS-approved prescription drug card from another company. Even if you choose to take advantage of ScriptSave Premier, the new CMS-approved prescription drug card from Arkansas Blue Cross and ScriptSave, you can still keep the original ScriptSave discount card you have now. You can even continue to use the original card. However, you cannot use your current ScriptSave card in conjunction with ScriptSave Premier, the new card, or any other CMS-approved prescription drug card. * Enrollment is free; however, there is a cost for prescription drugs.
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Arkansas Blue Cross and Blue Shield Financial Information Privacy Notice
At Arkansas Blue Cross and Blue Shield and its
affiliates (HMO Partners, Inc. d/b/a Health Advantage and BlueAdvantage Administrators of Arkansas), we understand how important it is to keep your private information just that — private. Because of the nature of our business, we must collect some personal information from our members, but we also are committed to maintaining, securing and protecting that information.
Customer Information Arkansas Blue Cross and its affiliates only compile information necessary for us to provide the services that you, our member, requests from us and to administer your business. We collect non-public personal financial information (defined as any information that can be tied back to a specific person, and is gathered by any source that is not publicly available) about our members from: • Applications for insurance coverage. The application includes information such as name, address, personal identifiers such as Social Security number, and medical information that you authorize us to collect. • Payment history and related financial transactions from the purchase and use of our products. • Information related to the fact that you have been or currently are a member.
Sharing of Information Arkansas Blue Cross and its affiliates do not disclose, and do not wish to reserve the right to disclose, nonpublic personal information about you to one another or to other parties except as permitted or required by law. Examples of instances in which Arkansas Blue Cross and its affiliates will provide information to one another or other third parties are: • To service or process products that you have requested. • To provide information as permitted and required by
law to accrediting agencies. • To provide information to comply with federal, state or local laws in an administrative or judicial process.
How we protect your information Arkansas Blue Cross and its affiliates use various security mechanisms to protect your personal data including electronic and physical measures as well as company policies that limit employee access to nonpublic personal financial information. Improper access and use of confidential information by an employee can result in disciplinary action up to and including termination of employment.
Disclosure of Privacy Notice Arkansas Blue Cross and its affiliates recognize and respect the privacy concerns of potential, current and former customers. Arkansas Blue Cross and its affiliates are committed to safeguarding this information. As required by state regulation, we must notify our members about how we handle non-public financial information of our members. Nothing has changed in the way we conduct our business. If you would like to review the Financial Information Privacy Notices for all Arkansas Blue Cross members, you may visit our Web site at www.ArkansasBlueCross.com or call the appropriate Arkansas Blue Cross company to receive the Privacy Notice. Our customer service areas are open from 8 a.m. – 4:30 p.m., Central Time, Monday through Friday. To receive a copy of the Privacy Notice, members should call: Arkansas Blue Cross — 1-800-238-8379 BlueAdvantage Administrators of Arkansas — (members should call Customer Service using the tollfree telephone number on their identification card) Health Advantage — 1-800-843-1329.
New discounts for members A rkansas Blue Cross and Blue Shield is continually looking for new opportunities for our members to save money and get fit — all at the same time. Bowman Fitness Club, 1121 S. Bowman Road in Little Rock, is the newest fitness center to offer a discount to our members. Additionally, one of the clubs that currently offers a discount to our members has changed its
name but not its discount. Ultimate Fitness of Maumelle, 2 Country Club Circle, is under new ownership and has a new name — Maumelle Fitness Club. If you are curious about whether your favorite fitness spot offers a discount, visit the Arkansas Blue Cross Web site at www.ArkansasBlueCross.com for a complete list of participating fitness vendors. Blue & You Summer 2004
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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. Healthy ClassAct BlueAnn Ewe traveled to Pangburn recently to share her Healthy ClassAct with elementary school students in grades K-3. More than 200 students got a chance to learn about eating right, exercise, buckling their seat belts, brushing their teeth and getting good sleep — all as part of staying healthy and safe. The Pangburn High School Future Business Leaders of America (FBLA) A Pangburn High School FBLA students pitched in to student shows an elementary help BlueAnn encour- student how to brush BlueAnn’s age students to “Have teeth during her Healthy ClassAct. fun. Stay healthy.” Public Health Hero The Independence County Hometown Wellness Coalition, of which Arkansas Blue Cross (Northeast Regional Office in Jonesboro) is a member, recently was selected to receive a Public Health Hero Award from the Arkansas Department of Health. The award was presented to team members, including RuthAnn Harp, R.N., and Connie Meeks, M.D., at the Public Health Week media conference on April 5 on the steps of the State Capitol. The award is given annually to individuals and groups who work throughout the year to promote wellness in the community. BlueAnn Ewe joined Harp and Meeks and other team members to accept the award. The Heart of the Matter Arkansas Blue Cross employees helped raise money and awareness at the American Heart Association’s Heart Walks in Conway, Fayetteville, Fort Smith, Hot Springs, Jonesboro and Little Rock this spring. The Blue Teams walked in step with thousands of other participants to raise hundreds of thousands of dollars for the cause. Blue & You Summer 2004
Arkansas Blue Cross served as the Red Cap Survivor sponsor for several events. Marching for Babies The Arkansas Blue Cross team burst onto the scene at the March of Dimes Walk at Riverside Park in North Little Rock on March 27, ready to put the The Blue Team, accompanied by the finishing touches Lusk triplets (March of Dimes ambason a successful sadors), poses with trophies won for its fund-raising effort efforts to fight birth defects . for organization. A 77-member contingency of limegreen-T-shirt-clad employees hiked along the Arkansas River with 2004 March of Dimes Walk Chair Sharon Allen to take home lots of trophies for the team’s energetic efforts. Team awards included first place for money raised, first place for T-shirt design, top insurance team and honorable mention for number of walkers.
