Winter 09
• See what’s replacing the Explanation of Benefits, Page 4 • Keep your young adults covered, Page 6 • Develop a relationship with your doctor, Page 18
Ruben Rodriguez of Greene County, Ark., is back to helping others after heart surgery. See his story on Page 10.
A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
INSIDE 3 Out of the Blue 4 Personal Health Statement keeps members 6 7 8 9 10 14 16 17 18 Jason Green and Tona Schmidt discuss the Fit4Life program at the Baldor Electric Company headquarters in Fort Smith.
20 22
on Page 30 14 A SilverSneakers competition winner 23 Medicare benefits for 2010 24
Online Health Tools
Winter 09
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.
23 24 25 26 28 30 31 32
“up to date” Keeping your young adult covered Are you taking prescription antacids? Healthy lifestyle may reduce Alzheimer’s risk Let the sunshine in — for your health Treating gestational diabetes reduces health risks Heart attacks on the rise in women Healing a giving heart SilverSneakers competition winner logs more than 1,000 miles Behavioral health services now available Lose weight The Healthy Weigh! Babies born to obese women at greater risk Mammogram wellness benefits continue Costs Matter: Developing a relationship with your doctor Senior Moments with Dr. David From the Pharmacist — Paying for your medications Happy New Year to our Medi-Pak and Medi-Pak Advantage members Online Health Tools Blue & You Fitness Challenge registration under way The Doctor’s Corner Good for Your Community What is a hospitalist? Baldor — Building a lean machine Customer Service telephone numbers Good for you
Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer: Gio Bruno Photographer: Chip Bayer Contributors: Chip Bayer, Matthew Creasman, Damona Fisher, Kristy Fleming, Jennifer Gordon, 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
themselves fortunate to have good jobs during these difficult times, they always are mindful of those whose paths have been more challenging. And they walk the talk. Collectively, they contribute thousands of volunteer hours to communities all across the state. And they open their pocketbooks to help the causes they believe in as well. In fact, just the con-
Employees who care The beginning of a new year is a time in which many
tributions our employees made to nonprofit organizations through Arkansas Blue Cross totaled more than
of us pause to reflect on the blessings we’ve enjoyed
$100,000 in 2009. That doesn’t count what they did on
during the past year. As I stop to consider the things I
their own.
am most grateful for, the men and women who work
Because of their generosity, tornado victims got a
at Arkansas Blue Cross and Blue Shield are always near
helping hand. Cures for diabetes and sickle cell ane-
the top of the list. I am grateful for their concern for
mia and cystic fibrosis are a little closer to reality. They
you, our valued customers. I am grateful for the energy
donated to hospice organizations and humane societies
and dedication with which they approach their jobs here
and helped children with disabilities. Our employees
at Arkansas Blue Cross. But above all, I am grateful for
provided money to feed the hungry and shelter the
the kinds of citizens they are; the kind of compassion-
homeless. They were there for the victims of fires and
ate, engaged and accountable people that every com-
accidents and poverty. They are people of value con-
munity can use.
tributing to organizations of value. And I am grateful for
With so many comments in the media today vilifying those of us who work in the insurance industry, I
them every day. At Arkansas Blue Cross, we know that being a good
hope you will allow me a moment to tell you about the
corporate citizen begins with employing productive
people that walk the halls of this insurance company
and responsible citizens. I’m proud to work with such
every day. Although we have a few employees out of
a community-minded group of men and women. And
state, our employees are largely Arkansans. Many are
you’ll be glad to know they bring that same spirit of ser-
your friends, your neighbors, your children’s coaches
vice to the workplace as they serve you, our members,
and your Sunday school teachers. Because they count
every day. Blue & You Winter 2009
3
A new
view of your claims
Personal Health Statement keeps members “up to date”
At Arkansas Blue Cross and Blue Shield, we want
the conversations we have with our members to be
reminded of their health benefits. Charts and graphs,
helpful, clear and complete, whether we’re talking by
hopefully, will make the information displayed easier to
telephone, on our Web sites or in writing.
understand.”
One of our most frequent member communications — the Explanation of Benefits (EOB) — is getting a new look and content, and, a new name. The EOB is the health-care benefit statement generated every time your doctor or hospital files a claim. The EOB notifies you that we received a claim and how we handled that claim. Beginning in March, many Arkansas
4
added a ‘Benefits at a Glance’ section, so members are
Members also asked for:
• A better description of the discounts they receive on their health-care services.
• Information on how to get in touch with us. • A quick understanding of how much they owe and to whom.
• Help in understanding the benefits they have and
Blue Cross members will begin receiving a Personal
how they work.
Health Statement (PHS) in place of their EOB.
A Benefit Summary section shows members their
The PHS is more comprehensive than the EOB and designed to make claims processing easier to understand. The PHS also gives more information about health benefits. “Health insurance is a complex industry with lots of moving parts and a language all its own,” said Karen Raley, vice president of Communications and Product
personal health benefits and tracks where they are in meeting deductibles and out-of-pocket maximums. Pharmacy information has been added, including generic medication recommendations. Another new feature on the PHS will be personal health messages and reminders to get health screenings. Members still have the option to confidentially view
Development. “We want to simplify industry terms into
their PHS electronically. To sign up for a notification
everyday language, clearly explain claims, and help our
e-mail, members can go online and sign up through the
members know exactly where they are with their out-
My Blueprint member self-service center. Then, when a
of-pocket costs (deductibles, copayments, coinsurance and more).” The new PHS is the result of feedback from member focus groups. “First and foremost, members told us they want to know ‘what do I owe?’” Raley said. “So we’ve put this information in red on the first page. We’ve also
Blue & You Winter 2009
new PHS is generated, you will receive an e-mail. The new PHS will be issued two times a month
— it’s easy to see what has been paid to whom and what is owed. The discounts on health-care
instead of every time a claim is filed. If a member only
services are easier to see, and, wow,
has pharmacy claims during a month, the PHS will be
what a difference in cost! I don’t think
issued quarterly.
many employees realized the true cost
The PHS was piloted with three groups in Arkansas to get member reaction to the new format and content. “We love the new statements!” said Sharon Burdine, vice president and assistant director of Human Resources with Simmons First.
“We think the
of prescription drugs until the new format. Once you become familiar with the new format, it is more understandable overall.” Ann Freeman, vice presi-
“Our associates are finding
dent of Benefits with First
the new Personal Health
National Bank and Trust of
new PHS will
Statement is easy to un-
Mountain Home, said,
derstand. The statement
“Our employees are
shows several things
finding the new Personal
that were not available
Health Statement
before, such as pre-
easier to read. The
scriptions. The infor-
language is better
mation shown is more
and doesn’t sound
Northwest Arkansas
descriptive of what our
so ‘insurance-y’
Community
benefits are, of services
and the charts
received, what the health
provide a good
be a valuable tool for helping us to become
better consumers of health care.” — Barb Gordon,
College
plan pays for and what the
picture of where
member’s portion is going to be. We’re seeing how the
the employees
PHS also can serve as a backup for a flexible spending
are with their
account (cafeteria plan) — all services are listed in case
deductibles and
you lose a receipt or forget to include an expense to
out-of-pocket
be filed.”
maximums.”
