Date post: | 23-Mar-2016 |
Category: |
Documents |
Upload: | arkansas-blue-cross-and-blue-shield |
View: | 220 times |
Download: | 1 times |
A publication for the policyholders of the Arkansas
Blue Cross and Blue Shield family of companies
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.
14 A SilverSneakers
competition winner
23 Medicare benefits for 2010
24 Online Health Tools
Out of the Blue
Personal Health Statement keeps members
“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
34
678
9
1014
16
17
18
2022
23
24
252628303132
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.
on Page 30
INSIDE
Jason Green and Tona Schmidt discuss the Fit4Life program at the Baldor Electric Company headquarters in Fort Smith.
Editor: Kelly Whitehorn — [email protected]: Gio Bruno Photographer: Chip BayerContributors: Chip Bayer, Matthew Creasman, Damona Fisher, Kristy Fleming, Jennifer Gordon, Trey Hankins, Heather Iacobacci-Miller, Ryan Kravitz, Kathy Luzietti and Mark MoreheadVice President, Communications and Product Development: Karen Raley
3
Blue & You Winter 2009
The beginning of a new year is a time in which many
of us pause to reflect on the blessings we’ve enjoyed
during the past year. As I stop to consider the things I
am most grateful for, the men and women who work
at Arkansas Blue Cross and Blue Shield are always near
the top of the list. I am grateful for their concern for
you, our valued customers. I am grateful for the energy
and dedication with which they approach their jobs here
at Arkansas Blue Cross. But above all, I am grateful for
the kinds of citizens they are; the kind of compassion-
ate, engaged and accountable people that every com-
munity can use.
With so many comments in the media today vilify-
ing those of us who work in the insurance industry, I
hope you will allow me a moment to tell you about the
people that walk the halls of this insurance company
every day. Although we have a few employees out of
state, our employees are largely Arkansans. Many are
your friends, your neighbors, your children’s coaches
and your Sunday school teachers. Because they count
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-
tributions our employees made to nonprofit organiza-
tions through Arkansas Blue Cross totaled more than
$100,000 in 2009. That doesn’t count what they did on
their own.
Because of their generosity, tornado victims got a
helping hand. Cures for diabetes and sickle cell ane-
mia and cystic fibrosis are a little closer to reality. They
donated to hospice organizations and humane societies
and helped children with disabilities. Our employees
provided money to feed the hungry and shelter the
homeless. They were there for the victims of fires and
accidents and poverty. They are people of value con-
tributing to organizations of value. And I am grateful for
them every day.
At Arkansas Blue Cross, we know that being a good
corporate citizen begins with employing productive
and responsible citizens. I’m proud to work with such
a community-minded group of men and women. And
you’ll be glad to know they bring that same spirit of ser-
vice to the workplace as they serve you, our members,
every day.
Out of the
BlueA message from our CEO and President, Mark White
Employees who care
4
Blue & You Winter 2009
At Arkansas Blue Cross and Blue Shield, we want
the conversations we have with our members to be
helpful, clear and complete, whether we’re talking by
telephone, on our Web sites or in writing.
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 gener-
ated 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
Blue Cross members will begin receiving a Personal
Health Statement (PHS) in place of their EOB.
The PHS is more comprehensive than the EOB and
designed to make claims processing easier to under-
stand. 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
Development. “We want to simplify industry terms into
everyday language, clearly explain claims, and help our
members know exactly where they are with their out-
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
added a ‘Benefits at a Glance’ section, so members are
reminded of their health benefits. Charts and graphs,
hopefully, will make the information displayed easier to
understand.”
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
how they work.
A Benefit Summary section shows members their
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
their PHS electronically. To sign up for a notification
e-mail, members can go online and sign up through the
My Blueprint member self-service center. Then, when a
A new view of your claimsPersonal Health Statement keeps members “up to date”
5
Blue & You Winter 2009
new PHS is generated, you will receive an e-mail.
The new PHS will be issued two times a month
instead of every time a claim is filed. If a member only
has pharmacy claims during a month, the PHS will be
issued quarterly.
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.
“Our associates are finding
the new Personal Health
Statement is easy to un-
derstand. The statement
shows several things
that were not available
before, such as pre-
scriptions. The infor-
mation shown is more
descriptive of what our
benefits are, of services
received, what the health
plan pays for and what the
member’s portion is going to be. We’re seeing how the
PHS also can serve as a backup for a flexible spending
account (cafeteria plan) — all services are listed in case
you lose a receipt or forget to include an expense to
be filed.”
“We think the new PHS will be a valuable tool for
helping us become better consumers of health care,”
said Barb Gordon, benefits specialist with Northwest
Arkansas Community College in Fayetteville. “The PHS
gives employees a great snapshot of where they are at
a given time and is backed up with all the details they
need to be informed about their benefits. For employ-
ees who have spouses with other insurance coverage,
the PHS is a great tool for coordination of benefits
— it’s easy to see what has been paid to whom and
what is owed. The discounts on health-care
services are easier to see, and, wow,
what a difference in cost! I don’t think
many employees realized the true cost
of prescription drugs until the new for-
mat. Once you become familiar with the
new format, it is more understandable
overall.”
Ann Freeman, vice presi-
dent of Benefits with First
National Bank and Trust of
Mountain Home, said,
“Our employees are
finding the new Personal
Health Statement
easier to read. The
language is better
and doesn’t sound
so ‘insurance-y’
and the charts
provide a good
picture of where
the employees
are with their
deductibles and
out-of-pocket
maximums.”
The new PHS will be avail-
able to many Arkansas Blue
Cross members beginning in the
spring of 2010 and later in the
year for Health Advantage. “We
love to hear from our members,” said
Raley. “Feedback always is welcome
on how the PHS can be improved.”
“We think the
new PHS will
be a valuable tool for
helping us to become
better consumers
of health care.” —
Barb Gordon,
Northwest Arkansas
Community
College
5
Blue & You Winter 2009
6
Blue & You Winter 2009
Parents with young adults know
they can’t protect them at every
turn, but now they can have peace
of mind about their health-care
coverage. Arkansas Blue Cross and
Blue Shield and Health Advantage
are changing the dependent cover-
age requirements under our fully
insured group health plans to help
more families continue covering their
young adults.
