2011 - Spring

A publication for the policyholders of

the Arkansas Blue Cross and Blue Shield

family of companies

• Health Advantage has new Web site design, Page 7

• Dr. David on the impact of diabetes, Page 10

• Blue & You Foundation funds CPR training, Page 18

Spring 11

Gift to UAMS promotes primary

care, Page 4

Out of the Blue

Arkansas Blue Cross invests $1 million in Arkansas’

medical future

GR8 plans 4 U

Updated, fresh look for Health Advantage Web site

SilverSneakers becomes a silver lining

Lifelong Health with Dr. David

Kids and caffeine overload

Lose weight The Healthy Weigh!

Chickenpox vaccine cuts hospitalization

Is there a link between breast cancer risk and when

women begin hormone therapy?

Kids with asthma: The battle to breathe

Updated Vitamin D and Calcium recommendations

From the Pharmacist — Here’s the rub … vapor rub.

The Doctor’s Corner

Foundation grant helps save children’s lives

Good for you starts with … Pharmacy

Good for your community

Customer Service telephone numbers

Good for you

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Spring 11

is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health care professionals and other persons interested in health care and wellness.

on Page 18

INSIDE

Editor: Kelly Whitehorn — [email protected] Editor: Jennifer GordonDesigner: Gio Bruno Photographer: Chip BayerContributors: Chip Bayer, Matthew Creasman, Damona Fisher, Kristy Fleming, Trey Hankins, Heather Iacobacci-Miller, Ryan Kravitz, Kathy Luzietti and Mark MoreheadVice President, Communications and Product Development: Karen Raley

Early childhood professionals learn first aid and cardio

pulmonary resuscitation (CPR) through a grant from the

Blue & You Foundation for a Healthier Arkansas.

Joyce Elrod finds her silver lining in the SilverSneakers® Fitness Program. See the story on Page 8.

On the Cover:

3

Blue & You Spring 2011

Out of the

BlueA message from our CEO and President,Mark White

Providing better access to primary care in Arkansas

As Congress and federal courts around the country

continue to discuss the nuances of health insurance

reform in Washington D.C., Arkansas Blue Cross and

Blue Shield is focused on implementation of the new

law and taking steps to ensure that some unintended

consequences do not negatively impact our members.

One of our concerns is our members’ ability to get

needed care from primary care doctors in a timely

fashion. The shortage of primary care physicians is a

national problem, and a problem that will become even

more apparent when the provisions of the new law that

expand the Medicaid program take effect in 2014. For

Arkansas, that means 251,000 new Medicaid beneficia-

ries will be seeking primary care from an already taxed

delivery system.

In Arkansas’ small towns, the shortage of primary

care physicians is particularly acute and is exacerbated

by limited medical technology (which makes medical

care delivery less efficient), high rates of chronic illness

and an aging population. It is here where we see all too

clearly that we must work to improve not only the cost

of care but the availability and quality of care as well.

At Arkansas Blue Cross, we recognize that it is not

enough to provide medical insurance if the doctor’s

waiting room is overflowing, or if there simply isn’t a

doctor nearby. As the state’s leading health insurer, we

have a responsibility to address these problems for our

members and for all Arkansans. And, we already are

addressing that obligation in several ways.

One program designed to improve the quality and ef-

ficiency of primary care delivery is our patient-centered

medical home pilot program. There are currently seven

patient-centered medical home pilot practices through-

out the state. This innovative approach to comprehen-

sive primary medical care has been proven to provide

better access to health care, produce patients who are

more satisfied with their care, and improve the health

of patients.

Medical homes provide quick access for sick pa-

tients, yet are available to patients who are taking steps

to prevent illness. By using a team approach, medical

homes can be sure patients are cared for by the team

member who can best treat their needs. This may in-

clude advanced practice nurses, dietitians, pharmacists

and other health professionals, as well as primary care

physicians.

This issue of Blue & You features another initiative

we’ve taken to address the shortage of primary care

Access, continued on Page 22

4


Arkansans deserve,” said Mark White, president and

chief executive officer of Arkansas Blue Cross. “Instead

of reacting to these changes, we want to be in the fore-

front, helping to mold

the future of health

care in Arkansas.