“We think the new PHS will be a valuable tool for
5
The new PHS will be avail-
helping us become better consumers of health care,”
able to many Arkansas Blue
said Barb Gordon, benefits specialist with Northwest
Cross members beginning in the
Arkansas Community College in Fayetteville. “The PHS
spring of 2010 and later in the
gives employees a great snapshot of where they are at
year for Health Advantage. “We
a given time and is backed up with all the details they
love to hear from our members,” said
need to be informed about their benefits. For employ-
Raley. “Feedback always is welcome
ees who have spouses with other insurance coverage,
on how the PHS can be improved.”
the PHS is a great tool for coordination of benefits Blue & You Winter 2009
Keeping your young adult
covered
(one less thing to worry about!) 6
they reach the maximum dependent
dependent be enrolled. Dependents
they can’t protect them at every
age on the policy. The maximum
not currently covered will not be
turn, but now they can have peace
dependent age varies based on the
subject to late enrollment rules, nor
of mind about their health-care
plan selected by the employer. This
deferred to open enrollment, as long
coverage. Arkansas Blue Cross and
change also applies to groups that
as the application is submitted by
Blue Shield and Health Advantage
have Arkansas Blue Cross dental
Feb. 28, 2010. Groups may submit
are changing the dependent cover-
coverage plans.
applications anytime between now
Parents with young adults know
age requirements under our fully
Arkansas Blue Cross and Health
and February 28. The first effective
insured group health plans to help
Advantage will no longer request
date will be Jan. 1, 2010. Applica-
more families continue covering their
verification of a dependent’s sta-
tions received in January will get
young adults.
tus as a student and will no longer
February 1 effective dates, and
cancel coverage for those who do
those received in February will have
Blue Cross and Health Advantage
not meet the previous student status
March 1 effective dates.
will no longer require dependents 19
requirements. Dependents under
and older to be in an accredited col-
the maximum dependent age who
upon reaching the age of 19; as long
lege or university in order to remain
currently are not covered, (due to
as they remain dependents, cover-
a dependent under their parents’
attending non-accredited education
age will continue until they reach
group health plan. Dependents who
facilities, etc.) and who meet the
the maximum dependent age. If you
are unmarried, whose parents pro-
criteria, now can be added to their
have questions, please don’t hesitate
vide the majority of their financial
parents’ coverage.
to contact us using the Customer
Beginning Jan. 1, 2010, Arkansas
support and whose parents’ home
If you wish to have a dependent
is their primary residence can re-
covered, you may complete an
main on their health-care plan until
employee application asking that the
Blue & You Winter 2009
Dependents do not have to apply
Service number on your member ID card.
If you take the Proton Pump Inhibitors (PPI) Prevacid, Prilosec or Nexium, you should be aware that some upcoming changes in the PPI class of medications might save you money. PPIs are medications, often called antacids, that are taken for conditions such as heartburn or acid reflux. In the past, the Arkansas Blue Cross and Blue Shield standard formulary (drug list) has covered Prevacid and Nexium on its high-
Prevacid was removed from the formulary when available OTC. Kapidex now is available on our highest cost level of the drug plan. Omeprazole, the generic for Prilosec, now is available on the lowest cost level of the drug plan for those members requiring prescription strength. Nexium has been removed from
been three significant changes in
the drug plan altogether as it lacks
the PPI class of medications, and
the advantages of – and is priced
because of these changes, we
30 percent higher (retail) – than
are changing our drug list. The
Kapidex.
1. In November, Prevacid became available for purchase over the counter (OTC).
antacids?
lowing changes have occurred:
est cost level. However, there have
changes are:
Are you taking prescription
for their prescription drugs. The fol-
2. Prescription-strength Omeprazole, a generic version of Prilosec, previously was not priced as a generic medication but now is priced as a generic. OTC versions (lower strength) of these medications are available. 3. A new PPI — Kapidex — has proven to be effective anytime, even if taken during or following meals. All other PPIs have to be taken one hour ahead of meals. Whenever there are multiple changes in a class of medications, Arkansas Blue Cross reviews its drug list to ensure members are receiving the best therapy and value
Arkansas Blue Cross takes the importance of making safe, affordable prescription medications available to our members seriously. Our staff pharmacists seek advice from a Pharmacy and Therapeutics (P&T) Committee comprised of independent physicians and pharmacists (who practice in both retail and hospital environments) throughout Arkansas to ensure our formularies are complete and current. For a drug to be included in our formulary, the P&T Committee members consider (in order of importance) safety and efficacy, then uniqueness, then cost. After additional review, our P&T Committee reaffirmed that there is no clinical difference between any of the PPIs.
Blue & You Winter 2009
7
Healthy lifestyle may reduce Alzheimer’s risk Based on data from two separate studies, research concludes that people who follow diets resembling a Mediterranean diet, which is rich in fruits, vegetables, legumes and healthy fats, and who remain physically active had a 61-67 percent lower risk of Alzheimer’s disease. The research does conclude that one of these behaviors may not be enough, and it may be best to focus on both eating well and staying active. Sources: WebMD and Medline Plus
—
8
in e n i h s n u s e Let th ! h t l a e h r u o for y More and more research is pointing to vitamin D defi-
The American Heart Association found that vitamin D
ciency as the culprit for a number of conditions, and the
deficiency in premenopausal women may increase the
quickest way to improve your levels is to step outside!
risk of developing high blood pressure later in life. The
The body produces vitamin D in response to sunlight.
study showed that women who had vitamin D deficien-
It also occurs naturally in some foods (oily fish, egg
cy in 1993 had three times the risk of developing high
yolks and beef liver) and in fortified dairy and grain prod-
blood pressure 15 years later.
ucts. Vitamin D is essential for strong bones because it
Taking vitamin D also may reduce falls in older
helps the body use calcium. Extreme vitamin D defi-
people by improving muscle strength. In clinical trials,
ciency causes rickets, an illness resulting in soft bones
people older than 65 who took vitamin D supplements
and skeletal deformities. But subtle vitamin D defi-
between 700 and 1000 IU per day reduced falls by
ciency is harder to trace and may affect more people,
about a fifth within two to five months of starting treat-
across all ages, than once realized.
ment.
A recent Harvard Medical School study found that
Low vitamin D blood levels also have been associ-
6.3 million children in the United States — almost one
ated with the following:
in five — have less than the recommended amount of
• Increased risk of death from cardiovascular disease
vitamin D in their systems. The amount of deficiency
• Cognitive impairment in older adults
was even higher in black and Hispanic children.
• Severe asthma in children
A study by Johns Hopkins School of Public Health
• Cancer
found that teens with low vitamin D levels were more
• Diabetes
likely to have high blood pressure and high blood sugar
• Glucose intolerance
and were at greater risk for diabetes and heart disease.
• Multiple sclerosis
Blue & You Winter 2009
Treating even mild gestational diabetes reduces health risks According to a National Institutes of Health network study, treating even mild gestational diabetes appears to have advantages for both infant and mother. It was found that women who received treatment were: • Half as likely to have a large baby at risk for health problems later in life. • Half as likely to deliver a baby with shoulder dystocia, an emergency condition in which the baby’s shoulder becomes stuck during delivery. • Less likely to deliver by Cesarean. • Less likely to develop high blood pressure. Source: National Institutes of Health
Good news, bad news: Heart attacks on the rise in women
9
The bad news is that the heart attack gap between men and women is narrowing. A study of more than 8,000 men and women aged 35 to 54 shows that while men still have
the rise, it’s important for
more heart attacks, heart attacks
women to know the symptoms.
• Nausea
among women is on the rise.
While some may be similar to those
• Dizziness
for men, many, like chest pain, are
• Lower chest discomfort
good news is that while heart
not as common for women. So pay
• Upper abdominal pressure that
attacks in women are rising, the
attention to your body and know the
risk of death after a heart attack is
different symptoms:
improving more for women than for
• Shortness of breath
men under the age of 55.
• Weakness
So what’s the good news? The
With heart attacks for women on
may resemble indigestion • Back pain Source: WebMD
• Unusual fatigue Blue & You Winter 2009
Healing a giving
heart
10
Ruben Rodriguez, 58, has a generous and giving
they discussed going into Paragould for pizza, but he
heart. As an associate pastor at Stonewall Community
confessed that he was having some discomfort in his
Church outside the little community of Lafe in Greene
chest. Ruben tried to reassure Martha that it didn’t hurt
County, Ark., he and his wife Martha help with the
much and it was probably indigestion. The two headed
church’s outreach activities, take and teach classes
for Paragould, but instead of getting pizza they went
through Integrity Bible College and share their faith
straight to the emergency room at Arkansas Methodist
through music and ministry. But on July 14, Ruben’s
Medical Center. “We don’t fool with that,” was Martha’s
giving heart started giving out.
steadfast response.