Beginning Jan. 1, 2010, Arkansas
Blue Cross and Health Advantage
will no longer require dependents 19
and older to be in an accredited col-
lege or university in order to remain
a dependent under their parents’
group health plan. Dependents who
are unmarried, whose parents pro-
vide the majority of their financial
support and whose parents’ home
is their primary residence can re-
main on their health-care plan until
they reach the maximum dependent
age on the policy. The maximum
dependent age varies based on the
plan selected by the employer. This
change also applies to groups that
have Arkansas Blue Cross dental
coverage plans.
Arkansas Blue Cross and Health
Advantage will no longer request
verification of a dependent’s sta-
tus as a student and will no longer
cancel coverage for those who do
not meet the previous student status
requirements. Dependents under
the maximum dependent age who
currently are not covered, (due to
attending non-accredited education
facilities, etc.) and who meet the
criteria, now can be added to their
parents’ coverage.
If you wish to have a dependent
covered, you may complete an
employee application asking that the
Keeping your young adultcovered
(one less thing to worry about!)dependent be enrolled. Dependents
not currently covered will not be
subject to late enrollment rules, nor
deferred to open enrollment, as long
as the application is submitted by
Feb. 28, 2010. Groups may submit
applications anytime between now
and February 28. The first effective
date will be Jan. 1, 2010. Applica-
tions received in January will get
February 1 effective dates, and
those received in February will have
March 1 effective dates.
Dependents do not have to apply
upon reaching the age of 19; as long
as they remain dependents, cover-
age will continue until they reach
the maximum dependent age. If you
have questions, please don’t hesitate
to contact us using the Customer
Service number on your member
ID card.
7
Blue & You Winter 2009
If you take the Proton Pump In-
hibitors (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 condi-
tions 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-
est cost level. However, there have
been three significant changes in
the PPI class of medications, and
because of these changes, we
are changing our drug list. The
changes are:
1. In November, Prevacid became
available for purchase over the
counter (OTC).
2. Prescription-strength Omepra-
zole, 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
for their prescription drugs. The fol-
lowing changes have occurred:
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 prescrip-
tion strength.
Nexium has been removed from
the drug plan altogether as it lacks
the advantages of – and is priced
30 percent higher (retail) – than
Kapidex.
Arkansas Blue Cross takes the
importance of making safe, afford-
able prescription medications avail-
able to our members seriously. Our
staff pharmacists seek advice from
a Pharmacy and Therapeutics (P&T)
Committee comprised of indepen-
dent 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 be-
tween any of the PPIs.
7
Blue & You Winter 2009
Are you taking
prescription antacids?
8
Blue & You Winter 2009
Let the sunshine in —
for your health!
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
Healthy lifestyle may reduce Alzheimer’s risk
More and more research is pointing to vitamin D defi-
ciency as the culprit for a number of conditions, and the
quickest way to improve your levels is to step outside!
The body produces vitamin D in response to sunlight.
It also occurs naturally in some foods (oily fish, egg
yolks and beef liver) and in fortified dairy and grain prod-
ucts. Vitamin D is essential for strong bones because it
helps the body use calcium. Extreme vitamin D defi-
ciency causes rickets, an illness resulting in soft bones
and skeletal deformities. But subtle vitamin D defi-
ciency is harder to trace and may affect more people,
across all ages, than once realized.
A recent Harvard Medical School study found that
6.3 million children in the United States — almost one
in five — have less than the recommended amount of
vitamin D in their systems. The amount of deficiency
was even higher in black and Hispanic children.
A study by Johns Hopkins School of Public Health
found that teens with low vitamin D levels were more
likely to have high blood pressure and high blood sugar
and were at greater risk for diabetes and heart disease.
The American Heart Association found that vitamin D
deficiency in premenopausal women may increase the
risk of developing high blood pressure later in life. The
study showed that women who had vitamin D deficien-
cy in 1993 had three times the risk of developing high
blood pressure 15 years later.
Taking vitamin D also may reduce falls in older
people by improving muscle strength. In clinical trials,
people older than 65 who took vitamin D supplements
between 700 and 1000 IU per day reduced falls by
about a fifth within two to five months of starting treat-
ment.
Low vitamin D blood levels also have been associ-
ated with the following:
• Increasedriskofdeathfromcardiovasculardisease
• Cognitiveimpairmentinolderadults
• Severeasthmainchildren
• Cancer
• Diabetes
• Glucoseintolerance
• Multiplesclerosis
8
Blue & You Winter 2009
9
Blue & You Winter 2009
The bad news is that the heart at-
tack 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
more heart attacks, heart attacks
among women is on the rise.
So what’s the good news? The
good news is that while heart
attacks in women are rising, the
risk of death after a heart attack is
improving more for women than for
men under the age of 55.
With heart attacks for women on
According to a National Institutes of Health network study, treating even mild gesta-
tional diabetes appears to have advantages for both infant and mother. It was found that
women who received treatment were:
• Halfaslikelytohavealargebabyatriskforhealthproblemslaterinlife.
• Halfaslikelytodeliverababywithshoulderdystocia,anemergencyconditionin
which the baby’s shoulder becomes stuck during delivery.
• LesslikelytodeliverbyCesarean.
• Lesslikelytodevelophighbloodpressure.
Source: National Institutes of Health
Good news, bad news: Heart attacks on the rise in women
Treating even mild gestational diabetes reduces health risks
the rise, it’s important for
women to know the symptoms.
While some may be similar to those
for men, many, like chest pain, are
not as common for women. So pay
attention to your body and know the
different symptoms:
• Shortnessofbreath
• Weakness
• Unusualfatigue
• Nausea
• Dizziness
• Lowerchestdiscomfort
• Upperabdominalpressurethat
may resemble indigestion
• Backpain
Source: WebMD
9
Blue & You Winter 2009
10
Blue & You Winter 2009
they discussed going into Paragould for pizza, but he
confessed that he was having some discomfort in his
chest. Ruben tried to reassure Martha that it didn’t hurt
much and it was probably indigestion. The two headed
for Paragould, but instead of getting pizza they went
straight to the emergency room at Arkansas Methodist
Medical Center. “We don’t fool with that,” was Martha’s
steadfast response.
Doctors quickly confirmed that Ruben was having
pain associated with a lack of blood to his heart and
sent the two to St. Bernards Medical Center in Jones-
boro, about 25 miles away. Through an agreement
between the two hospitals, heart patients at Arkansas
Methodist Medical Center often are referred to St. Ber-
nards for their excellent care. That high quality is one
reason St. Bernards has been named a Blue Distinction
Center of Excellence for Cardiac Care by the Blue Cross
and Blue Shield Association.
