Spring 11
A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
Gift to UAMS promotes primary care, Page 4 • Health Advantage has new Web site design, Page 7 • Dr. David on the impact of diabetes, Page 10 • Blue & You Foundation funds CPR training, Page 18
INSIDE 3 Out of the Blue 4 Arkansas Blue Cross invests $1 million in Arkansas’ medical future
6 GR8 plans 4 U 7 Updated, fresh look for Health Advantage Web site 8 SilverSneakers becomes a silver lining 10 Lifelong Health with Dr. David 12 Kids and caffeine overload Lose weight The Healthy Weigh!
13 Chickenpox vaccine cuts hospitalization Early childhood professionals learn first aid and cardio pulmonary resuscitation (CPR) through a grant from the Blue & You Foundation for a Healthier Arkansas.
Is there a link between breast cancer risk and when women begin hormone therapy?
14 Kids with asthma: The battle to breathe 15 Updated Vitamin D and Calcium recommendations 16 From the Pharmacist — Here’s the rub … vapor rub.
on Page 18
17 The Doctor’s Corner 18 Foundation grant helps save children’s lives 20 Good for you starts with … Pharmacy 22 Good for your community
On the Cover:
23 Customer Service telephone numbers
Joyce Elrod finds her silver lining in the SilverSneakers Fitness Program. See the story on Page 8.
Spring 11
®
is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health care professionals and other persons interested in health care and wellness.
24 Good for you
Editor: Kelly Whitehorn — bnyou-ed@arkbluecross.com Assistant Editor: Jennifer Gordon Designer: Gio Bruno Photographer: Chip Bayer Contributors: Chip Bayer, Matthew Creasman, Damona Fisher, Kristy Fleming, Trey Hankins, Heather Iacobacci-Miller, Ryan Kravitz, Kathy Luzietti and Mark Morehead Vice President, Communications and Product Development: Karen Raley
Out of the
Blue
A message from our CEO and President, Mark White and an aging population. It is here where we see all too clearly that we must work to improve not only the cost of care but the availability and quality of care as well. At Arkansas Blue Cross, we recognize that it is not enough to provide medical insurance if the doctor’s waiting room is overflowing, or if there simply isn’t a doctor nearby. As the state’s leading health insurer, we have a responsibility to address these problems for our
Providing better access to primary care in Arkansas As Congress and federal courts around the country
members and for all Arkansans. And, we already are addressing that obligation in several ways. One program designed to improve the quality and efficiency of primary care delivery is our patient-centered
continue to discuss the nuances of health insurance
medical home pilot program. There are currently seven
reform in Washington D.C., Arkansas Blue Cross and
patient-centered medical home pilot practices through-
Blue Shield is focused on implementation of the new
out the state. This innovative approach to comprehen-
law and taking steps to ensure that some unintended
sive primary medical care has been proven to provide
consequences do not negatively impact our members.
better access to health care, produce patients who are
One of our concerns is our members’ ability to get
more satisfied with their care, and improve the health
needed care from primary care doctors in a timely fashion. The shortage of primary care physicians is a
of patients. Medical homes provide quick access for sick pa-
national problem, and a problem that will become even
tients, yet are available to patients who are taking steps
more apparent when the provisions of the new law that
to prevent illness. By using a team approach, medical
expand the Medicaid program take effect in 2014. For
homes can be sure patients are cared for by the team
Arkansas, that means 251,000 new Medicaid beneficia-
member who can best treat their needs. This may in-
ries will be seeking primary care from an already taxed
clude advanced practice nurses, dietitians, pharmacists
delivery system.
and other health professionals, as well as primary care
In Arkansas’ small towns, the shortage of primary care physicians is particularly acute and is exacerbated by limited medical technology (which makes medical care delivery less efficient), high rates of chronic illness
physicians. This issue of Blue & You features another initiative we’ve taken to address the shortage of primary care Access, continued on Page 22
Blue & You Spring 2011
3
Arkansas Blue Cross invests $1
m
Debra Fiser, M.D., dean of the UAMS College of Medicine, addresses medical students during a “white coat ceremony,” which is held at the beginning of their first year at UAMS.
4
P rimary care is in critical condition throughout
Arkansans deserve,” said Mark White, president and
the United States, and small towns in areas like rural
chief executive officer of Arkansas Blue Cross. “Instead
Arkansas are particularly hard hit. Arkansas Blue Cross
of reacting to these changes, we want to be in the fore-
and Blue Shield is working to increase the number of
front, helping to mold
primary care physicians (PCPs) available to patients in
the future of health
Arkansas by committing $1 million to the University
care in Arkansas.
of Arkansas for Medical Sciences (UAMS) College of
We believe that by
Medicine.
encouraging medical
The grant will create the Arkansas Blue Cross and
students today to go
Blue Shield Primary Care Scholarship, to be given to
into primary care, our
a junior or senior medical student in the UAMS Col-
members will have
lege of Medicine. Scholarship recipients will be chosen
the care they need to
from those planning to pursue post-graduate training in
live healthier lives in
family medicine, general internal medicine or general
the future.”
pediatrics. The students also must intend to practice
The main reasons
“We want to be in the forefront, helping to mold the future of health care in Arkansas.” — Mark White, president and CEO of Arkansas Blue Cross
primary care in Arkansas, preferably in the more rural
for the primary care crisis are:
parts of the state.
• A shortage of primary care physicians, including
“We know changes need to take place in the health care environment in order to provide the quality of care
family practice, pediatric and general internal medicine doctors.