It started as a pressure in Ruben’s chest while he
Doctors quickly confirmed that Ruben was having
was working at his day job at Emerson Electric Co. in
pain associated with a lack of blood to his heart and
Paragould, but eased off after he took one of the nitro-
sent the two to St. Bernards Medical Center in Jones-
glycerin tablets he’d been keeping with him since his
boro, about 25 miles away. Through an agreement
first heart attack 12 years earlier. He’d already had three
between the two hospitals, heart patients at Arkansas
stents put in the arteries leading to his heart at two
Methodist Medical Center often are referred to St. Ber-
different times, but in the last decade he’d been feeling
nards for their excellent care. That high quality is one
pretty good, so good he hadn’t bothered with the cho-
reason St. Bernards has been named a Blue Distinction
lesterol medication he was supposed to be taking.
Center of Excellence for Cardiac Care by the Blue Cross
That evening Ruben met Martha at the house and Blue & You Winter 2009
and Blue Shield Association.
Blue Distinction Centers of Excellence must meet
He added that Ruben was much like his father in that
high quality standards established by an expert panel
he was determined to get well and was willing to take
of physicians, surgeons and other health-care profes-
the steps needed to get there. And both men enjoyed
sionals. When a hospital has been designated a Blue
the opportunity to speak Spanish with Dr. Stevenson
Distinction Center, you know they have expertise in
who is conversational in the language but always look-
that specialty, that they focus on quality and that they
ing for opportunities to brush up his skills.
have a history of patients with positive outcomes.
Dr. Stevenson said it also helped that Ruben was in
Hospitals provide care differently, and Blue Cross has
a cardiac program that has gone to great lengths to be
created a process where hospitals can demonstrate
comparable with some of the top cardiac programs in
their expertise.
the nation.
If you are looking for a hospital with a Blue Distinc-
“If you are in our hospital, we want to provide the
tion designation, go to our Web sites and visit our
same environment and offer the same technology you
“Member” section. We do the work for you, so you can
would see at Mount Sinai in New York or Vanderbilt
be assured you are receiving the best care possible.
Medical Center in Nashville,” he said. “We strive to of-
In the St. Bernards emergency room, Ruben was fussing more about his missed pizza than his heart
fer care commensurate with any top cardiac facility.” Dr. Stevenson said that the excellent care at St. Ber-
pain, but the results from the tests brought some
nards begins even before patients get to the operating
somber news; blockage in Ruben’s heart arteries had
room. This care then continues through the operating
caused a small heart attack. He needed a triple bypass.
staff to the ICU staff and on to the progressive care
Had the nitroglycerin tablet that afternoon helped? “It
staff. In the progressive care unit the patient-to-nurse
wasn’t any good,” he said laughing, thinking about that
ratio is four to one. And before a patient leaves, each
10-year-old pill. He later learned that nitroglycerin tab-
one is referred to outpatient rehabilitation to continue
lets are only good for about six months.
recovery. “It’s a compendium of care across a continu-
Ruben requested Richard Stevenson, M.D., medical director of the cardiovascular program at St. Bernards to do the surgery. For Dr. Stevenson, the request was an honor; he had performed a successful heart surgery on Ruben’s father, Eusebio “E.S.” Rodriguez, years earlier. “That is the highest compliment I could have received,” Dr. Stevenson
Ruben and Martha Rodriguez sit in front of flags representing the countries helped by their church.
said of Ruben’s request. Blue & You Winter 2009
11
Richard Stevenson, M.D., (also in inset photo) performs surgery at St. Bernards Medical Center.
12 um of care,” he explained. Dr. Stevenson said the cardiac care physicians and
tion Center of Excellence. Each Blue Distinction Center for Cardiac Care must meet stringent clinical criteria
hospital leaders have collaborated on training the nurs-
recommended by expert physicians and medical orga-
es in cardiac care. “I’m extremely proud of our heart
nizations, including the American College of Cardiology
care nurses,” he said. “We told them, ‘We will train you
and the Society of Thoracic Surgeons. Blue Distinction
to take care of any complication and manage it until a
Centers for Cardiac Care provide a full range of cardiac
doctor can get there.’” The nurses are empowered to
care services, including inpatient cardiac care, cardiac
take actions they know will help their patients. “‘No
rehabilitation, cardiac catheterization and cardiac sur-
Fear’ is our motto.”
gery (including coronary artery bypass graft surgery),
Dr. Stevenson has a special tie with St. Bernards — he was born there, back when many of the nurses were
and each center is re-evaluated regularly. The cardiac program at St. Bernards seeks to be
Catholic nuns. He left Jonesboro to pursue his medi-
the tertiary care center for the area, only taking cases
cal career and ended up at Louisiana State University
when needed. Dr. Stevenson said that when it comes
Medical Center in Shreveport, La., but found himself
to working with the other hospitals, the heart surgeons
wanting to return to his family and his roots, and to
try to be available. Most of all, Dr. Stevenson said, he
provide care that could make a difference in Northeast
is grateful to St. Bernards for allowing the physicians
Arkansas.
to look beyond the scope of what an average hospital
The high level of care Dr. Stevenson described is exactly what qualifies St. Bernards as a Blue DistincBlue & You Winter 2009
does to truly make it a center of excellence. That excellence is what brought Ruben Rodriguez to Dr. Ste-
He said he has learned not to ignore the warning signs his body may give him and to continue on his medications even when he is feeling well. venson in July, trusting in his skills, St. Bernards and, as
Shield of Alabama, but through BlueCard®, his medical
always, God.
care was coordinated between their office and Arkan-
Asked if he was concerned at all about the procedure, Ruben thought back to the moment the hugs
sas Blue Cross and Blue Shield. BlueCard is a national program that enables mem-
and kisses from family ended and he was being rolled
bers of one Blue Plan to obtain health-care services
into the operating room. In that quiet moment, he said,
while traveling or living in another Blue Plan’s service
he reached out to God and heard, “Fear not, for I am with you,” and he was at peace. At the same time, Martha said she had also put
area. The program links The Heartcare Center at St. Bernards Medical Center is a Blue Distinction Center of Excellence.
participating health-care providers with the independent Blue Plans worldwide through a single electronic
her faith in God. A gospel
network for claims process-
song, “I’ve Been Through
ing and reimbursement.
Enough to Know that He’ll
The Alabama Blue Cross
be Enough for Me,” ran
Plan took care of Ruben’s
through her mind as Ruben
needs, and Arkansas Blue
was wheeled away.
Cross made sure the
Ruben’s surgery was suc-
doctors, specialists and
cessful, and within hours
hospital received the quick
he was up and walking. He
service they needed.
said the breathing treat-
Ruben is back to work
ments were painful, but he
and sharing his faith with
knew the more he did them
others. He said he has
the easier it would become.
learned not to ignore the
Within the week, Dr. Ste-
warning signs his body may
venson told him, “I take care
give him and to continue on
of sick people, and you’re
his medications even when
not sick.” Martha cared for
he is feeling well. His giving
him at home, grateful to be a teacher and be out for the
heart has been given another chance.
summer. She and other family members drove Ruben to Paragould to meet with Dr. Stevenson for his follow up appointments and rehabilitation. While the Rodriguez family was very focused on Ruben’s health, they didn’t have to worry about his health-care coverage. Ruben’s
Go to Blue & You Online on our Arkansas Blue Cross and Health Advantage Web sites for more on our Blue Distinction Centers.
insurance was through Blue Cross and Blue Blue & You Winter 2009
13
SilverSneakers competition winner logs more than 1,000 miles
14
Dorothy Straub on the stationary bicycle and in the Rogers Adult Wellness Center garden.