Healing a giving heart
10
Ruben Rodriguez, 58, has a generous and giving
heart. As an associate pastor at Stonewall Community
Church outside the little community of Lafe in Greene
County, Ark., he and his wife Martha help with the
church’s outreach activities, take and teach classes
through Integrity Bible College and share their faith
through music and ministry. But on July 14, Ruben’s
giving heart started giving out.
It started as a pressure in Ruben’s chest while he
was working at his day job at Emerson Electric Co. in
Paragould, but eased off after he took one of the nitro-
glycerin tablets he’d been keeping with him since his
first heart attack 12 years earlier. He’d already had three
stents put in the arteries leading to his heart at two
different times, but in the last decade he’d been feeling
pretty good, so good he hadn’t bothered with the cho-
lesterol medication he was supposed to be taking.
That evening Ruben met Martha at the house and
11
Blue & You Winter 2009
Blue Distinction Centers of Excellence must meet
high quality standards established by an expert panel
of physicians, surgeons and other health-care profes-
sionals. When a hospital has been designated a Blue
Distinction Center, you know they have expertise in
that specialty, that they focus on quality and that they
have a history of patients with positive outcomes.
Hospitals provide care differently, and Blue Cross has
created a process where hospitals can demonstrate
their expertise.
If you are looking for a hospital with a Blue Distinc-
tion designation, go to our Web sites and visit our
“Member” section. We do the work for you, so you can
be assured you are receiving the best care possible.
In the St. Bernards emergency room, Ruben was
fussing more about his missed pizza than his heart
pain, but the results from the tests brought some
somber news; blockage in Ruben’s heart arteries had
caused a small heart attack. He needed a triple bypass.
Had the nitroglycerin tablet that afternoon helped? “It
wasn’t any good,” he said laughing, thinking about that
10-year-old pill. He later learned that nitroglycerin tab-
lets are only good for about six months.
Ruben requested
Richard Stevenson, M.D.,
medical director of the
cardiovascular program
at St. Bernards to do the
surgery. For Dr. Steven-
son, 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
said of Ruben’s request.
He added that Ruben was much like his father in that
he was determined to get well and was willing to take
the steps needed to get there. And both men enjoyed
the opportunity to speak Spanish with Dr. Stevenson
who is conversational in the language but always look-
ing for opportunities to brush up his skills.
Dr. Stevenson said it also helped that Ruben was in
a cardiac program that has gone to great lengths to be
comparable with some of the top cardiac programs in
the nation.
“If you are in our hospital, we want to provide the
same environment and offer the same technology you
would see at Mount Sinai in New York or Vanderbilt
Medical Center in Nashville,” he said. “We strive to of-
fer care commensurate with any top cardiac facility.”
Dr. Stevenson said that the excellent care at St. Ber-
nards begins even before patients get to the operating
room. This care then continues through the operating
staff to the ICU staff and on to the progressive care
staff. In the progressive care unit the patient-to-nurse
ratio is four to one. And before a patient leaves, each
one is referred to outpatient rehabilitation to continue
recovery. “It’s a compendium of care across a continu-
Ruben and Martha Rodriguez sit in front of flags representing the countries helped by their church.
12
Blue & You Winter 2009
um of care,” he explained.
Dr. Stevenson said the cardiac care physicians and
hospital leaders have collaborated on training the nurs-
es in cardiac care. “I’m extremely proud of our heart
care nurses,” he said. “We told them, ‘We will train you
to take care of any complication and manage it until a
doctor can get there.’” The nurses are empowered to
take actions they know will help their patients. “‘No
Fear’ is our motto.”
Dr. Stevenson has a special tie with St. Bernards —
he was born there, back when many of the nurses were
Catholic nuns. He left Jonesboro to pursue his medi-
cal career and ended up at Louisiana State University
Medical Center in Shreveport, La., but found himself
wanting to return to his family and his roots, and to
provide care that could make a difference in Northeast
Arkansas.
The high level of care Dr. Stevenson described is
exactly what qualifies St. Bernards as a Blue Distinc-
tion Center of Excellence. Each Blue Distinction Center
for Cardiac Care must meet stringent clinical criteria
recommended by expert physicians and medical orga-
nizations, including the American College of Cardiology
and the Society of Thoracic Surgeons. Blue Distinction
Centers for Cardiac Care provide a full range of cardiac
care services, including inpatient cardiac care, cardiac
rehabilitation, cardiac catheterization and cardiac sur-
gery (including coronary artery bypass graft surgery),
and each center is re-evaluated regularly.
The cardiac program at St. Bernards seeks to be
the tertiary care center for the area, only taking cases
when needed. Dr. Stevenson said that when it comes
to working with the other hospitals, the heart surgeons
try to be available. Most of all, Dr. Stevenson said, he
is grateful to St. Bernards for allowing the physicians
to look beyond the scope of what an average hospital
does to truly make it a center of excellence. That
excellence is what brought Ruben Rodriguez to Dr. Ste-
Richard Stevenson, M.D., (also in inset photo) performs surgery at St. Bernards Medical Center.
13
Blue & You Winter 2009
venson in July, trusting in his skills, St. Bernards and, as
always, God.
Asked if he was concerned at all about the proce-
dure, Ruben thought back to the moment the hugs
and kisses from family ended and he was being rolled
into the operating room. In that quiet moment, he said,
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
her faith in God. A gospel
song, “I’ve Been Through
Enough to Know that He’ll
be Enough for Me,” ran
through her mind as Ruben
was wheeled away.
Ruben’s surgery was suc-
cessful, and within hours
he was up and walking. He
said the breathing treat-
ments were painful, but he
knew the more he did them
the easier it would become.
Within the week, Dr. Ste-
venson told him, “I take care
of sick people, and you’re
not sick.” Martha cared for
him at home, grateful to be a teacher and be out for the
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 fo-
cused on Ruben’s health, they didn’t have to
worry about his health-care coverage. Ruben’s
insurance was through Blue Cross and Blue
Shield of Alabama, but through BlueCard®, his medical
care was coordinated between their office and Arkan-
sas Blue Cross and Blue Shield.