We believe that by

encouraging medical

students today to go

into primary care, our

members will have

the care they need to

live healthier lives in

the future.”

The main reasons

for the primary care crisis are:

• A shortage of primary care physicians, including

family practice, pediatric and general internal

medicine doctors.

Arkansas Blue Cross invests $1 m illion in Arkansas’ medical future

Debra Fiser, M.D., dean of the UAMS College of Medicine, addresses medical students during a “white coat ceremony,” which is held at the beginning of their first year at UAMS.

Sources: UAMS Center for Rural Health, Johns Hopkins Primary Care Policy Center, Association of American Medical Colleges, Arkansas Department of Health and Arkansas Center for Health Improvement

“We want to be in the forefront, helping to mold

the future of health care in

Arkansas.” — Mark White, president

and CEO of Arkansas Blue Cross

4

P rimary care is in critical condition throughout

the United States, and small towns in areas like rural

Arkansas are particularly hard hit. Arkansas Blue Cross

and Blue Shield is working to increase the number of

primary care physicians (PCPs) available to patients in

Arkansas by committing $1 million to the University

of Arkansas for Medical Sciences (UAMS) College of

Medicine.

The grant will create the Arkansas Blue Cross and

Blue Shield Primary Care Scholarship, to be given to

a junior or senior medical student in the UAMS Col-

lege of Medicine. Scholarship recipients will be chosen

from those planning to pursue post-graduate training in

family medicine, general internal medicine or general

pediatrics. The students also must intend to practice

primary care in Arkansas, preferably in the more rural

parts of the state.

“We know changes need to take place in the health

care environment in order to provide the quality of care

5


• An aging population and an illness

burden higher than the national av-

erage, which creates high patient

volume for the physicians who are

available.

• The potential projected influx of

more than 251,000 Arkansans

to the Medicaid program in 2014

under health insurance reform.

“The shortage of primary care

physicians is at a critical point in this

country,” said UAMS Chancel-

lor Dan Rahn, M.D., “Primary

care physicians are the first line

of defense and the ones who

promote preventive care, which

in turn builds healthier commu-

nities and reduces health care

costs. This is truly a noble and

visionary gift by Arkansas Blue

Cross, and it will greatly ben-

efit Arkansas and the future of

health care.”

The scholarship, given in

honor of the Board of Direc-

tors of Arkansas Blue Cross, will be

awarded each year, beginning with

the 2012-2013 academic year. It is

estimated that about $40,000 will

be available each year for the schol-

arship, using interest accrued from

the grant.

According to the Arkansas De-

partment of Health, in 2008 the ma-

jority of the state met the definition

of “medically underserved,” with

one primary care physician available

for every 3,000 people. That same

year, the Healthy Workforce in Ar-

kansas study by the UAMS Center

for Rural Health indicated that there

were almost 1,000 vacancies for

PCPs in the state. Instead of im-

proving, these trends are steadily

worsening.

A big reason for the shortage of

primary care physicians is the high

cost of medical school. The Associa-

tion of American Medical Colleges

estimates that the average medical

student ends up $125,000 in debt

by graduation.

“It is on the lower end here in

Arkansas, but there is still an enor-

mous amount of debt staring most

of them in the face when they look

toward graduation,” said College of

Medicine Dean Debra Fiser, M.D.

Many medical students, she said,

assume that it makes sense to go

into a field of study where they can

pay off the loans quickly, and that

steers them toward specializing and

away from primary care.

“Even for students who want

to go into primary care, there is a

mindset that they would never

be able to earn enough to

pay off their debt,”

she said.

According to the Johns

Hopkins Primary Care

Policy Center, adults in

the United States who

had a primary care physi-

cian had 33 percent lower

costs of care and were 19

percent less likely to die

prematurely from their

conditions than those

who had received care

from a specialist, after adjusting

for demographic and health charac-

teristics. The center found that the

availability of primary care physi-

cians is consistently associated

with improved health outcomes for

conditions like cancer, heart dis-

ease, stroke, infant mortality, low

birth weight, life expectancy and

self-managed care.