Go to Blue & You Online on our Arkansas Blue Cross and Health Advantage Web sites for more on SilverSneakers.
Blue & You Winter 2009
Dorothy Straub is a fierce competitor. As the old-
world, Dorothy and Don settled on a 20-acre cattle farm
est of six children and the mother of three boys, she
in Summers, Ark., just miles from the Oklahoma border.
quickly learned to dust herself off and keep going when
Dorothy worked for the Fayetteville Prosecutor’s Office
faced with a challenge. So when the SilverSneakers
and helped Don on the farm, but in 2003 she had to
®
100 Miles, 100 Days Challenge kicked off, she said, “I
take time off as Don’s memory became clouded from
can do that,” and she did. When her grown sons shared
the Alzheimer’s. She measured out a small track on
their doubts that she could log more (1,000 miles in 100
the farm so she could walk and keep an eye on Don.
days), she didn’t quit until she had logged 1,145 miles
When Don’s disease progressed to the point where he needed more care than she could give him at home,
— winning the statewide contest. For Dorothy, the contest wasn’t just a race against her buddies at the Adult Wellness Center in Rogers, Ark., it was also a way to get her out of the house after losing her loving husband, Donald Straub, to Alzheimer’s disease in April.
Dorothy Dorothy moved him to a nursing home and in retired and joined the 2005 went back to work full time, but shifted Adult Wellness Center, her hours so she could leave in the afternoon a benefit provided to to spend the rest of the day with Don, often her through Medi-Pak walking with him in the park. “It was very Advantage as part of the good for him,” she said. SilverSneakers In May 2008, Dorothy retired to spend more Program. time with Don and joined the Adult Wellness
“It’s easy to sit and feel sorry for
Center, a benefit provided to her through Medi-Pak
yourself, and I did that for awhile,” Doro-
Advantage (PFFS) as part of the SilverSneakers Pro-
thy remembered, but after a few weeks she said she
gram. To enroll in SilverSneakers, Medi-Pak and Medi-
started looking for things to do — about the same time
Pak Advantage (PFFS) members can go to a participat-
flyers showed up at the Wellness Center advertising the
ing fitness center near them and show their ID card. Fit-
contest. Dorothy decided, “why not,” and proceeded to
ness center staff will assist with enrollment and provide
log in five miles at a time, several times a day.
tours of the locations. Because new fitness centers are
After the first month, Dorothy already had logged 300
being added to the program regularly, members can
miles, so she made it her goal to reach 1,000 miles,
go online to silversneakers.com to find all participating
putting off a trip to Florida until after the contest, and
locations in Arkansas.
working in extra sessions on the stationary bike or on the track if she had to miss a day. Lucky for Dorothy, the Adult Wellness Center in
Even though Don has passed away, Dorothy continues to visit the nursing home where he stayed because she has developed so many friendships there. She even
Rogers has state-of-the-art exercise equipment and
has become a volunteer ombudsman for the home
a beautiful walking trail that wraps around a waterfall
through the Arkansas Area Agencies on Aging. She still
and fishpond and includes several exercise stations. As
volunteers one day a week at the prosecutor’s office.
Dorothy got closer and closer to her goal, she realized
And she still logs her miles on the track and the station-
that the walking and biking did wonders for her blood
ary bikes at the Adult Wellness Center. Because Doro-
pressure. “It has gone down tremendously,” she said.
thy Straub doesn’t give up.
Dorothy has used exercise to ease tension for years. After a whirlwind life, living in more than 10 states and raising their boys to appreciate the wonders of the
Healthways, Inc. administers the SilverSneakers Fitness Program for Arkansas Blue Cross Medi-Pak and Medi-Pak Advantage (PFFS) policyholders. Healthways, Inc. is an independent company that operates separately from Arkansas Blue Cross.
Blue & You Winter 2009
15
Lose weight The Healthy Behavioral health services now available Weigh! Behavioral health referral and management services now are available
to some employer group health plans with Arkansas Blue Cross and Blue Shield and Health Advantage, and a number of plans administered by BlueAdvantage Administrators of Arkansas. If you receive a new ID card with a mental health assistance telephone number, your plan includes these services. A customer service staff trained to help with the special requirements
16
of accessing behavioral health services is available from 7 a.m. to 7 p.m., Monday through Friday, to assist in explaining benefits and available services, selecting a mental health provider and gaining access to needed services. For assistance, please call toll free 1-877-801-1159. (This telephone number will be on the back of your health plan ID card if this service is available to you.) Please be aware that you have some new responsibilities in order to make best use of your behavioral health benefits. These responsibilities are: • Calling 1-877-801-1159 (or ensuring that your mental health provider has made the call) for prior authorization of any outpatient mental health visits after the eighth session. • Calling the number above (or ensuring that the inpatient facility does so) prior to any inpatient mental health/substance abuse inpatient stay. • Check your benefits certificate for full details on any excluded mental health/substance abuse services. To find out if your health plan includes modifications for behavioral health, you can contact your human resources administrator, check our Web sites and review your benefits information on My Blueprint, or call the customer service number on your health plan ID card. We love to hear from you! Blue & You Winter 2009
The Healthy Weigh! Education Program is free for members of Arkansas Blue Cross and Blue Shield, Health Advantage, Blue Cross and Blue Shield Service Benefit Plan (Federal Employee Program), and eligible members of BlueAdvantage Administrators of Arkansas. To enroll, complete the attached enrollment form and return it in the 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 your own home and at your own pace. The program is completely voluntary, and you may leave the program at any time. If you have further questions about the program, call the Health Education Program’s toll-free number at 1-800-686-2609. Simply complete, sign and return the attached enrollment form in the self-addressed, postage-paid envelope.
Members continue to receive screening mammograms as a wellness benefit Although the U.S. Preventive Services Task Force announced recently that routine mammograms are no longer recommended for women 40 to 49, Arkansas Blue Cross and Blue Shield and its wholly owned subsidiary, Health Advantage, will continue to cover screening mammograms as a part of our wellness benefit. “We understand there is concern among our members
Obese women at
greater risks of
giving birth to babies with heart defects Women who are overweight or obese before they become pregnant have approximately an 18 percent higher chance of having
about the new recommendations from the U.S. Preventive Services Task Force, but we want to assure our members that we will continue to cover annual screening mammograms for all Arkansas Blue Cross and Health Advantage female members age 40 and above who have our wellness benefit and who have the service performed by an in-network physician and facility,� said James Adamson, M.D., Arkansas Blue Cross senior vice president and chief medical officer. The U.S. Preventive Services Task Force recently reversed
a baby with certain heart defects as compared
a 2002 recommendation by eliminating the recommendation
to women who were not overweight while
for screening for women ages 40 to 49, and increasing the
severely obese women have approximately a
screening interval to every two years for women 50 to 74.
30 percent higher chance — this, according to
The American Cancer Society and the American College of
a study by the Centers for Disease Control and
Radiology have expressed significant concerns over the new
Prevention.
recommendations of the U.S. Preventive Services Task Force,
The study, which is the largest study ever
and these two organizations continue to recommend screen-
conducted in the United States to identify risk
ing mammography on an annual basis to all women beginning
factors for birth defects, found a significant
at age 40. Recommendations vary for those who are consid-
increase in several types of heart defects in
ered at higher risk.
babies born to overweight or obese women. Blue & You Winter 2009
17
Costs Matter:
Developing a relationship with your doctor
18
You might not think about it in financial terms, but
having a good relationship with your primary care physician (PCP) can save you money. How? Studies show that people who have a trusting relation-
work, paying for high-priced medications, trips to the emergency room, inpatient hospital costs and more. Even if you seldom get sick, it is good to have a relationship with your doctor. PCPs are trained to
ship with their PCP, and regularly go for wellness screen-
help you prevent health problems. They can point out
ings and checkups, are less likely to develop chronic
choices you may be making today that can affect your
illness later in life. Chronic illness can lead to missed
health tomorrow.