BlueCard is a national program that enables mem-
bers of one Blue Plan to obtain health-care services
while traveling or living in another Blue Plan’s service
area. The program links
participating health-care
providers with the indepen-
dent Blue Plans worldwide
through a single electronic
network for claims process-
ing and reimbursement.
The Alabama Blue Cross
Plan took care of Ruben’s
needs, and Arkansas Blue
Cross made sure the
doctors, specialists and
hospital received the quick
service they needed.
Ruben is back to work
and sharing his faith with
others. 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. His giving
heart has been given another chance.
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.
The Heartcare Center at St. Bernards
Medical Center is a Blue Distinction
Center of Excellence.
Go to Blue & You Online on our Arkansas Blue Cross and Health Advantage Web sites for more on our Blue Distinction Centers.
14
Blue & You Winter 2009
SilverSneakers competition winner logs more than 1,000 miles
14
Blue & You Winter 2009
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.
15
Blue & You Winter 2009
Dorothy Straub is a fierce competitor. As the old-
est of six children and the mother of three boys, she
quickly learned to dust herself off and keep going when
faced with a challenge. So when the SilverSneakers®
100 Miles, 100 Days Challenge kicked off, she said, “I
can do that,” and she did. When her grown sons shared
their doubts that she could log more (1,000 miles in 100
days), she didn’t quit until she had logged 1,145 miles
— 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.
“It’s easy to sit and feel sorry for
yourself, and I did that for awhile,” Doro-
thy remembered, but after a few weeks she said she
started looking for things to do — about the same time
flyers showed up at the Wellness Center advertising the
contest. Dorothy decided, “why not,” and proceeded to
log in five miles at a time, several times a day.
After the first month, Dorothy already had logged 300
miles, so she made it her goal to reach 1,000 miles,
putting off a trip to Florida until after the contest, and
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
Rogers has state-of-the-art exercise equipment and
a beautiful walking trail that wraps around a waterfall
and fishpond and includes several exercise stations. As
Dorothy got closer and closer to her goal, she realized
that the walking and biking did wonders for her blood
pressure. “It has gone down tremendously,” she said.
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
world, Dorothy and Don settled on a 20-acre cattle farm
in Summers, Ark., just miles from the Oklahoma border.
Dorothy worked for the Fayetteville Prosecutor’s Office
and helped Don on the farm, but in 2003 she had to
take time off as Don’s memory became clouded from
the Alzheimer’s. She measured out a small track on
the farm so she could walk and keep an eye on Don.
When Don’s disease progressed to the point where he
needed more care than she could give him at home,
Dorothy moved him to a nursing home and in
2005 went back to work full time, but shifted
her hours so she could leave in the afternoon
to spend the rest of the day with Don, often
walking with him in the park. “It was very
good for him,” she said.
In May 2008, Dorothy retired to spend more
time with Don and joined the Adult Wellness
Center, a benefit provided to her through Medi-Pak
Advantage (PFFS) as part of the SilverSneakers Pro-
gram. To enroll in SilverSneakers, Medi-Pak and Medi-
Pak Advantage (PFFS) members can go to a participat-
ing fitness center near them and show their ID card. Fit-
ness center staff will assist with enrollment and provide
tours of the locations. Because new fitness centers are
being added to the program regularly, members can
go online to silversneakers.com to find all participating
locations in Arkansas.
Even though Don has passed away, Dorothy contin-
ues to visit the nursing home where he stayed because
she has developed so many friendships there. She even
has become a volunteer ombudsman for the home
through the Arkansas Area Agencies on Aging. She still
volunteers one day a week at the prosecutor’s office.
And she still logs her miles on the track and the station-
ary bikes at the Adult Wellness Center. Because Doro-
thy Straub doesn’t give up.
15
Dorothy
retired and joined the
Adult Wellness Center,
a benefit provided to
her through Medi-Pak
Advantage as part of the
SilverSneakers
Program.
Healthways, Inc. administers the SilverSneakers Fitness Program for Arkansas Blue Cross Medi-Pak and Medi-Pak Advantage (PFFS) poli-cyholders. Healthways, Inc. is an independent company that operates separately from Arkansas Blue Cross.
16
Blue & You Winter 2009
The Healthy Weigh! Education
Program is free for members of Ar-
kansas 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 enve-
lope 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 Educa-
tion 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.
Lose weight
The Healthy 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
of accessing behavioral health services is available from 7 a.m. to
7 p.m., Monday through Friday, to assist in explaining benefits and avail-
able 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 responsi-
bilities are:
• Calling1-877-801-1159(orensuringthatyourmentalhealthprovider
has made the call) for prior authorization of any outpatient mental
health visits after the eighth session.
• Callingthenumberabove(orensuringthattheinpatientfacility
does so) prior to any inpatient mental health/substance abuse
inpatient stay.
• Checkyourbenefitscertificateforfulldetailsonanyexcluded 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!
Behavioral health services now available
Blue & You Winter 2009
17
Blue & You Winter 2009Blue & You Winter 2009
17
Women who are overweight or obese
before they become pregnant have approxi-
mately an 18 percent higher chance of having
a baby with certain heart defects as compared
to women who were not overweight while
severely obese women have approximately a
30 percent higher chance — this, according to
a study by the Centers for Disease Control and
Prevention.
The study, which is the largest study ever
conducted in the United States to identify risk
factors for birth defects, found a significant
increase in several types of heart defects in
babies born to overweight or obese women.
Obese women at greater risks of giving birth to babies with heart defects
Although the U.S. Preven-
tive 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 subsid-
iary, Health Advantage, will
continue to cover screening
mammograms as a part of our wellness benefit.
“We understand there is concern among our members
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 mammo-
grams 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 2002 recommendation by eliminating the recommendation
for screening for women ages 40 to 49, and increasing the
screening interval to every two years for women 50 to 74.
The American Cancer Society and the American College of
Radiology have expressed significant concerns over the new
recommendations of the U.S. Preventive Services Task Force,
and these two organizations continue to recommend screen-
ing mammography on an annual basis to all women beginning
at age 40. Recommendations vary for those who are consid-
ered at higher risk.
Members continue to receive screening mammograms as
a wellness benefit
18
Blue & You Winter 2009
You might not think about it in financial terms, but
having a good relationship with your primary care physi-
cian (PCP) can save you money. How?
Studies show that people who have a trusting relation-
ship with their PCP, and regularly go for wellness screen-
ings and checkups, are less likely to develop chronic
illness later in life. Chronic illness can lead to missed
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 rela-
tionship with your doctor. PCPs are trained to
help you prevent health problems. They can point out
choices you may be making today that can affect your
health tomorrow.