Sources: UAMS Center for Rural Health, Johns Hopkins Primary Care Policy Center, Association of American Medical Blue & You Spring 2011
illion in Arkansas’ medical future Gift funds UAMS scholarships of “medically underserved,” with
toward graduation,” said College of
burden higher than the national av-
one primary care physician available
Medicine Dean Debra Fiser, M.D.
erage, which creates high patient
for every 3,000 people. That same
Many medical students, she said,
volume for the physicians who are
year, the Healthy Workforce in Ar-
assume that it makes sense to go
available.
kansas study by the UAMS Center
into a field of study where they can
for Rural Health indicated that there
pay off the loans quickly, and that
more than 251,000 Arkansans
were almost 1,000 vacancies for
steers them toward specializing and
to the Medicaid program in 2014
PCPs in the state. Instead of im-
away from primary care.
under health insurance reform.
proving, these trends are steadily
“The shortage of primary care
worsening.
• An aging population and an illness
• The potential projected influx of
physicians is at a critical point in this
A big reason for the shortage of
“Even for students who want to go into primary care, there is a mindset that they would never be able to earn enough to
country,” said UAMS Chancellor Dan Rahn, M.D., “Primary care physicians are the first line
Arkansas’ Physician Shortage ) Where we stand _
of defense and the ones who promote preventive care, which in turn builds healthier communities and reduces health care costs. This is truly a noble and visionary gift by Arkansas Blue Cross, and it will greatly benefit Arkansas and the future of health care.” The scholarship, given in
pay off their debt,” she said. According to the Johns
• No. 42 in the nation for PCPs per 100,000 population. • No. 48 in the nation for active physicians per 100,000 population. • 1/3 of Arkansas physicians are over the age of 55; many are retiring. • 5th highest percentage of elderly nationwide.
Hopkins Primary Care Policy Center, adults in the United States who had a primary care physician had 33 percent lower costs of care and were 19 percent less likely to die prematurely from their conditions than those who had received care
honor of the Board of Directors of Arkansas Blue Cross, will be
primary care physicians is the high
from a specialist, after adjusting
awarded each year, beginning with
cost of medical school. The Associa-
for demographic and health charac-
the 2012-2013 academic year. It is
tion of American Medical Colleges
teristics. The center found that the
estimated that about $40,000 will
estimates that the average medical
availability of primary care physi-
be available each year for the schol-
student ends up $125,000 in debt
cians is consistently associated
arship, using interest accrued from
by graduation.
with improved health outcomes for
“It is on the lower end here in
conditions like cancer, heart dis-
According to the Arkansas De-
Arkansas, but there is still an enor-
ease, stroke, infant mortality, low
partment of Health, in 2008 the ma-
mous amount of debt staring most
birth weight, life expectancy and
jority of the state met the definition
of them in the face when they look
self-managed care.
the grant.
Colleges, Arkansas Department of Health and Arkansas Center for Health Improvement Blue & You Spring 2011
5
GR8 plans 4 U Wanna communicate with your teenagers or even
campaign in Central Arkansas in January.
TXT.
messages (using a specified keyword) were sent to a
In Arkansas Blue Cross and Blue Shield’s 62-year
5-digit number. For those who have smart phones, they
history, health insurance has changed … a lot. So has
answered three questions on a Web site in their phone
technology. And communication.
browser and received a base rate quote for health insur-
your young adult children?
And, while health insurance is a common consid-
ance — almost instantly — through their phone. For
eration for many people, it’s not always the first thing
those who have text capabilities, but can’t get online on
younger people are looking to spend their money on,
their phone, they answered the three questions, one
especially when they feel “invincible.” So, to reach out to
at a time, in a texting conversation and got a rate quote
a younger adult market
6
Through the mobile messaging digital campaign, text
right in a text message. Everyone received a
about our health insur-
follow-up e-mail to continue the conversation
ance plans, Arkan-
and sales process.
sas Blue Cross launched its first “Mobile Messaging” digital
The campaign was promoted on local radio stations and thousands of listeners sent texts for quotes. “When people are in their 20s and even early 30s, they may think they don’t really need health insurance,” said Karen Raley, vice president of Communications and Product Development. “They’re healthy, they think insurance is too costly, and they would rather spend their money on other things. We want young adults to understand that health is not to be taken for granted (anything can happen), that insurance is surprisingly affordable, and that it is important for people of all ages to have health insurance.” Although the cool mobile messaging campaign has ended, our affordable, individual and family health and dental plans still are just a telephone call or a mouse click away … for people of all ages. For more details, call 1-800-392-2583 or visit our Web site at arkansasbluecross.com, select “Looking for Insurance,” and then select “Individual and Families.”
Blue & You Spring 2011
Updated, fresh look for Health Advantage Web site If you are a Health
Advantage member and you have visited the Web site recently at healthadvantage-hmo.com, you have probably noticed a new look and feel that combines creativity with ease of use. The Health Advantage Web site has always been a place for our members,
7
potential members and visitors to find information about our insurance plans and services. From the home page, you can select our self-
• Pharmacy benefit information
service center (My Blueprint) where you have 24/7
• Health insurance options if you are an employer
access to your recent pharmacy and medical claims,
• Health and wellness information and discounts
your personal health record, physician cost and quality
• And much more!
information, the ability to print or order a new ID card and much more. Also, visit our Web site to find: • A doctor or hospital in the Health Advantage network • An office near you or our customer service telephone numbers • Your health plan’s medical benefit information
If you are a Health Advantage member, visit your new and improved Web site today! It was designed to help you find the information you need from your health insurance plan … healthadvantage-hmo.com. It’s good for you. Please use the “Contact Us” link to let us know what you think about the new Web site. We love to hear from you.