Blue & You Winter 2009
Developing the relationship Communication is a two-way street, but sometimes it can be hard to start the conversation with your doctor. According to the Annals of Family Medicine, the average face-to-face time with a doctor during an appointment is about 15 minutes. That means you have to be prepared with your concerns and questions right off the bat. Writing information down ahead of time, and bringing a family member with you to write information down during the visit, can help keep the conversation on course. Getting started As soon as the appointment starts, be sure to tell your doctor the main reason for your visit, including any symptoms you are having, or have had recently. Don’t leave out symptoms that seem unrelated; they may be important. Keeping a health journal can give a day-today log of symptoms and be valuable in your diagnosis. Let your doctor know if your personal life has changed since you last came in. Did you change jobs? Are you stressed? Bring any medications, vitamins and supplements you may be taking with you, or make a list. Be sure you include the strength of the medication and how often it is taken. Let your doctor know of any side effects you have had from your past or present medications. If you have any medical records or test results from other locations, bring them with you.
Ask questions Ask your doctor if you don’t understand something. If you don’t, your doctor will think you understand everything he or she has told you. The following are some tips on asking your doctor questions during the exam: • Write down questions before the appointment and ask them during the exam. Be sure to ask the most important questions first. • Bring a family member with you to take notes and have them write down the answers to
your questions. • Let the doctor know if you don’t understand something. • Tell your doctor if you need more information or assistance to understand your condition. He or she may get a physician assistant or nurse to help you. • If your doctor prescribed a medicine, ask if there are generics available.
Take it home Take the following information home: • Notes taken during the appointment by you or your family member. • Written instructions from your doctor. • Brochures or other educational materials. Follow up Make sure to follow any instructions your doctor gave you during the appointment, like taking medicine, going for a test or going to an appointment with a specialist. Contact your doctor: • If you have questions after the appointment. Ask to leave a message for the doctor or speak with a nurse. • If you start to feel worse or have problems with your medicine. • If you haven’t gotten the results of tests. Source: American Academy of Family Physicians
… the average face-toface time with a doctor during an appointment is about 15 minutes. That means you have to be prepared with your concerns and questions right off the bat.
Blue & You Winter 2009
19
Senior Moments with Dr. David tion to treat Alzheimer’s disease instead of directing David A. Lipschitz, M.D., Ph.D.
them to a specialist. This is the least important component of the evaluation. If you suspect that you or a loved one may have a memory problem, it is important to be seen by a doctor who specializes in memory disorders.
Making the diagnosis The first step in the evaluation is to confirm that a memory problem exists. Mild decreases in intellectual function, often referred to as benign forgetfulness (you may have difficulty remembering names), is not significant. In order to diagnose the problem, a person must have a decline in memory that is of sufficient severity to interfere with his or her ability to function in the community or interact with others (work, shop, remember appointments). Family members may raise concerns that a loved one is repeating information, seems confused, cannot accomplish familiar tasks and is obviously forgetful. The diagnosis is made through extensive memory testing to determine the extent of the problem and assist in identifying the cause.
20
Is it Alzheimer’s disease? Every 70 seconds an American is diagnosed with Alzheimer’s disease. In the coming years, as the 72 million baby boomers reach the age of 80 and beyond, the burden of this illness could single-handedly overwhelm our health-care system. There are many myths and misconceptions about memory loss. The evaluation and care of those who suffer from memory loss and their families leaves much to be desired. Most see their primary care physician who, sadly, if a problem is suspected, prescribes a medicaBlue & You Winter 2009
Identifying the cause The earliest sign of Alzheimer’s disease is loss of short-term memory. Other causes, such as multiple strokes or vascular disease, depression and medication use can lead to different patterns of memory loss. To confirm the diagnosis, blood tests and imaging studies of the brain are done. Eighty percent of the time, the cause is Alzheimer’s disease or multiple small or larger strokes. In the remainder, a potentially treatable cause may be found. This includes certain medications, depression (a common treatable cause of significant
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.
forgetfulness), Vitamin B12 deficiency, sleep disorders,
delusions, aggressive behavior, agitation and difficulties
Parkinson’s disease and a condition called Normal Pres-
with sleep become common. Having access to a team
sure Hydrocephalus in which memory loss is accom-
of health-care providers is critical to optimally deal with
panied by problems with walking, balance and bowel
these problems. It does indeed take a village to care for
and bladder incontinence. Identifying and treating these
someone with Alzheimer’s disease and their family.
conditions on occasion can lead to dramatic improve-
Medications to treat Alzheimer’s Several drugs have been shown to slow the progresTreating conditions that can make memory sion of memory loss. They include Aricept, Exelon, Reminyl and Namenda. None of these drugs will lead to loss worse dramatic improvements in memory, but they should be Even if the diagnosis is Alzheimer’s disease, other considered based on evidence that slowing the promedical conditions such as diabetes, high blood presgression of the disease may provide sure, depression, sleep problems If you suspect that you a number of additional years of inor inappropriate medication use can or a loved one may have dependent life and reduce the need make memory loss worse. Treating for placement in a nursing home. these conditions can improve health ments in memory.
and slow the rate at which the dis-
a memory problem, it is
The future While we do not know the cause Paying attention to the care- doctor who specializes in and cannot prevent Alzheimer’s disease, there is much we can do to giver and family education memory disorders. reduce the rate at which the illness Taking care of a family member with memory loss is an overwhelming burden. Caregiv- progresses. Living a stress free, heart-healthy lifestyle, exercising your mind and your body can delay the age ers, often spouses or children, often do not take care at which Alzheimer’s disease presents by 10 or more of themselves, are severely stressed, are at great risk of becoming ill and are desperate for help. Understand- years. We also must commit to more research to understand the fundamental cause of this serious disease. ing the condition and how to approach someone with There is hope that through research, new approaches to Alzheimer’s disease is essential. Caregivers must be care will become available, and that in our lifetime there encouraged to meet their own needs, have regular will be a cure. medical checkups and spend some time alone. ease progresses.
important to be seen by a
Treating complications of the disease As Alzheimer’s progresses to other areas of the brain, unusual additional symptoms may develop. Personality changes are common, hallucinations and Blue & You Winter 2009
21
Paying for your medications “Why do I pay for some medications through my insurance
receive your medication, how much
differently?”
you pay is determined by the allow-
If you are on several medica-
22
If you went to your pharmacy to
able charge for the medication and
tions, you may have noticed that the
the type of retail pharmacy benefit
claims for some of your medications
plan you have. When you receive
may be filed under your medical
medications from a retail pharmacy,
benefit, and others may be filed
you may have to pay a prescription
under your retail pharmacy benefit.
drug copayment. Finally, if you need
You may even see the same medi-
home infusion therapy and you get
cation filed differently under both
it from a designated provider, your
benefits. Why?
medication is covered under your
Where did you get it? The first thing to look at is where the medication is given. If you received a medication while in a hospital or in an outpatient surgical center, it is included in the allowable charge for the hospital services. If you received a medication in your physician’s office, your payment is based upon allowable charges under your medical benefit. That means you may have to pay toward your calendar-year deductible and coinsurance.
medical benefit based upon the allowable charge for the medication.
How did you get it? Another situation to consider is how the medication is administered. If you can take the medication yourself, orally or through an injection under the skin (subcutaneous), it is filed through your retail pharmacy benefit, and you pay a copayment. If your medication must be given by injection into the muscle, or in a vein, then it is intended to be administered only by a health-care
professional, and is considered part of your medical benefit. If covered, you may have to pay toward your calendar-year deductible and coinsurance. Your Benefit Certificate lists self-administered medications as “A” medications and professionally administered medications as “B” medications. If you need to know if a medication is an “A” or “B” medication you can contact Customer Service.