Costs Matter:
Developing a relationship
with your doctor
18
19
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 doc-
tor. According to the Annals of Family Medicine, the
average face-to-face time with a doctor during an ap-
pointment 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-to-
day 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 every-
thing he or she has told you. The following are some
tips on asking your doctor questions during the exam:
• Writedownquestionsbeforetheappointmentand
ask them during the exam. Be sure to ask the most
important questions first.
• Bringafamilymemberwithyoutotakenotes
and have them write down the answers to
your questions.
• Letthedoctorknowifyoudon’tunderstand
something.
• Tellyourdoctorifyouneedmoreinformationor
assistance to understand your condition. He or she
may get a physician assistant or nurse to help you.
• Ifyourdoctorprescribedamedicine,askifthereare
generics available.
Take it home
Take the following information home:
• Notestakenduringtheappointmentbyyouoryour
family member.
• Writteninstructionsfromyourdoctor.
• Brochuresorothereducationalmaterials.
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:
• Ifyouhavequestionsaftertheappointment.Ask
to leave a message for the doctor or speak with a
nurse.
• Ifyoustarttofeelworseorhaveproblemswithyour
medicine.
• Ifyouhaven’tgottentheresultsoftests.
Source: American Academy of Family Physicians
… 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.
20
Blue & You Winter 2009
Is it Alzheimer’s disease?Every 70 seconds an American is diagnosed with
Alzheimer’s disease. In the coming years, as the 72 mil-
lion 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 suf-
fer 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 medica-
tion to treat Alzheimer’s disease instead of directing
them to a specialist. This is the least important com-
ponent 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 signifi-
cant. 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 com-
munity or interact with others (work, shop, remember
appointments). Family members may raise concerns
that a loved one is repeating information, seems con-
fused, 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.
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 stud-
ies 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
Senior Momentswith Dr. David
David A. Lipschitz, M.D., Ph.D.
21
Blue & You Winter 2009
forgetfulness), Vitamin B12 deficiency, sleep disorders,
Parkinson’s disease and a condition called Normal Pres-
sure Hydrocephalus in which memory loss is accom-
panied by problems with walking, balance and bowel
and bladder incontinence. Identifying and treating these
conditions on occasion can lead to dramatic improve-
ments in memory.
Treating conditions that can make memory
loss worse
Even if the diagnosis is Alzheimer’s disease, other
medical conditions such as diabetes, high blood pres-
sure, depression, sleep problems
or inappropriate medication use can
make memory loss worse. Treating
these conditions can improve health
and slow the rate at which the dis-
ease progresses.
Paying attention to the care-
giver and family education
Taking care of a family member
with memory loss is an overwhelming burden. Caregiv-
ers, often spouses or children, often do not take care
of themselves, are severely stressed, are at great risk
of becoming ill and are desperate for help. Understand-
ing the condition and how to approach someone with
Alzheimer’s disease is essential. Caregivers must be
encouraged to meet their own needs, have regular
medical checkups and spend some time alone.
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
delusions, aggressive behavior, agitation and difficulties
with sleep become common. Having access to a team
of health-care providers is critical to optimally deal with
these problems. It does indeed take a village to care for
someone with Alzheimer’s disease and their family.
Medications to treat Alzheimer’s
Several drugs have been shown to slow the progres-
sion of memory loss. They include Aricept, Exelon,
Reminyl and Namenda. None of these drugs will lead to
dramatic improvements in memory, but they should be
considered based on evidence that slowing the pro-
gression of the disease may provide
a number of additional years of in-
dependent life and reduce the need
for placement in a nursing home.
The future
While we do not know the cause
and cannot prevent Alzheimer’s
disease, there is much we can do to
reduce the rate at which the illness
progresses. Living a stress free, heart-healthy lifestyle,
exercising your mind and your body can delay the age
at which Alzheimer’s disease presents by 10 or more
years. We also must commit to more research to under-
stand the fundamental cause of this serious disease.
There is hope that through research, new approaches to
care will become available, and that in our lifetime there
will be a cure.
Editor’s Note: David A. Lipschitz, M.D, Ph.D., is na-
tionally 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.
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.
22
Blue & You Winter 2009
by Trey Gardner, Pharm D.,Arkansas Blue Cross and Blue Shield
Paying for your medications
From the Pharmacist
“Why do I pay for some medi-
cations through my insurance
differently?”
If you are on several medica-
tions, you may have noticed that the
claims for some of your medications
may be filed under your medical
benefit, and others may be filed
under your retail pharmacy benefit.
You may even see the same medi-
cation filed differently under both
benefits. Why?
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.
If you went to your pharmacy to
receive your medication, how much
you pay is determined by the allow-
able charge for the medication and
the type of retail pharmacy benefit
plan you have. When you receive
medications from a retail pharmacy,
you may have to pay a prescription
drug copayment. Finally, if you need
home infusion therapy and you get
it from a designated provider, your
medication is covered under your
medical benefit based upon the al-
lowable 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 your-
self, 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” medi-
cation you can contact Customer
Service.
23
Blue & You Winter 2009
Happy New Year means resolutions; and in 2010,
Arkansas Blue Cross and Blue Shield will make it easier
for our Medi-Pak and Medi-Pak Advantage (PFFS) mem-
bers to keep them — if one of your New Year’s resolu-
tions is to have a Healthy 2010.
As a Medi-Pak or Medi-Pak Advantage (PFFS) mem-
ber you may enroll — or continue your enrollment — in
SilverSneakers® at no cost to you. As a member of
SilverSneakers, you have access to amenities such
as treadmills, weights and — in some cases — even
heated pools at no additional cost. As a SilverSneakers
member, you can take advantage of all the equipment
and services available with a basic membership at a Sil-
verSneakers participating fitness center. Many of these
fitness centers also offer the signature SilverSneakers
exercise classes, designed for older adults and taught
by SilverSneakers-certified instructors. Don’t know
which fitness centers in your area participate? Simply
go to the SilverSneakers Web site at silversneakers.
com. The SilverSneakers Web site also offers fabulous
resources such as great new recipes and tools to create
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
doctor a printout of your Personal Health Record (PHR)
from our Web site at arkansasbluecross.com (you must
register with My Blueprint to access your PHR). And,
speaking of doctor’s visits — don’t forget — as a Medi-
Pak Advantage (PFFS) member, you get an annual exam
with no copayment!