• Information specifically for ASE/PSE employees
Blue & You Spring 2011
SilverSneakers becomes a silver lining
8
Joyce Elrod has quite a view of the University of Arkansas for Medical Sciences campus as she exercises on the treadmill at the Donald W. Reynolds Institute on Aging.
Blue & You Spring 2011
while allowing them to sit in a
If you had met Joyce Elrod
chair so they don’t lose bal-
in 2008 and then again in 2011,
ance. It was just what Joyce
you might think she was a dif-
needed to help repair a torn
ferent person, and in a way she
rotator cuff in her shoulder.
is, thanks to the SilverSneak-
It didn’t take long before
ers® Fitness Program.
Joyce became a regular at the
The day after Thanksgiving
Reynolds Institute on Aging,
in 2008, Joyce’s husband of
exercising about four times a
47 years, Lowell, passed away.
week. She tried the cardio cir-
She had been his caregiver for
cuit class for more activity and
years and had also cared for her
has branched off to enjoy other
mother before her passing. As
classes, including an exercise
with many caregivers, Joyce put
dance class! Her New Year’s
her needs on hold to take care
resolution is to take more ad-
of her loved ones.
vantage of the pool at UAMS,
With the dawning of 2009,
which offers SilverSplash®, a
Joyce found herself overweight,
SilverSneakers classes have helped Joyce tremen-
ceived information about SilverSneakers through the
dously; she has lost about 16 pounds and her doctor
mail and in Blue & You magazine but never had the time and motivation to check it out. Then a friend at a church luncheon talked to her about the program at the University of Arkansas for Medical Sciences’ (UAMS) Donald W. Reynolds Institute on Aging. Her daughter already had been encouraging her to go, and she said it seemed like a sign that she should give it a try.
has lowered her blood pressure medicine. But the benefits don’t stop there. She has been able to use exercise to get off medication for anxiety and depression. Joyce has gone from being a wallflower to being a leader; at 70 years old, she is chairman of outreach at Mount Pleasant United Methodist Church in Little Rock, a volunteer in the UAMS gift shop and recently agreed
SilverSneakers is the nation’s leading exercise program designed exclusively for older adults, offering an innovative blend of physical activity, healthy lifestyles and socially oriented programming. SilverSneakers is available to Arkansas Blue Cross and Blue Shield MediPak and Medi-Pak Advantage (PFFS) members at no additional cost at wellness centers, YMCAs and Curves
9
SilverSneakers water class.
depressed and on several medications. She had re-
®
locations in all 50 states, Puerto Rico and Washington. “I started exercising just on my own, with the machines, but after a while I decided it would be fun to try one of the SilverSneakers classes,” Joyce remembered. First she tried the Muscular Strength and Range of
to help teach a class at the Institute on Aging on selfmanagement of chronic diseases. “SilverSneakers helped me to get back to living my life,” Joyce said. “It keeps seniors healthy; not in hospitals.” For more information on SilverSneakers, call 1-888-423-4632 or visit silversneakers.com.
SilverSneakers is a registered mark of Healthways, Inc. The SilverSneakers Fitness Program is provided by Healthways, Inc., an independent company that operates separately from Arkansas Blue Cross and Blue Shield.
Movement class, which gives participants a work out Blue & You Spring 2011
Lifelong Health
with Dr. David
dren and teenagers. In the next 10 years, the Centers for Disease Control and Prevention estimates that more than 100 million Americans will either have diabetes or prediabetes. The differences in these two conditions David A. Lipschitz, M.D., Ph.D.
are a matter of degree. Prediabetes is diagnosed if the fasting blood glucose is above 100 but below 125. If the value is above 125, the diagnosis is diabetes. This disease is important because of its devastating impact. In overweight individuals, diabetes occurs because the body loses the ability of the hormone insulin to pump glucose (sugar) into the cells. This condition, called insulin resistance, causes the blood glucose to
10
rise and diabetes to develop. Sadly, the elevation of glucose causes widespread changes in the body that can impair a person’s quality of life and longevity.
Effects of elevated blood glucose By itself, elevated blood glucose leads to dehydration. Excess glucose spills into the urine taking gallons of fluid with it. As dehydration develops, confusion sets in and eventually the patient may become comatose. The diagnosis is made in the hospital, and with appro-
The widespread and devastating impact of
diabetes.
Type 2, or adult onset diabetes, is a complex dis-
ease. Virtually every American has a genetic predisposition to the disease that often only manifests in individuals who are overweight, sedentary and have much
priate treatment blood glucose can return to normal. Interestingly, in the earliest phases of diabetes a dramatic drop in blood sugar can follow very high blood glucose levels after a meal. Anyone who says that they have low blood glucose may in fact have diabetes.
