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 — [email protected] 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.

Blue & You Winter 2009

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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

30

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

31

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.