If you are a Medi-Pak Advantage (PFFS) member,
throughout the year, you will receive helpful newsletters
offering sound advice on staying healthy. And if you have
the holiday blues, we have a new depression hotline.
With all of these resources available to you, keeping
your New Year’s resolution of working to maintain your
health should be easier!
If you have questions, we’re here to help. Please call
the appropriate toll-free customer service telephone
number listed below:
Medi-Pak Customer Service
1-800-338-2312
Medi-Pak Advantage (PFFS) Customer Service
1-877-233-7022
If you’re not a Medi-Pak or Medi-Pak Advantage
(PFFS) member but want to learn more, call our li-
censed, 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.
Medi-Pak and Medi-Pak Advantage (PFFS)Members: Resolve to Have a Healthy 2010
24
Blue & You Winter 2009
A healthier life is only keystrokes away with online
health tools available to Arkansas Blue Cross and Blue
Shield and Health Advantage members and eligible
members of BlueAdvantage Administrators of Arkansas
through My Blueprint.
Our online programs can provide support on a variety
of topics, including:
• Gettingactive
• Healthyeating
• Healthyweight
• Healthythinking
• Quittingsmoking
• Dealingwithlowbackpain
• Sleepingwell
Online Health ToolsTo access these programs, go to My Blueprint on
the Arkansas Blue Cross, Health Advantage or BlueAd-
vantage Web sites, select HealthConnect Blue, choose
the HealthyLiving tab from the Dialog Center and then
choose a “Healthy Conversation.” The name of these
tools has changed, but the ability to create a plan as
unique as you are has not!
To start a program, all you need to do is answer a
questionnaire about yourself and the way you live,
which takes about 15 minutes. The health-care profes-
sionals will use that information to create a one-of-a-
kind just plan for you.
Need help waking from a long
winter’s nap back into the “fit”
of things? Then move from hiber-
nation to becoming part of the
“hyper”nation with the 2010 Blue
& You Fitness Challenge exercise
contest.
Although spring is months away,
now is the time to plan for the Chal-
lenge. All you have to do get 10 of
your friends together, pick one of
you to sign up your group and keep
up with the details (the group
administrator) and register on blue-
andyoufitnesschallenge-ark.com.
The Blue & You Fitness Challenge
is an exercise contest that encour-
ages participants to work toward
the public health recommendation
of adult physical activity 30 minutes
each day, most days of the week.
A total of 167 groups — large and
small — with more than 11,500
participants took part in the 2009
Challenge.
The Web site is live, and there’s
still time to sign up for the contest.
Whether your group has 10 or 1,000
members, you have until January
31 to sign up. Individuals who will
be participating in Challenge groups
will begin registration in February.
Schools, companies and organiza-
tions and others may form teams
within their larger body of partici-
pants, too. Students ages 13 and
older can form teams and challenge
other schools or other teams within
their schools. (Note: Group admin-
istrators must be 18 or older.) All
individuals must be registered on a
team by Feb. 28, 2010.
We will begin exercising on our
virtual tour on March 1. For more
information, call toll free 1-800-686-
2609. You may download a planning
kit in PDF form from the Web site.
Blue & You Fitness Challenge group registration under way
24
25
Blue & You Winter 2009
by Ray Bredfeldt, M.D.,Regional Medical DirectorNorthwest Region, Fayetteville
TheDoctor’s CornerDrinking hot liquids associ-
ated with throat cancer
Smoking and heavy alcohol use
are both associated with throat
cancer. Now, another risk factor has
been identified — very hot beverag-
es. 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 warn-
ing signs that your
child’s backpack
is too heavy,
courtesy of
the U.S. Na-
tional Safety
Council:
• Yourchild’sposturechanges
when the backpack is on.
• Yourchildhasdifficultyputting
the backpack on or taking it off.
• Yourchildhaspainwhilethe
backpack is on.
• Yourchildfeelsasensationof
numbness or tingling while wear-
ing the backpack.
• Yourchildhasredmarkson
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 proce-
dures 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 colonos-
copy, 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 morn-
ing procedure rather than one later
in the day.
26
Blue & You Winter 2009
BlueAnn Ewe was checking her
e-mail one day and came across
a special request. The e-mail was
from Jenni Smith, who is the
mother of a 2-year-old boy affected
by Down syndrome, a genetic disor-
der caused by the presence of too
many chromosomes.
Each year, Texarkana hosts a
National Down Syndrome Society
Buddy Walk®, and Jenni’s son,
Ethan, asked his mom if BlueAnn
could come and participate. Jenni,
a registered nurse at CHRISTUS
St. Michael, immediately contacted
Arkansas Blue Cross and Blue Shield’s South-
east 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’ Cen-
tral Regional Office, also attended the first annual
Back-to-School Community Health Fair at Trinity
Worship Center in Conway, Ark., on August 15.
BlueAnn Ewe makes a Buddy!
Arkansas Blue Cross
and Blue Shield and
asked if BlueAnn
could be Ethan’s
buddy at Texarkana’s
2009 National
Buddy Walk.
Traci Gatlin, R.N.,
medical affairs
manager, and Hillary
Cross, R.N., regional
case manager from
the Arkansas Blue
Cross Southwest
Regional Office, gladly volunteered
to take BlueAnn to the walk to meet
Ethan. More than 500 people, along
with BlueAnn, walked around Buddy
Ferguson Park on October 31, to help
raise money for families and indi-
viduals affected by Down syndrome.
Mothers of children with Down syn-
drome hope the National Buddy Walk
will help raise awareness about the
condition and build support systems,
both of which last long after the one-
mile walk is over.
BlueAnn participated in the walk
and played games that helped raise
$15,000 for those locally born with
Down syndrome.
Ethan Smith was delighted to
have BlueAnn’s support!
BlueAnn goes back to school
Jenni Smith, R.N. and her son, Ethan
27
Blue & You Winter 2009
Mark White, president and chief
executive officer for Arkansas Blue
Cross and Blue Shield, was named
the corporate walk chair for the
Greater Arkansas Chapter of the
Juvenile Diabetes Research Founda-
tion (JDRF). In support of Mark and
JDRF, more than 500 Arkansas Blue
Cross employees joined him at Mur-
ray Park on September 19.