Effects on body lipids Most diabetics have elevated cholesterol, with
more fat than muscle. In the past two decades, this
increases in the level of bad or LDL cholesterol and
exploding epidemic of obesity has reached such propor-
reductions in the good or HDL cholesterol. Diabetes
tions that for the first time it is occurring in young chil-
also causes very high triglyceride levels, as unused
Blue & You Spring 2011
Editor’s Note: David A. Lipschitz, M.D., Ph.D., is nationally recognized as a leader in the field of geriatrics. Arkansas Blue Cross and Blue Shield is honored to have him as a contributor to Blue & You magazine.
glucose is converted to fat in the liver. These changes
mise in these small vessels, the ability of any injury
lead to widespread vascular disease affecting the heart,
to heal is compromised leading to progressive and
brain, abdomen and lower limbs. Not only are heart
devastating foot and leg problems.
attacks and strokes more common, but their severity is
• Kidneys — Small vessel disease leads to progressive loss of kidney tissue eventually causing them to
increased as well.
fail and require dialysis. Today, adult onset diabetes
Effect of diabetes on tiny arteries in the body For reasons that are poorly understood, the tiniest arteries become totally blocked in patients with diabetes. Called diabetic microangiopathy, this change virtually affects every organ in the body. Here are some of the
is the most common cause of chronic renal failure. Kidney damage also causes high blood pressure increasing the risk of heart attack and stroke.
What should be done First and foremost, we as a nation must recognize the serious nature of the obesity and seden-
most critical:
tary lifestyle epidemic. Through new
• Eyes — Blockage of tiny vessels in the eye leads to a condition called diabetic retinopathy. The retina is that part of the eye
mandates, Medi-Pak and Medi-Pak
First and
Advantage plans and most other
foremost, we as a nation
that sees and interprets light. As blockage occurs, blood supply to the retina becomes impaired. To overcome this, the body produces new tiny and fragile
plans offered by Arkansas Blue
must recognize the
Cross and Blue Shield are
serious nature of the
and screening for disease.
obesity and sedentary lifestyle epidemic.
blood vessels. This overgrowth
blindness in adults. • Lower Limbs — Here impaired supply to nerves
Counseling on nutrition and exercise must be a critical component of patient care. There must be a strong emphasis assuring that overweight individuals learn
can lead to retinal detachments and bleeding, two major causes of
focusing on promoting health
how to become fit and healthy through a prudent diet and exercise. Just as important is screening tests to diagnose either prediabetes or diabe-
causes a condition called peripheral neuropathy. This
tes. Appropriate lifestyle and medication treatment can
causes severe pain, burning and tingling that can be
guarantee a lower rate of complications and a longer
most distressing. Weakness impairs gait and balance
and better life.
and loss of sensation means that a patient will not recognize an injury. Even worse because of comproBlue & You Spring 2011
11
Lose weight The Healthy Weigh!
Kids and
The Healthy Weigh! Education Program is free for members of Arkansas Blue Cross and Blue Shield, Health Advantage (except ARHealth members*), Blue Cross and Blue Shield Service Benefit Plan (Federal Employee Program), Medi-Pak Advantage (PFFS), Medi-Pak Advantage • St. Vincent PPO and eligible members
12
of BlueAdvantage Administrators of Arkansas. To enroll, complete the attached enrollment form and return it in the
caffeine overload
self-addressed, postage-paid envelope included in this magazine. The program starts when you enroll. After enrollment, you will begin to receive information through the mail, which you can read in the privacy of
According to a recent study in the Journal of Pediatrics, three-
your own home and at your own pace.
quarters of children ages 5 to 12 consume caffeine. The study found
The program is completely voluntary,
that children ages 5 to 7 consumed around 52 milligrams of caffeine
and you may leave the program at any
per day, and children 8 to 12 consumed approximately 109 milligrams,
time. If you have further questions
which is equivalent to 36 ounces of soda.
about the program, call the Health
But what does this mean? The study suggests that this caffeine
Education Program’s toll-free number
consumption is keeping kids up at night. Lack of sleep can affect school
at 1-800-686-2609.
performance and also is associated with obesity. Moreover, the con-
* Arkansas state and public school employees and retirees can access the “Nourish” program through LifeSynch.
sumption of excess soda amounts also is linked to obesity as well as high blood pressure. Source: WebMD Blue & You Spring 2011
Simply complete, sign and return the attached enrollment form in the selfaddressed, postage-paid envelope to join The Healthy Weigh!
Chickenpox vaccine cuts hospitalizations It is estimated that between 2000 and 2006, 50,000
hospitalizations were prevented thanks to the chickenpox (varicella) vaccine says a recent study published in
the February 2011 issue of Pediatrics. This equates to a 71 percent reduction in hospitalization due to varicella. This is a timeframe known as the one-dose chickenpox vaccination era. Today, the CDC recommends two doses of the vaccine. Thus, further declines in hospitalization are predicted. Source: WebMD
Is there a link between breast cancer risk and when women begin hormone therapy? Breast cancer risk increases among women who
start hormone therapy around menopause, according to findings from a recent study that appeared in the Journal of the National Cancer Institute. In a follow-up to a 2003 report, researchers in the “Million Women Study” examined outcomes in some 1.1 million postmenopausal women. The findings include the following: •
Both current and past users were at significantly higher cancer risk than those who had never used hormone therapy, and risk increased with duration of use. • The risk was greater among current users if therapy started before or soon after menopause, compared with starting later. • The greatest risk was among current users of estrogen-progestin formulations. • Risk declined rapidly after stopping use, falling to that of non-users within three years. Blue & You Spring 2011
13
Kids with
asthma: The
battle to breathe
14
Parents who have children with asthma often have
To do the study, investigators created a device to sim-
an ongoing battle. You hear that dreaded wheeze, but
ulate the breathing patterns of 118 children with asthma
your child hates the inhaler, and you wonder if the
as if they were actually taking their inhaled medication.
medication is even getting into his or her lungs.