• No. 42 in the nation for PCPs per 100,000 population.

• No. 48 in the nation for active physicians per 100,000 population.

• 1/3 of Arkansas physicians are over the age of 55;

many are retiring.• 5th highest percentage of elderly nationwide.

Arkansas Blue Cross invests $1 m illion in Arkansas’ medical future

Sources: UAMS Center for Rural Health, Johns Hopkins Primary Care Policy Center, Association of American Medical Colleges, Arkansas Department of Health and Arkansas Center for Health Improvement

Gift funds UAMS scholarships

Arkansas’ Physician Shortage ) Where we stand _

5

6


Wanna communicate with your teenagers or even

your young adult children?

TXT.

In Arkansas Blue Cross and Blue Shield’s 62-year

history, health insurance has changed … a lot. So has

technology. And communication.

And, while health insurance is a common consid-

eration for many people, it’s not always the first thing

younger people are looking to spend their money on,

especially when they feel “invincible.” So, to reach out to

a younger adult market

about our health insur-

ance plans, Arkan-

sas Blue Cross

launched its

first “Mobile

Messaging”

digital

campaign in Central Arkansas in January.

Through the mobile messaging digital campaign, text

messages (using a specified keyword) were sent to a

5-digit number. For those who have smart phones, they

answered three questions on a Web site in their phone

browser and received a base rate quote for health insur-

ance — almost instantly — through their phone. For

those who have text capabilities, but can’t get online on

their phone, they answered the three questions, one

at a time, in a texting conversation and got a rate quote

right in a text message. Everyone received a

follow-up e-mail to continue the conversation

and sales process.

The campaign was promoted on local radio

stations and thousands of listeners sent

texts for quotes.

“When people are in their 20s and

even early 30s, they may think they

don’t really need health insurance,”

said Karen Raley, vice president of

Communications and Product Devel-

opment. “They’re healthy, they think

insurance is too costly, and they would

rather spend their money on other things.

We want young adults to understand

that health is not to be taken for granted

(anything can happen), that insurance is sur-

prisingly affordable, and that it is important for

people of all ages to have health insurance.”

Although the cool mobile messaging campaign has

ended, our affordable, individual and family health and

dental plans still are just a telephone call or a mouse

click away … for people of all ages. For more details,

call 1-800-392-2583 or visit our Web site at arkansas-

bluecross.com, select “Looking for Insurance,” and

then select “Individual and Families.”

GR8 plans 4 U

7


Updated, fresh look for Health Advantage Web siteIf you are a Health

Advantage member and

you have visited the Web

site recently at healthad-

vantage-hmo.com, you

have probably noticed a

new look and feel that

combines creativity with

ease of use.

The Health Advantage

Web site has always been

a place for our members,

potential members and

visitors to find information

about our insurance plans

and services.

From the home page,

you can select our self-

service center (My Blueprint) where you have 24/7

access to your recent pharmacy and medical claims,

your personal health record, physician cost and quality

information, the ability to print or order a new ID card

and much more.

Also, visit our Web site to find:

• A doctor or hospital in the Health Advantage

network

• An office near you or our customer service

telephone numbers

• Your health plan’s medical benefit information

• Information specifically for ASE/PSE employees

• Pharmacy benefit information

• Health insurance options if you are an employer

• Health and wellness information and discounts

• And much more!

If you are a Health Advantage member, visit your

new and improved Web site today! It was designed to

help you find the information you need from your health

insurance plan … healthadvantage-hmo.com. It’s good

for you.

Please use the “Contact Us” link to let us know

what you think about the new Web site. We love to

hear from you.

Updated, fresh look for Health Advantage Web site


8


8


Joyce Elrod has quite a view of the University

of Arkansas for Medical Sciences campus as she exercises on the

treadmill at the Donald W. Reynolds Institute

on Aging.

SilverSneakers becomes a

silver lining

9


while allowing them to sit in a

chair so they don’t lose bal-

ance. It was just what Joyce

needed to help repair a torn

rotator cuff in her shoulder.