Arkansas Blue Cross “sparkles” at PRISM Awards I n April, Arkansas Blue Cross and Blue Shield received four awards in the 2004 PRISM Awards program of the Public Relations Society of America, Arkansas Chapter. PRISM Awards received included: • Blue & You (member magazine) for Periodicals/ Printed Version. (Kelly Whitehorn, editor; Gio Bruno, designer). • ArkansasBlueCross.com for Web Sites. (Janice Drennan, content management; Web Team, technical management). • Blue & Youth Health Program for Community Relations. (Damona Fisher, program management). • “Don’t Start” Smoking Storyboard Contest for Other Public Relations. (Damona Fisher, sponsor/program management).
www.ArkansasBlueCross.com www.HealthAdvantage-hmo.com www.BlueAdvantageArkansas.com www.BlueAndYouFoundationArkansas.org www.BlueAnnEwe-ark.com My Blueprint Broadens Reach All members of Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas may register to access claims and benefit information online through My Blueprint. In the past, only the policyholder or group health plan subscriber could register. Now all covered family members can register to check eligibility, review claims status and history, review primary care physician history (if applicable), order a replacement ID card and register for Special Delivery, a prenatal care program. Additional My Blueprint features are available on specific company sites. On www.HealthAdvantagehmo.com, eligible members (all except public school and state employees) may register to access HealthConnect Blue, a new service that provides health information and health coaching. (See related article on Page 25.) Health Advantage members also may order a Certificate of Coverage, which is sometimes needed when enrolling in a new plan. On www.BlueAdvantageArkansas.com, members may review a benefit summary showing what is covered, copayments and deductibles. With implementation of member-level registration, no functionality was taken away from the policyholder. The policyholder still may view eligibility and claims information for a covered spouse and covered dependents. Spouses and dependents will see only their personal information; they will not be able to see data for other members on the policy or group plan. The new member-level registration was necessary to enable all members to have access to records that contain sensitive personal medical information, such as online medication lists, correspondence with health coaches and prescription history. Member-level IDs and passwords protect the privacy of the personal information available through these new features. Some of these features are already available through My Blueprint, and others will be added soon.
Pharmacy Benefits Information Available Online Arkansas Blue Cross and Health Advantage members will find a new “Pharmacy Benefits” section on www.ArkansasBlueCross.com and www.HealthAdvantage-hmo.com. This section contains: Blue & You Summer 2004
• Pharmacy Search: Search for a network pharmacy by name, city, state or zip code. • Drug Cabinet: Check medications you are taking or plan to take for interactions. • Drug Search: Find information about medications, their use, how to take them and possible side effects. Members also will find printable drug lists in this section, including: • Preferred Drugs: Lower-cost, name-brand medications selected for your managed pharmacy plan based on effectiveness, safety, uniqueness and cost-efficiency. • Third-tier Drugs: Medications that have the highest level of copayment. These drugs will cost you more out of pocket. • Maintenance Drugs: Medications considered to be necessary for long periods of time. • Preferred Oral Contraceptives: Covered oral contraceptives. • Prior Authorization List: Medications that require prior approval. • Quantity Limits: Medications with quantity limits. Members soon will have additional pharmacy benefit features accessible through My Blueprint. Each member will need to register to access personal pharmacy claims and eligibility information. These improvements are part of a continuing effort to give members more information and tools to help them manage their health plan benefits. Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181
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