The device then recorded the amount of medication be-
Good news! Even if your child refuses to take more
ing delivered. The device simulated the children taking
than a few breaths from their inhaler through a spacer
medication both with normal breathing and with one
(a chamber that the child breathes through), they still
big breath. The device also was used to determine if
are probably getting enough aerosolized medication.
there was a difference in medication delivery when us-
A recent study in Australia found that children ages 2
ing smaller spacers and larger spacers.
to 7 inhaled as much aerosolized medication through
What the investigators found was that the children
a spacer with two or three regular breaths as they did
received an adequate amount of medication in their
with more inhalations.
lungs using normal breathing. The big breaths in some
Instructions from the medication’s manufacturers
cases actually lowered the amount of medication de-
have recommended that children inhale from five to
livered. They also determined that a maximum amount
“several” times, using normal breathing — or in some
of medication is received through two normal breaths
situations taking one big breath — when receiving a
for small-volume spacers and three normal breaths for
dose of medication from a pressurized metered dose
large-volume spacers.
inhaler (MDI) attached to a spacer. But parents know
For frustrated moms and dads, this means less time
this can be a difficult task. The Australian investigators
battling over taking medications and more confidence
set out to determine how much medication the children
that the medication that your child does get is actually
were getting in each breath.
enough to do some good. Source: The medical journal Pediatrics
Blue & You Spring 2011
Updated Vitamin D and Calcium Recommendations …
You are probably getting enough! Adolescents ages 9 through 18 require no more than 1,300 milligrams per day. For practically all adults ages 19 through 50 and for men until age 71, 1,000 milligrams covers daily calcium needs. Women starting at age 51 and both men and women age 71 and older need no more than 1,200 milligrams per day. As for vitamin D, 600 international units (IUs) daily meets the needs of almost everyone in the United States, although people 71 and older may require as much as 800 IUs per day because of potential physical and behavioral changes related to aging.
The Institute of Medicine (IOM) recently updated
The majority of Americans are getting enough vitamin D and calcium, however, some adolescent girls may not
its recommendations for the amount of vitamin D and
get quite enough calcium, and there is a greater chance
calcium Americans should be taking, and noted that,
that elderly individuals may fall short of the neces-
with a few exceptions, all Americans are receiving
sary amounts of calcium and
enough calcium and vitamin D. The IOM also pointed
vitamin D. These individuals
out that taking higher levels have not been shown to of-
should increase their intake
fer greater benefits, and in fact, they have been linked
of foods containing these
to other health problems, challenging the concept that
nutrients and possibly take
“more is better.”
a supplement.
The report’s recommendations take into account nearly 1,000 published studies as well as testimony from scientists and others. Evidence confirms the
Source: Institute of Medicine
roles of calcium and vitamin D in promoting skeletal growth and maintenance and the amounts needed to avoid poor bone health. The IOM’s calcium recommendations, based on age, range from 700 to 1300 milligrams (mg) daily. The science on calcium’s role in bone health shows that 700 milligrams per day meets the needs of almost all children ages 1 through 3, and 1,000 milligrams daily is appropriate for almost all children ages 4 through 8. Blue & You Spring 2011
15
Here’s the rub … vapor
A recent clinical trial article in
the journal Pediatrics presented
The results indicated that vapor
impact the results. This trial also limited the patients
some information that might be use-
rub showed the great-
to children 2 years old or older.
ful for those of us who have children
est improvement on all
If you’ll take the time to read
or know someone who has children.
of the symptoms except
the back label of the vapor rub
What I liked most about it was that
runny nose. The article
products — and you should
the data showed it was beneficial for
then states that the most
always read the label of any
the child and the parent.
profound results were for
over-the-counter product —
the outcomes related to
you will see that vapor rub
The article describes a clinical trial
16
the parent’s ability to sleep.
rub.
only is approved for treatment
with children ages 2 to 11 who were
child and parent sleep. As rated
suffering at night from cough, con-
by parents, children with the vapor
of children who are at least 2 years
gestion and runny nose. The children
rub slept better than the children
old. The label also warns about the
were placed into one of three groups
receiving topical petroleum jelly or
danger of eating vapor rub, and as
— overnight treatment with topi-
no treatment. Similarly, the parents
with any medication, you should be
cal vapor rub, overnight treatment
of children treated with topical vapor
sure to keep this out of the reach of
with topical plain petroleum jelly, or
rub said they slept much better.
children.
no treatment at all. Thirty minutes
When the symptoms and ability to
So, vapor rub, when used safely,
before the children went to bed, the
sleep were combined for analysis,
applied appropriately and applied to
rubs (vapor rub and petroleum jelly)
vapor rub was proven superior.
the appropriately aged patient, helps
Any good clinical trial also looks
relieve cough and cold symptoms
upper chest and neck area of the chil-
at safety and adverse effects. In this
leading to a better night’s sleep for
dren and massaged in for one min-
case, nearly half of the children who
both the child and the parent. To me,
ute. The next morning, the parents
received the vapor rub treatment
that is good news.
were asked to describe the effects
experienced some sort of expected
of the treatments on the children’s
mild burning sensation, but the
use vapor rub on your child, always
symptoms (cough, stuffy nose and
article says the burning sensation
read the label and follow the direc-
runny nose) and on the child’s and
was short lived and didn’t appear to
tions as they are listed.