From the
Pharmacist
by Trey Gardner, Pharm D., Arkansas Blue Cross and Blue Shield
Blue & You Winter 2009
Medi-Pak and Medi-Pak Advantage (PFFS) Members: Resolve to Have a Healthy 2010 Happy New Year means resolutions; and in 2010,
doctor a printout of your Personal Health Record (PHR)
Arkansas Blue Cross and Blue Shield will make it easier
from our Web site at arkansasbluecross.com (you must
for our Medi-Pak and Medi-Pak Advantage (PFFS) mem-
register with My Blueprint to access your PHR). And,
bers to keep them — if one of your New Year’s resolu-
speaking of doctor’s visits — don’t forget — as a Medi-
tions is to have a Healthy 2010.
Pak Advantage (PFFS) member, you get an annual exam
As a Medi-Pak or Medi-Pak Advantage (PFFS) member you may enroll — or continue your enrollment — in
with no copayment! If you are a Medi-Pak Advantage (PFFS) member,
SilverSneakers at no cost to you. As a member of
throughout the year, you will receive helpful newsletters
SilverSneakers, you have access to amenities such
offering sound advice on staying healthy. And if you have
as treadmills, weights and — in some cases — even
the holiday blues, we have a new depression hotline.
®
heated pools at no additional cost. As a SilverSneakers
With all of these resources available to you, keeping
member, you can take advantage of all the equipment
your New Year’s resolution of working to maintain your
and services available with a basic membership at a Sil-
health should be easier!
verSneakers participating fitness center. Many of these
If you have questions, we’re here to help. Please call
fitness centers also offer the signature SilverSneakers
the appropriate toll-free customer service telephone
exercise classes, designed for older adults and taught
number listed below:
by SilverSneakers-certified instructors. Don’t know which fitness centers in your area participate? Simply go to the SilverSneakers Web site at silversneakers.
Medi-Pak Customer Service 1-800-338-2312
com. The SilverSneakers Web site also offers fabulous
Medi-Pak Advantage (PFFS) Customer Service
resources such as great new recipes and tools to create
1-877-233-7022
shopping lists and design your own exercise plans. Another benefit available to both Medi-Pak and Medi-Pak Advantage (PFFS) members is our online Personal Health Record. This tool combines information from your medical claims and information you enter yourself to provide a clear medical history. By keeping this record current, it will make visits to your doctor go more smoothly and efficiently. You simply can hand your
If you’re not a Medi-Pak or Medi-Pak Advantage (PFFS) member but want to learn more, call our licensed, certified agents toll free at 1-800-392-2583. You can also use the Medi-Pak Choice Plan Finder on our Web site at arkansasbluecross.com/MedicarePlans to help you determine which of our Medi-Pak Choice products works best for you. Blue & You Winter 2009
23
Online Health Tools A healthier life is only keystrokes away with online
To access these programs, go to My Blueprint on
health tools available to Arkansas Blue Cross and Blue
the Arkansas Blue Cross, Health Advantage or BlueAd-
Shield and Health Advantage members and eligible
vantage Web sites, select HealthConnect Blue, choose
members of BlueAdvantage Administrators of Arkansas
the HealthyLiving tab from the Dialog Center and then
through My Blueprint.
choose a “Healthy Conversation.” The name of these
Our online programs can provide support on a variety of topics, including:
tools has changed, but the ability to create a plan as unique as you are has not!
• Getting active
To start a program, all you need to do is answer a
• Healthy eating
questionnaire about yourself and the way you live,
• Healthy weight
which takes about 15 minutes. The health-care profes-
• Healthy thinking
sionals will use that information to create a one-of-a-
• Quitting smoking
kind just plan for you.
• Dealing with low back pain • Sleeping well
Blue & You Fitness Challenge group registration under way
24
Need help waking from a long
ages participants to work toward
winter’s nap back into the “fit”
the public health recommendation
of things? Then move from hiber-
of adult physical activity 30 minutes
nation to becoming part of the
each day, most days of the week.
“hyper”nation with the 2010 Blue
A total of 167 groups — large and
within their larger body of partici-
& You Fitness Challenge exercise
small — with more than 11,500
pants, too. Students ages 13 and
contest.
participants took part in the 2009
older can form teams and challenge
Challenge.
other schools or other teams within
Although spring is months away, now is the time to plan for the Chal-
The Web site is live, and there’s
their schools. (Note: Group admin-
lenge. All you have to do get 10 of
still time to sign up for the contest.
istrators must be 18 or older.) All
your friends together, pick one of
Whether your group has 10 or 1,000
individuals must be registered on a
you to sign up your group and keep
members, you have until January
team by Feb. 28, 2010.
up with the details (the group
31 to sign up. Individuals who will
administrator) and register on blue-
be participating in Challenge groups
virtual tour on March 1. For more
andyoufitnesschallenge-ark.com.
will begin registration in February.
information, call toll free 1-800-686-
The Blue & You Fitness Challenge is an exercise contest that encour-
Blue & You Winter 2009
Schools, companies and organizations and others may form teams
We will begin exercising on our
2609. You may download a planning kit in PDF form from the Web site.
The
Doctor’s
Corner
Drinking hot liquids associated with throat cancer Smoking and heavy alcohol use are both associated with throat cancer. Now, another risk factor has been identified — very hot beverages. Researchers recently found that people who drink very hot beverages increase their risk of developing throat cancer. The study found that people who drink tea within two minutes after boiling were five times more likely to develop throat cancer than those who waited four minutes or more to drink their tea. Kids losing hearing from loud noise exposure Do your kids like loud music or loud computer games? You may want them to turn it down a notch. Studies indicate 12 percent or more of children between the ages of 6 and 19 already have suffered some degree of irreparable hearing loss. The major culprit is the loud noise they experience listening to music using headphones or while driving in vehicles. Be sure to talk to your
kids about the danger of permanent hearing loss from excessive noise. Encourage them to turn down the music and to use earplugs when they operate loud machinery such as lawnmowers.
Is your child’s backpack too heavy? Backpacks, if stuffed too full, can be so heavy that they can cause back pain and injury. Here are some warning signs that your child’s backpack is too heavy, courtesy of the U.S. National Safety Council: • Your child’s posture changes when the backpack is on. • Your child has difficulty putting the backpack on or taking it off. • Your child has pain while the backpack is on. • Your child feels a sensation of numbness or tingling while wearing the backpack. • Your child has red marks on
by Ray Bredfeldt, M.D., Regional Medical Director Northwest Region, Fayetteville
the shoulders or back from the backpack.
Surfing the Web can keep your brain young Surfing the Internet just might be a way to preserve your mental skills as you age. A new study suggests that Internet activity can help keep older people alert. Researchers found that older adults who started browsing the Web experienced improved brain function after only a few days. Have your medical procedures done early! Doctors are just like everyone else – they get tired after a long day at work. A recent study found that for people undergoing a colonoscopy, doctors do a better job of finding abnormalities in the morning than in the afternoon. What is true for colonoscopies may be true for other medical procedures. It makes sense, therefore, to ask for a morning procedure rather than one later in the day. Blue & You Winter 2009
25
Arkansas Blue Cross and Blue Shield and asked if BlueAnn could be Ethan’s buddy at Texarkana’s
BlueAnn Ewe makes a Buddy! BlueAnn Ewe was checking her
26
2009 National Buddy Walk. Traci Gatlin, R.N., medical affairs
e-mail one day and came across
manager, and Hillary
a special request. The e-mail was
Cross, R.N., regional
from Jenni Smith, who is the
case manager from
mother of a 2-year-old boy affected
the Arkansas Blue
by Down syndrome, a genetic disor-
Cross Southwest
will help raise awareness about the
der caused by the presence of too
Regional Office, gladly volunteered
condition and build support systems,
many chromosomes.
to take BlueAnn to the walk to meet
both of which last long after the one-
Each year, Texarkana hosts a
Ethan. More than 500 people, along
mile walk is over.