In addition to walking for a
cure, Arkansas Blue Cross hosts
an annual corporate fundraiser to
raise money for JDRF. Our leader-
ship team in past years has been
dunked, called Bingo and fought ob-
stacles, all to help juvenile diabetes
research. There only was one thing
they had not done — sing!
This year, our fundraiser theme
was, “Arkansas Blue Cross Idol:
Karaoke for a Cure,” styled after
the No. 1 hit television show,
“American Idol.”
Arkansas Blue Cross executives
agreed to be Idol contestants — but
only if the price was right. Each exec-
utive agreed to sing “karaoke style”
if $1,000 was raised in his or her
name through employee pledges.
The employees of Arkansas Blue
Cross raised more than $10,000
for JDRF!
Arkansas Blue Cross raises $10,000 for JDRF
The 2009 Arkansas Blue Cross JDRF “Walk for a Cure” team
Blue & You Foundation awards $1.5 million in grants to improve health
The Blue & You Foundation for a
Healthier Arkansas has awarded a
total of $1,574,691 in grants to 33
health improvement programs in
Arkansas.
“Our grants this year went to pro-
grams across the state that address
such issues as obesity, diabetes,
healthy lifestyle choices, medical
care for low-income individuals,
dental health, safety and worksite
wellness,” said Patrick O’Sullivan,
executive director of the Blue & You
Foundation.
Arkansas Blue Cross and Blue
Shield established the Blue & You
Foundation in 2001 as a charitable
foundation to promote better health
in Arkansas. The Blue & You Founda-
tion awards grants annually to non-
profit or governmental organizations
and programs that positively affect
the health of Arkansans.
In its eight years of operation, the
Blue & You Foundation has awarded
more than $10 million to 162 health
improvement programs in Arkansas.
The grants awarded for 2010 are:
• American Diabetes Association, Bentonville ($35,000)
• Area Agency on Aging of South-east Arkansas, Pine Bluff ($25,876)
• Arkansas Hunger Relief Alliance, Little Rock ($110,000)
• Arkansas Mission of Mercy, Sher-wood ($50,000)
• Arkansas Quality Foundation, Little Rock ($43,262)
• Baptist Health Foundation, Little Rock ($149,940)
• Cedarville Schools, Cedarville ($62,160)
• Chicot Memorial Hospital Founda-tion, Lake Village ($60,182)
Grants, continued on Page 29
28
Blue & You Winter 2009
by Randal F. Hundley, M.D., FACCSpecial Guest ContributorWhat is a hospitalist?
A hospitalist is a physician whose
primary professional focus is the care
of hospitalized patients, so if you or
someone in your family is ever hospi-
talized — there are doctors right there
when you need them to answer your
questions and coordinate hospital
care. These physicians have dedicated
their careers to the care of hospitalized
patients.
In the past, if you were hospitalized,
you could expect to see your primary
care physician (PCP) at the hospital co-
ordinating all your hospital care. Many
physicians continue to admit their
own patients to the hospital, and this
system works well for them.
Today, however, most PCPs focus
their attention on patients in their clinic
and entrust the care of their hospital-
ized patients to the specialist who ad-
mitted the patient (such as a surgeon
or cardiologist) or to the hospitalist.
The hospitalist usually is a general
medicine physician who is trained on
a wide variety of medical problems,
and who takes responsibility for the
patient during the hospitalization. The
hospitalist calls in other doctors as
needed, but primarily is in charge of
the hospitalization and communication
among all the doctors, the patient and
the family.
Hospitalists provide valuable
services by:
• Beingavailabletoquicklymeetthe
needs of hospitalized patients and
their families.
• Handlingsituationsquicklyby
having an in-depth knowledge of
the hospital and its staff.
• AllowingPCPstofocusonpa-
tients in their clinics.
• Providingareportofthehos-
pitalization with any treatment
changes to the PCP.
The possible downside of working
with a hospitalist is that he or she
may not know you as well as your
PCP. With thorough communication,
however, this issue can be avoided.
If your care (or a family member’s)
is coordinated by a hospitalist, you
should expect your PCP and the
hospitalist to communicate at the
beginning and end of the hospital-
ization, and if any big issues arise. It
is especially important for your PCP
to have all the important information
from the hospitalization.
You can help the process by ask-
ing the hospitalist whether there
has been or will be communication
with your PCP. If unsure, you can
call your physician’s office to be
sure they know that you (or a loved
one) are in the hospital. Although
the hospitalist will be able to obtain
your office records as needed, it is
extremely helpful to hospital admis-
sion staff to give your doctors and
nurses a list of:
• Yourcurrentmedications.
• Anyallergies.
28
29
Blue & You Winter 2009
• Previousoperationsandmedical
conditions.
• Allyourphysicians’namesand
telephone numbers.
• Thenameandtelephonenum-
ber of a family member or other
contact person.
At discharge, several things are
important:
• Haveaclearlistofall your medi-
cations. Be sure you understand
which medicines have been
started, stopped or changed, as
well as any instructions on diet
or other issues.
• Knowifyouwillhavehome
health visits and know when to
expect a visit.
• Knowwhenyouwillvisitwith
your PCP and any specialists you
saw in the hospital.
• Knowifyouneedtoscheduleap-
pointments with other providers
such as physical therapists.
• Askthatareportofyourhospi-
talization, with any changes in
medications or other treatment,
be forwarded to your PCP.
Gener-
ally, the
hospitalist
will not see
you again
unless you come back into the
hospital. A recent study showed
that many patients are discharged
from the hospital without adequate
follow-up arrangements, leading to
complications at home and readmis-
sion to the hospital.
At Arkansas Blue Cross and Blue
Shield, experiences with most
hospitalists have been excellent.
When there has been a problem,
it is often because the patient did
not have a PCP before going into
the hospital, making it difficult to
arrange good follow-up care after
hospital discharge. Arkansas Blue
Cross strongly recommends hav-
ing a relationship with a PCP before
needing to go into the hospital. This
is the best way to ensure a smooth
transition from hospital to home.