were applied by the parents to the
From the
Just remember, if you choose to
Source: Pediatrics, December 2010
Pharmacist
by Brandon Griffin, Pharm D., Arkansas Blue Cross and Blue Shield
Blue & You Spring 2011
The
Doctor’s
Corner Poor oral hygiene means a greater risk of heart disease
ever, you may want to encourage
Tell your dentist if you take a medication for bone loss
your teen to turn the music down. Research shows that repeated exposure to loud music will cause
Medications known as “bispho-
permanent hearing loss. A new
sphonates” are commonly used to treat bone loss due to osteoporosis (the thinning of bone tissue and loss of bone density over time). These drugs are heavily advertised and the names may sound familiar: Boniva (think the Sally Field “endorsement” commercial), Fosomax, Reclast and Actonel. These drugs have been shown to cause a rare but potentially very serious and painful condition known as osteonecrosis of the jaw. Although this condition is rare, it is more likely to happen to someone taking these medications if they have dental work such as a tooth extraction. Women who take these medications need to inform their dentist before any dental procedure is performed. In a recent study, 80 percent of women taking these drugs were not aware they should let their dentist know they take these medications.
by Ray Bredfeldt, M.D., Regional Medical Director Northwest Region, Fayetteville
study has found that 19 percent of Previous research has shown that inflammation of the gums (gingivitis) is associated with heart disease.
young people between the ages of 12 and 19 suffer from significant hearing loss. One good rule of
It’s been theorized that chronic inflammation (swelling) from dental disease causes a reaction by the body, which has negative effects on the arteries of the heart. Recent evidence indicates that people who brush their teeth less than two times per day are as much as 70 percent more likely to develop heart disease. It appears that people who brush twice a day and floss daily significantly reduce their risk of heart disease.
Hearing loss increasing sharply in adolescents If you have a teenager (or can
thumb is that if someone else in the room can hear the music when earphones or headphones are being used, the volume is probably too high. Encourage the teen in your life to keep the volume of their favorite music artists down to a normal level to protect their hearing (so they can keep listening for many years to come).
remember being a teen), you know they like their music loud. HowBlue & You Spring 2011
17
Foundation grant helps N
atasha Crosby had a concern.
She was the only person in her organization certified in first aid and
care for children from as young as six weeks old to five years old. “This is typically the time when
center in Bentonville attended the training on a Saturday,” said Natasha.
Cardio Pulmonary Resuscitation
they start to eat solid foods and
“The following Monday a child
(CPR). The facility where she works,
when they start to feed themselves,”
started choking in their center and
the Helen R. Walton Children’s
Natasha said. “This makes choking
one of the employees, who had
Enrichment Center in Bentonville, is
a real possibility. These little lives
been certified, was able to save that child’s life.”
rather large, serving 240 children.
Andrea Pearson was that
If a child needed help on one end
employee.
of the facility while she was on
“If I had not taken this class, I
the other end, it could be too late.
18
“The employees of a childcare
Others needed to be trained, too.
might have panicked,” she said.
That got her thinking.
“But because I did, I was able to save someone.”
“If we have this problem then I know other daycare centers do, too,” Natasha said. “The question was ‘how can we serve the
Employees learning cardio pulmonary resuscitation (CPR).
Natasha pointed out that Andrea’s experience was not the only one. “There have definitely been more,” she said.
greatest number of children in
Probably the most dire
our area?’”
situation, according to Michelle
They decided to write a grant application to the Blue &
Stephens, the executive director
You Foundation for a Healthier
of the Helen R. Walton Children’s
Arkansas to fund a program
Enrichment Center, occurred
that would teach early childhood
when a toddler in Siloam Springs
professionals first aid and CPR —
are in our hands. That’s why it’s so
accidentally hanged herself on a
and not just to their own employees
important we have training in
piece of classroom equipment.
but to early childhood professionals
this area.”
in childcare centers all across
The Blue & You Foundation
“When the teacher reached her, the toddler had turned blue and
agreed and awarded grants to fund
was not breathing. The teacher,
a training program for 2009 and
who had recently gone through
because, in our field, it is so vitally
again in 2010. In that time, 869 early
training, began CPR and continued
important to save children’s lives,”
childhood professionals in Arkansas
rescue breathing until EMS
said Natasha. “Especially with the
were trained in first aid and certified
arrived,” Stephens said. “The EMS
age groups that we serve.”
in CPR. And, just as soon as the
technician said if it had not been
training began, it paid off.
for the teacher, the child may have
Arkansas. “We decided to apply for a grant
Early childhood centers usually Blue & You Spring 2011
save children’s lives CPR, first-aid training program funded died. Everything we invested in this
like dropping a pebble in a pond,
center has established with the Blue
program in the past two years paid
creating ripples that have extended
& You Foundation is paving the way
for itself tenfold in just that one
outward across Arkansas,” said
for additional funding.
child. The first aid and CPR funding
Patrick O’Sullivan, executive director
from the Blue & You Foundation
of the Blue & You Foundation.
influence in our community,” said
saved a child’s life. There’s no doubt
“By training more than 800 child-
Stephens. “Instead of just being a
in my mind.”
care workers from more than 50
start-up organization, we now have
communities in Arkansas, we have
two years of data to fall back on.
helped ensure the health and safety
In fact, in another grant application
of approximately 20,000 children.”