National Down Syndrome Society
with BlueAnn, walked around Buddy
Buddy Walk®, and Jenni’s son,
Ferguson Park on October 31, to help
and played games that helped raise
Ethan, asked his mom if BlueAnn
raise money for families and indi-
$15,000 for those locally born with
could come and participate. Jenni,
viduals affected by Down syndrome.
Down syndrome.
a registered nurse at CHRISTUS
Mothers of children with Down syn-
St. Michael, immediately contacted
drome hope the National Buddy Walk
BlueAnn goes back to school Arkansas Blue Cross and Blue Shield’s Southeast Regional Office in Pine Bluff accompanied BlueAnn Ewe to the Back-to-School Festival in McGehee, Ark., on August 24. BlueAnn and Debi Attwood greeted kids and handed out BlueAnn coloring books to more than 100 children. BlueAnn, along with Arkansas Blue Cross’ Central Regional Office, also attended the first annual Back-to-School Community Health Fair at Trinity Worship Center in Conway, Ark., on August 15.
Blue & You Winter 2009
Jenni Smith, R.N. and her son, Ethan
BlueAnn participated in the walk
Ethan Smith was delighted to have BlueAnn’s support!
The 2009 Arkansas Blue Cross JDRF “Walk for a Cure” team
Arkansas Blue Cross raises $10,000 for JDRF Mark White, president and chief
cure, Arkansas Blue Cross hosts
the No. 1 hit television show,
executive officer for Arkansas Blue
an annual corporate fundraiser to
“American Idol.”
Cross and Blue Shield, was named
raise money for JDRF. Our leader-
Arkansas Blue Cross executives
the corporate walk chair for the
ship team in past years has been
agreed to be Idol contestants — but
Greater Arkansas Chapter of the
dunked, called Bingo and fought ob-
only if the price was right. Each exec-
Juvenile Diabetes Research Founda-
stacles, all to help juvenile diabetes
utive agreed to sing “karaoke style”
tion (JDRF). In support of Mark and
research. There only was one thing
if $1,000 was raised in his or her
JDRF, more than 500 Arkansas Blue
they had not done — sing!
name through employee pledges.
Cross employees joined him at Murray Park on September 19. In addition to walking for a
This year, our fundraiser theme
The employees of Arkansas Blue
was, “Arkansas Blue Cross Idol:
Cross raised more than $10,000
Karaoke for a Cure,” styled after
for JDRF!
Blue & You Foundation awards $1.5 million in grants to improve health The Blue & You Foundation for a
Arkansas Blue Cross and Blue
Healthier Arkansas has awarded a
Shield established the Blue & You
total of $1,574,691 in grants to 33
Foundation in 2001 as a charitable
health improvement programs in
foundation to promote better health
Arkansas.
in Arkansas. The Blue & You Founda-
“Our grants this year went to pro-
tion awards grants annually to non-
grams across the state that address
profit or governmental organizations
such issues as obesity, diabetes,
and programs that positively affect
healthy lifestyle choices, medical
the health of Arkansans.
care for low-income individuals,
In its eight years of operation, the
dental health, safety and worksite
Blue & You Foundation has awarded
wellness,” said Patrick O’Sullivan,
more than $10 million to 162 health
executive director of the Blue & You
improvement programs in Arkansas.
Foundation.
The grants awarded for 2010 are:
• American Diabetes Association, Bentonville ($35,000) • Area Agency on Aging of Southeast Arkansas, Pine Bluff ($25,876) • Arkansas Hunger Relief Alliance, Little Rock ($110,000) • Arkansas Mission of Mercy, Sherwood ($50,000) • Arkansas Quality Foundation, Little Rock ($43,262) • Baptist Health Foundation, Little Rock ($149,940) • Cedarville Schools, Cedarville ($62,160) • Chicot Memorial Hospital Foundation, Lake Village ($60,182) Grants, continued on Page 29
Blue & You Winter 2009
27
What is a hospitalist? A hospitalist is a physician whose primary professional focus is the care
• Handling situations quickly by having an in-depth knowledge of
someone in your family is ever hospi-
the hospital and its staff.
when you need them to answer your questions and coordinate hospital
• Allowing PCPs to focus on patients in their clinics. • Providing a report of the hos-
care. These physicians have dedicated
pitalization with any treatment
their careers to the care of hospitalized
changes to the PCP.
patients.
The possible downside of working
In the past, if you were hospitalized,
with a hospitalist is that he or she
you could expect to see your primary
may not know you as well as your
care physician (PCP) at the hospital co-
PCP. With thorough communication,
ordinating all your hospital care. Many
however, this issue can be avoided.
physicians continue to admit their
If your care (or a family member’s)
own patients to the hospital, and this
is coordinated by a hospitalist, you
system works well for them.
should expect your PCP and the
Today, however, most PCPs focus
hospitalist to communicate at the
their attention on patients in their clinic
beginning and end of the hospital-
and entrust the care of their hospital-
ization, and if any big issues arise. It
ized patients to the specialist who ad-
is especially important for your PCP
mitted the patient (such as a surgeon
to have all the important information
or cardiologist) or to the hospitalist.
from the hospitalization.
The hospitalist usually is a general
You can help the process by ask-
medicine physician who is trained on
ing the hospitalist whether there
a wide variety of medical problems,
has been or will be communication
and who takes responsibility for the
with your PCP. If unsure, you can
patient during the hospitalization. The
call your physician’s office to be
hospitalist calls in other doctors as
sure they know that you (or a loved
needed, but primarily is in charge of
one) are in the hospital. Although
the hospitalization and communication
the hospitalist will be able to obtain
among all the doctors, the patient and
your office records as needed, it is
the family.
extremely helpful to hospital admis-
Hospitalists provide valuable
sion staff to give your doctors and
services by:
nurses a list of:
• Being available to quickly meet the
• Your current medications.
needs of hospitalized patients and Blue & You Winter 2009
their families.
of hospitalized patients, so if you or talized — there are doctors right there
28
by Randal F. Hundley, M.D., FACC Special Guest Contributor
• Any allergies.
• Previous operations and medical conditions. • All your physicians’ names and telephone numbers. • The name and telephone number of a family member or other contact person.
• Know when you will visit with
from the hospital without adequate
your PCP and any specialists you
follow-up arrangements, leading to
saw in the hospital.
complications at home and readmis-
• Know if you need to schedule appointments with other providers such as physical therapists. • Ask that a report of your hospi-
sion to the hospital. At Arkansas Blue Cross and Blue Shield, experiences with most hospitalists have been excellent.
talization, with any changes in
When there has been a problem,
important:
medications or other treatment,
it is often because the patient did
• Have a clear list of all your medi-
be forwarded to your PCP.
not have a PCP before going into
Gener-
the hospital, making it difficult to
At discharge, several things are
cations. Be sure you understand
The hospitalist
takes responsibility arrange good follow-up care after
which medicines have been
ally, the
started, stopped or changed, as
hospitalist
for the patient
hospital discharge. Arkansas Blue
well as any instructions on diet
will not see
during
Cross strongly recommends hav-
or other issues.
you again
hospitalization.
ing a relationship with a PCP before
unless you come back into the
needing to go into the hospital. This
health visits and know when to
hospital. A recent study showed
is the best way to ensure a smooth
expect a visit.
that many patients are discharged
transition from hospital to home.