• Crawford-Sebastian Community Development Council, Fort Smith ($5,032)
• Dallas County Alliance Supporting Health, Fordyce ($8,805)
• FoodShare and Opportunity Net-work, Prescott ($11,250)
• Friendship Community Care, Rus-sellville ($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 Enrich-
ment Center, Bentonville ($58,255)• Hospice of Texarkana, Texarkana
($11,505)• Kimmons Junior High and Sutton
Elementary, Fort Smith ($104,860)• Lawrence Memorial Health Foun-
dation, Walnut Ridge ($42,270)• Madison County Health Coalition,
Huntsville ($66,360)
• 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 Educa-tion 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 Medi-cal Sciences (UAMS), Little Rock ($34,397)
• University of Arkansas for Medi-cal Sciences (UAMS), Little Rock ($80,961)
• Van Buren County Schools, Clin-ton ($55,200)
The Blue & You Foundation
received 94 grant applications re-
questing $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 informa-
tion, 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.
Grants, continued from Page 27
The hospitalist
takes responsibility
for the patient
during
hospitalization.
30
Blue & You Winter 2009
Baldor — Building a lean machineA Baldoremployeegets hisblood pressurechecked during ahealth screening.
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-
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 nation-
wide to one source for the administration of its group
health insurance, and BlueAdvantage Administrators of
Arkansas — a subsidiary of Arkansas Blue Cross and
Blue Shield — was a perfect fit. Baldor, whose world
headquarters is located in Fort Smith, Ark., wanted a
health plan administrator that understood their long-
term objectives around creating a healthy workplace
and had the resources to assist them in creating a
culture of health.
So in early 2009, the Baldor Wellness Council, com-
prised of employees from each of
its 22 U.S. locations, was formed
to promote the new “Fit4Life”
wellness program nationwide and
engage all 6,500 employees in
healthier lifestyles. The Fit4Life
program encourages employees to
get involved in workplace wellness
educational activities and initia-
tives, while focusing on improving
their overall health and well being.
Martha Carlson, regional executive for the Arkansas
Blue Cross West Central Regional Office in Fort Smith,
started discussing the concept of wellness with Jason
Green, the vice-president of human resources at Baldor,
and Tona Schmidt, the staffing manager and coordinator
of the Baldor Wellness Council.
“Martha helped us understand the resources that
were available to us through our relationship with Ar-
kansas Blue Cross,” Green said, referring to HealthCon-
nect Blue, Arkansas Blue Cross’ multi-faceted integrat-
ed health resource that provides a wide variety of tools
for healthy living.
Get Your Motor Running
As a start to their Fit4Life companywide wellness
efforts, Baldor encouraged all employees, not just those
on the company’s insurance plan, to
complete the online Personal Health
Assessment available through
HealthConnect Blue. This was not
an easy accomplishment in an en-
vironment where most employees
work on a production line.
Baldor began the process by
providing onsite biometric screen-
ings (blood pressure, blood sugar,
cholesterol and weight) for em-
ployees to assess their health. Arkansas Blue Cross
representatives then walked Baldor employees through
the registration process for My Blueprint using onsite
computers and instructed them on how to complete
the Personal Health Assessment. By participating in the
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.
31
Blue & You Winter 2009
Personal Health Assessments, Baldor will establish a
benchmark on their employee’s current health status.
While individual results are strictly confidential, aggre-
gate 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 infor-
mation on how they can improve their health and, if
needed, were guided to health education programs pro-
vided by BlueAdvantage to help them care for chronic
conditions.
“Baldor is a great company,” Carlson said. “They
are very focused on treating their team members with
respect and dignity. That certainly shows through the
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 well-
ness 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 suc-
cessful and ultimately improve the health of our em-
ployees,” 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.”
We love to hear from you!May we help? For customer service, please call:
Little Rock Toll-free Number (501) Number
Medi-Pak members 378-3062 1-800-338-2312
Medi-Pak Advantage members 1-877-233-7022
Medi-Pak Rx members 1-866-390-3369
Arkansas Blue Cross members 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 1-800-863-5567
BlueAdvantage members 378-3600 1-888-872-2531
Pharmacy questions 1-888-293-3748
State and Public School members 378-2364 1-800-482-8416
Federal Employee members 378-2531 1-800-482-6655
Looking for health or dental insurance? We can help!
For individuals, families and those age 65 or older 378-2937 1-800-392-2583
For employer groups 378-3070 1-800-421-1112 (Arkansas Blue Cross Group Services, which includes Health Advantage and BlueAdvantage Administrators of Arkansas)
Prefer to speak with someone close to home? Regional Office telephone numbers:
Pine Bluff/Southeast Region 1-800-236-0369 1800 West 73rd St.Jonesboro/Northeast Region 1-800-299-4124 707 East Matthews Ave.Hot Springs/South Central Region 1-800-588-5733 100 Greenwood Ave., Suite CTexarkana/Southwest Region 1-800-470-9621 1710 Arkansas BoulevardFayetteville/Northwest Region 1-800-817-7726 516 East Milsap Rd., Suite 103Fort Smith/West Central Region 1-866-254-9117 3501 Old Greenwood Rd., Suite 5Little Rock/Central Region 1-800-421-1112 320 West Capitol Ave., Suite 900
Web sites: arkansasbluecross.comhealthadvantage-hmo.com
blueadvantagearkansas.com blueandyoufoundationarkansas.org
blueannewe-ark.com
Go to Blue & You Online on our Arkansas
Blue Cross and Health Advantage Web sites
for more on Baldor’s Fit 4 Life Program.
32
Blue & You Winter 2009
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.
Information is good for you! Especially information from
your member magazine, Blue & You! That’s why we’ve
created Blue & You Online. It’s an online version of our
magazine with more information about our featured
stories, more photos and links to more information on
plans, products and information to help you better man-
age your health and your health plan. Go to our Arkan-
sas Blue Cross and Blue Shield and Health Advantage
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 sav-
ing money and get fit!
Prepare for a PandemicArkansas Blue Cross and Blue Shield wants you to be
prepared during a pandemic or other emergency, so we
have updated a special publication to help you and your
family. “Preparing for a Pandemic,” is available in the
“Members” section of all of our Web sites, or you can
find a link to the publication in the Blue & You Online
section on the home page of the Arkansas Blue Cross
and Health Advantage Web sites.
In Preparing for a Pandemic, you will find:
• Tipsonhowtoavoidspreadinggermsandhowcom-
munities may respond during an emergency.
• Instructionsoncaringforsickfamilymembersand
when to seek medical help.
• Keylocalandnationalpandemicresources,howto
access your personal health information, and a place
to assemble critical information about your family.
• Informationonhowyourbenefitsmaychangeduring
a declared pandemic and how to reach us during an
emergency.