we received a letter asking for
“The first aid and CPR funding from the Blue & You Foundation saved a child’s life. There’s no doubt in my mind.” — Michelle Stephens, the executive director of the Helen R. Walton Children’s Enrichment Center
the history of our organization
And the benefits have gone well beyond the classroom. “Some who have received the training have come back and said, ‘I haven’t had to use it in our center yet, thank God,’ but they’ve had to use it in their home,” Natasha said. “One woman saved her husband from choking. So it’s not only benefitted our centers but our communities as well.” Even if the training is never used, it provides a peace of mind. “Having all of my employees CPRtrained gives me a better peace of mind,” said Tonie Scaife, director of
Based on the success of this
“It has helped us become a stable
because they did not fund start-up organizations. Blue & You Foundation funding has given credibility to our program and opened up a new funding source we were never able to tap into before.” In its nine years of operation, the Blue & You Foundation has awarded nearly $12 million to 185 health improvement programs in Arkansas. Arkansas Blue Cross and Blue Shield established the Foundation
Cotton Candie Childcare, Inc. in Fort
program, the Walton Children’s
in 2001 to promote better health in
Smith. “We are a 24-hour facility,
Enrichment Center applied for
Arkansas. The Foundation awards
and this allows parents to be more
and received a new grant for
grants annually to non-profit or
comfortable with leaving their prized
2011. According to Stephens, their
governmental organizations and
possessions, their children, in the
2011 work will train 1,000 early
programs that positively affect the
care of my staff. It allows me to rest
childhood professionals in northwest
health of Arkansans.
easier knowing that if something
Arkansas in child and playground
The application deadline for the
did happen — God forbid — I
safety, provide playground safety
Foundation’s next funding cycle is
have a competent, trained, CPR-
improvements for child-care centers,
July 15, 2011. For more information
certified staff in place to handle any
and administer tuberculosis clinics
about the grant application process,
emergency situation.”
and testing.
visit the foundation Web site at
“Funding this program has been
Beyond that, the relationship the
blueandyoufoundationarkansas.org. Blue & You Spring 2011
19
good for you
starts with …
Pharmacy Christmas is long since over, but the generosity shared by one
time,” said Sherrill Montgomery,
division at Arkansas Blue Cross and
rebate administrator. Karen Bragg,
Blue Shield continues in the lives
prior authorization coordinator,
of two families — people they have
said the experience puts her life in
never met.
perspective. “We are so blessed,
For three years, the Pharmacy
20
shouldn’t go without at Christmas
and if we can put a smile on
Division has adopted families
the face of a child — that’s the
to help during the holidays. The
whole point.”
tradition began with Stephanie
Toward the end of November,
Carpenter, pharmacy analyst, who
after the families have been picked,
credits her mother with making it a
the 15 team members start their
part of her Christmas as a child.
shopping. They receive a detailed
“My mom always did this when
list that includes each child’s age
we were younger,” she said,
and size, and “pretty much they get
explaining that for her it was a
everything on their list,” said Sherrill.
part of the celebration. The first
If they have information on the
family the Pharmacy team helped
parents, they give them gift cards
was someone they knew who
and household items.
needed help, but the last two years
“When you’re out shopping for
they picked families through Big
them, you think about what they
Brothers Big Sisters of Central
are like,” said Stephanie. She said
Arkansas. This year, they decided to
her daughter Jasmine, 12, goes
expand their generosity by helping
shopping with her for the children
two families with a total of four
and helps pick the gifts. Sherrill
children.
agreed, adding that one girl this
“So many families are
year “loves to read and wants to
struggling, but their kids
be a lawyer.”
Blue & You Spring 2011
At Arkansas Blue Cross and Blue Shield, w
Customer Service, and we have a saying — of our employees, serving others doesn’t e
After the gifts are selected, the
working toward one goal. “And, I’ve
are committed to continuing their
Pharmacy team members have a
actually learned how to wrap gifts!”
tradition of generosity.
potluck and wrapping party. The
said Sherrill.
time together is important because
While the Pharmacy team
the team’s jobs are very diverse,
members don’t actually get to
but during the holidays they are all
meet the families they help, they
“We love being Santa,” Sherrill said.
21
e recognize that every one of us is in
— “good for you starts with me.” For many
Employees of the Arkansas Blue Cross Pharmacy Division prepare to ship Christmas gifts to a family in need. For the third consecutive year, Pharmacy employees brought in gifts, wrapped them and sent them to needy families.
nd with the workday or the workplace.
Blue & You Spring 2011
Operation Woolly Mittens It was cold this winter, but Arkansas Blue Cross and Blue Shield’s Operation Woolly Mittens warmed many Arkansans in need. More than 1,400 warm gloves, coats, scarves and other winter-weather items were collected during
Skaters enjoy time on the ice “purchased” with donations of “woolly” items to Operation Woolly Mittens.
Operation Woolly Mittens, which was held in December at the ARVEST River Market on Ice (a temporary, public ice skating rink) in downtown Little Rock. The donated items were distributed through five Central Arkansas
22
charities: Little Rock Compassion Center, Women and Children First, Our House, Dorcas House/Union Rescue Mission and the Salvation Army (Benton, Hot Springs,
who donated to help those in need this winter,” said
Jacksonville, Little Rock, North Little Rock and Pine Bluff
Mark White, president and chief executive officer of
shelters).