• NEA Clinic Charitable Foundation, Jonesboro ($30,400) • North Arkansas Partnership for Health Education, Harrison ($117,371) • Northwest Arkansas Free Health Center, Fayetteville ($50,000) • Northwest Arkansas Women’s Resources, Rogers ($49,756) • Paragould Light, Water and Cable Employees, Paragould ($17,000) • Parenting and Childbirth Education Services, Jonesboro ($33,617) • Pulaski County Youth Services, Little Rock ($16,050) • River City Ministry of Pulaski County, North Little Rock ($24,000) • Shepherd’s Hope Neighborhood Health Clinic, Little Rock ($25,000) • University of Arkansas at Little Rock (UALR), Little Rock ($50,100) • University of Arkansas for Medical Sciences (UAMS), Little Rock ($34,397)
• University of Arkansas for Medical Sciences (UAMS), Little Rock ($80,961) • Van Buren County Schools, Clinton ($55,200)
• Know if you will have home
Grants, continued from Page 27
• Crawford-Sebastian Community Development Council, Fort Smith ($5,032) • Dallas County Alliance Supporting Health, Fordyce ($8,805) • FoodShare and Opportunity Network, Prescott ($11,250) • Friendship Community Care, Russellville ($41,528) • Group Living, Arkadelphia ($4,107) • Harding University College of Pharmacy, Searcy ($50,447) • Harmony Health Clinic, Little Rock ($50,000) • Helen R. Walton Children’s Enrichment Center, Bentonville ($58,255) • Hospice of Texarkana, Texarkana ($11,505) • Kimmons Junior High and Sutton Elementary, Fort Smith ($104,860) • Lawrence Memorial Health Foundation, Walnut Ridge ($42,270) • Madison County Health Coalition, Huntsville ($66,360)
The Blue & You Foundation received 94 grant applications requesting $5.7 million in support. The Blue & You Foundation will accept proposals for its next funding cycle any time between Jan. 1 and July 15, 2010. For more information, visit the foundation Web site at blueandyoufoundationarkansas.org. 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.
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Baldor — Building a lean machine At Baldor Electric Company, employees are encour-
aged to look for innovation — whether it is creating
new products and work processes, finding ways to trim excess costs, developing and implementing leading edge information technology or developing and pro-
A Baldor employee gets his blood pressure checked during a health screening.
moting wellness initiatives. Baldor’s leadership knows that when everyone contributes, everyone wins. And, when you want to both lower costs and improve health, visionary companies like Baldor look to themselves and their employees to lead the way. In 2008, Baldor chose to switch all employees nationwide to one source for the administration of its group health insurance, and BlueAdvantage Administrators of Arkansas — a subsidiary of Arkansas Blue Cross and
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Blue Shield — was a perfect fit. Baldor, whose world headquarters is located in Fort Smith, Ark., wanted a health plan administrator that understood their longterm objectives around creating a healthy workplace
of the Baldor Wellness Council. “Martha helped us understand the resources that were available to us through our relationship with Arkansas Blue Cross,” Green said, referring to HealthConnect Blue, Arkansas Blue Cross’ multi-faceted integrated health resource that provides a wide variety of tools for healthy living.
and had the resources to assist them in creating a
Get Your Motor Running culture of health. As a start to their Fit4Life companywide wellness So in early 2009, the Baldor Wellness Council, comefforts, Baldor encouraged all employees, not just those prised of employees from each of on the company’s insurance plan, to I think Arkansas Blue complete the online Personal Health its 22 U.S. locations, was formed to promote the new “Fit4Life” Cross has as much Assessment available through wellness program nationwide and HealthConnect Blue. This was not of a vested interest in engage all 6,500 employees in an easy accomplishment in an enhealthier lifestyles. The Fit4Life vironment where most employees not only the program encourages employees to work on a production line. of the program but get involved in workplace wellness Baldor began the process by in the of our providing onsite biometric screeneducational activities and initiatives, while focusing on improving employees as we do. ings (blood pressure, blood sugar, their overall health and well being. cholesterol and weight) for emMartha Carlson, regional executive for the Arkansas ployees to assess their health. Arkansas Blue Cross Blue Cross West Central Regional Office in Fort Smith, representatives then walked Baldor employees through started discussing the concept of wellness with Jason the registration process for My Blueprint using onsite Green, the vice-president of human resources at Baldor, computers and instructed them on how to complete and Tona Schmidt, the staffing manager and coordinator the Personal Health Assessment. By participating in the
success
health
Blue & You Winter 2009
We love to hear from you! Personal Health Assessments, Baldor will establish a
May we help? For customer service, please call:
benchmark on their employee’s current health status.
Little Rock Number (501)
Medi-Pak members
378-3062 1-800-338-2312
While individual results are strictly confidential, aggregate data (overall results combined) can be used to help the Wellness Council define activities and support the needs of Baldor employees in the future. Additionally, after completing the Personal Health Assessment, each employee received a copy of personalized information on how they can improve their health and, if needed, were guided to health education programs provided by BlueAdvantage to help them care for chronic conditions. “Baldor is a great company,” Carlson said. “They
Toll-free Number
Medi-Pak Advantage members
1-877-233-7022
Medi-Pak Rx members
1-866-390-3369
Arkansas Blue Cross members
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
are very focused on treating their team members with
Federal Employee members
respect and dignity. That certainly shows through the
Looking for health or dental insurance? We can help!
investment they’ve made in their employee’s health and wellness. This is a top down initiative with a solid company wellness team focused on a multi-year wellness plan. We enjoyed working side by side with Baldor during these onsite events, and it’s just the beginning.” “We are working together to make the program successful and ultimately improve the health of our employees,” Green said. “I think Arkansas Blue Cross has as much of a vested interest in not only the success of the program but in the health of our employees as we do. So I think that makes a big difference. It isn’t just another wellness program, it’s our vision for the future.”
Go to Blue & You Online on our Arkansas Blue Cross and Health Advantage Web sites for more on Baldor’s Fit 4 Life Program.
For individuals, families and those age 65 or older
378-2531 1-800-482-6655
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? Regional Office telephone numbers: Pine Bluff/Southeast Region 1800 West 73rd St. Jonesboro/Northeast Region 707 East Matthews Ave. 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
Web sites:
1-800-236-0369 1-800-299-4124 1-800-588-5733 1-800-470-9621 1-800-817-7726 1-866-254-9117 1-800-421-1112
arkansasbluecross.com healthadvantage-hmo.com blueadvantagearkansas.com blueandyoufoundationarkansas.org blueannewe-ark.com
Blue & You Winter 2009
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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.
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Prepare for a Pandemic Information is good for you! Especially information from
Arkansas Blue Cross and Blue Shield wants you to be
your member magazine, Blue & You! That’s why we’ve
prepared during a pandemic or other emergency, so we
created Blue & You Online. It’s an online version of our
have updated a special publication to help you and your
magazine with more information about our featured
family. “Preparing for a Pandemic,” is available in the
stories, more photos and links to more information on
“Members” section of all of our Web sites, or you can
plans, products and information to help you better man-
find a link to the publication in the Blue & You Online
age your health and your health plan. Go to our Arkan-
section on the home page of the Arkansas Blue Cross
sas Blue Cross and Blue Shield and Health Advantage
and Health Advantage Web sites.
Web sites and enjoy even more information that’s good for you!
Want to get fit and need a good deal? We offer both! If you are a member, visit our Web sites and receive a discount to a fitness center near you! Go to arkansasbluecross.com or healthadvantage-hmo.com, select the “Discount Wellness Program” in the Blue & You Online section or visit the “Members” section and select the “Member Discount Programs” under the Popular Links heading. Either way, find a gym, start saving money and get fit! Blue & You Winter 2009
In Preparing for a Pandemic, you will find: • Tips on how to avoid spreading germs and how communities may respond during an emergency. • Instructions on caring for sick family members and when to seek medical help. • Key local and national pandemic resources, how to access your personal health information, and a place to assemble critical information about your family. • Information on how your benefits may change during a declared pandemic and how to reach us during an emergency.