Arkansas Blue Cross. “The outpouring of donations was
“We are so pleased with the success of Operation Woolly Mittens and would like to thank all of the people
heart warming and all of the items collected certainly helped keep men, women and children in Central
Access, continued from Page 3 physicians in the state. Arkansas Blue Cross contribut-
dents to choose primary care as their specialty and help
ed $1 million to the University of Arkansas for Medical
to refill the pipeline of primary care students graduating
Sciences (UAMS) Foundation Fund to provide scholar-
from Arkansas’ medical school. The gift to UAMS for
ships to students in the College of Medicine who are
primary care scholarships is a good start and we hope
planning to practice in Arkansas, with an emphasis on
others will contribute to it eventually.
those who indicate a desire to practice in rural areas. Many medical students find it difficult to get through
These initiatives are coming not a moment too soon. In 2014, many Arkansans who will receive additional
medical school without staggering student loan bal-
help through health insurance reform live in the same
ances. Primary care physicians, in particular, find it hard
rural communities already struggling to provide health
to justify that investment with what they can expect
care services. It is vital that we do everything we can to
to earn once out of medical school compared to other
support the medical professionals already serving these
medical specialties. By helping to defray the cost of
communities and provide incentives to recruit more
medical school, we can encourage more medical stu-
physicians to rural Arkansas.
Blue & You Spring 2011
We love to hear from you!
Arkansas a little warmer during the winter months.” For each winter accessory donated, individuals received a voucher to redeem at the ice skating rink for one hour of skating.
May we help? For customer service, please call:
Little Rock Number (501)
Medi-Pak members
378-3062 1-800-338-2312
Medi-Pak Advantage members
1-877-233-7022
Medi-Pak Rx members
1-866-390-3369
Arkansas Blue Cross members BlueAnn Ewe greets health fair visitors in Fort Smith’s Central Mall.
Toll-free Number
378-2010 1-800-238-8379
Pharmacy questions
1-800-863-5561
Specialty Rx Pharmacy questions
1-866-295-2779
Health Advantage members
378-2363 1-800-843-1329
Pharmacy questions BlueAdvantage members
1-800-863-5567
378-3600 1-888-872-2531
Pharmacy questions
1-888-293-3748
State and Public School members 378-2364 1-800-482-8416
BlueAnn Ewe attends health fair in Fort Smith BlueAnn was a star at the Central Mall health fair held in Fort Smith on Jan. 29, 2011. The West Central Regional Office staff made popcorn, and handed out heart-health literature to more than 250 adults that attended the health fair. They also handed out BlueAnn’s “Wild and Woolly Health Tips for Kids” coloring books.
With change comes opportunity. And health insurance reform brings numerous changes. For this reason — we are excited. We are looking for ways to help Arkansans live healthier lives, have better access to care and have more resources to make smart health care decisions. We believe the future of health care will be one where the best of technology, medical research, health insurance and compassionate care join together, and where hometowns can be healthy places to live. At Arkansas Blue Cross, we are striving to be good for you, and good for Arkansas.
Federal Employee members
378-2531 1-800-482-6655
Looking for health or dental insurance? We can help! For individuals, families and those age 65 or older
378-2937 1-800-392-2583
For employer groups 378-3070 1-800-421-1112 (Arkansas Blue Cross Group Services, which includes Health Advantage and BlueAdvantage Administrators of Arkansas) Prefer to speak with someone close to home? Call or visit one of our regional offices: Pine Bluff/Southeast Region 1800 West 73rd St. Jonesboro/Northeast Region 707 East Matthews Ave.
1-800-236-0369
Hot Springs/South Central Region 100 Greenwood Ave., Suite C Texarkana/Southwest Region 1710 Arkansas Boulevard Fayetteville/Northwest Region 516 East Milsap Rd., Suite 103 Fort Smith/West Central Region 3501 Old Greenwood Rd., Suite 5 Little Rock/Central Region 320 West Capitol Ave., Suite 900
1-800-588-5733
1-800-299-4124
1-800-470-9621 1-800-817-7726 1-866-254-9117 1-800-421-1112
Visit our Web sites for more information:
arkansasbluecross.com healthadvantage-hmo.com blueadvantagearkansas.com blueandyoufoundationarkansas.org
Blue & You Spring 2011
23
At Arkansas Blue Cross and Blue Shield, we are always looking for new ways to be "Good for You." Here are some of our latest accomplishments.
24 Blue & You Fitness Challenge reboots The 2011 Blue & You Fitness Challenge is under way! If you are one of the thousands participating in
categories. Arkansas Blue Cross and Blue Shield, the Arkansas Department of Health and the Department of Human Services host the Challenge.
the 2011 Blue & You Fitness Challenge, you should
If you missed the Challenge this year, you can
be well on your way to exercising (virtually) across
go to arkansasbluecross.com, select “Members,”
the United States. More than 260 groups with an
go to the “Popular Links” section and select “Blue
eligible population of 75,100 registered for the Chal-
& You Fitness Challenge.” Then encourage your
lenge this year.
co-workers, friends or people in your community to
The Blue & You Fitness Challenge is an exercise contest held March through May each year that encourages participants to work toward the public health recommendation of adult physical activity 30 minutes each day, most days of the week. Each day that a participant completes a cardiovascularoriented exercise session, he/she logs the exercise online to advance “virtually” one checkpoint on a national map. The winning entity is determined by
participate next year!
Arkansas Blue Cross Web site makeover Our flagship Web site has gotten a facial! The home page of arkansasbluecross.com now looks similar to its younger sister site, healthadvantage-hmo.com. Don’t be confused; the same great Arkansas Blue Cross information is still just a click away and is always good for you!
whose group members score the highest in four
MPI_#715
Blue & You Spring 2011