It didn’t take long before

Joyce became a regular at the

Reynolds Institute on Aging,

exercising about four times a

week. She tried the cardio cir-

cuit class for more activity and

has branched off to enjoy other

classes, including an exercise

dance class! Her New Year’s

resolution is to take more ad-

vantage of the pool at UAMS,

which offers SilverSplash®, a

SilverSneakers water class.

SilverSneakers classes have helped Joyce tremen-

dously; she has lost about 16 pounds and her doctor

has lowered her blood pressure medicine. But the ben-

efits don’t stop there. She has been able to use exer-

cise to get off medication for anxiety and depression.

Joyce has gone from being a wallflower to being a

leader; at 70 years old, she is chairman of outreach at

Mount Pleasant United Methodist Church in Little Rock,

a volunteer in the UAMS gift shop and recently agreed

to help teach a class at the Institute on Aging on self-

management of chronic diseases.

“SilverSneakers helped me to get back to living

my life,” Joyce said. “It keeps seniors healthy; not in

hospitals.”

For more infor-

mation on Silver-

Sneakers, call

1-888-423-4632 or

visit silversneak-

ers.com.

If you had met Joyce Elrod

in 2008 and then again in 2011,

you might think she was a dif-

ferent person, and in a way she

is, thanks to the SilverSneak-

ers® Fitness Program.

The day after Thanksgiving

in 2008, Joyce’s husband of

47 years, Lowell, passed away.

She had been his caregiver for

years and had also cared for her

mother before her passing. As

with many caregivers, Joyce put

her needs on hold to take care

of her loved ones.

With the dawning of 2009,

Joyce found herself overweight,

depressed and on several medications. She had re-

ceived information about SilverSneakers through the

mail and in Blue & You magazine but never had the

time and motivation to check it out. Then a friend at a

church luncheon talked to her about the program at the

University of Arkansas for Medical Sciences’ (UAMS)

Donald W. Reynolds Institute on Aging. Her daughter

already had been encouraging her to go, and she said it

seemed like a sign that she should give it a try.

SilverSneakers is the nation’s leading exercise pro-

gram designed exclusively for older adults, offering an

innovative blend of physical activity, healthy lifestyles

and socially oriented programming. SilverSneakers is

available to Arkansas Blue Cross and Blue Shield Medi-

Pak and Medi-Pak Advantage (PFFS) members at no ad-

ditional cost at wellness centers, YMCAs and Curves®

locations in all 50 states, Puerto Rico and Washington.

“I started exercising just on my own, with the ma-

chines, but after a while I decided it would be fun to try

one of the SilverSneakers classes,” Joyce remembered.

First she tried the Muscular Strength and Range of

Movement class, which gives participants a work out

SilverSneakers is a registered

mark of Healthways, Inc. The

SilverSneakers Fitness Program

is provided by Healthways, Inc.,

an independent company that

operates separately from Arkan-

sas Blue Cross and Blue Shield.

10


The widespread and devastating impact of

diabetes.Type 2, or adult onset diabetes, is a complex dis-

ease. Virtually every American has a genetic predispo-

sition to the disease that often only manifests in indi-

viduals who are overweight, sedentary and have much

more fat than muscle. In the past two decades, this

exploding epidemic of obesity has reached such propor-

tions that for the first time it is occurring in young chil-

dren and teenagers. In the next 10 years, the Centers

for Disease Control and Prevention estimates that more

than 100 million Americans will either have diabetes or

prediabetes. The differences in these two conditions

are a matter of degree. Prediabetes is diagnosed if the

fasting blood glucose is above 100 but below 125. If the

value is above 125, the diagnosis is diabetes.

This disease is important because of its devastating

impact. In overweight individuals, diabetes occurs be-

cause the body loses the ability of the hormone insulin

to pump glucose (sugar) into the cells. This condition,

called insulin resistance, causes the blood glucose to

rise and diabetes to develop. Sadly, the elevation of glu-

cose causes widespread changes in the body that can

impair a person’s quality of life and longevity.

Effects of elevated blood glucoseBy itself, elevated blood glucose leads to dehydra-

tion. Excess glucose spills into the urine taking gallons

of fluid with it. As dehydration develops, confusion sets

in and eventually the patient may become comatose.

The diagnosis is made in the hospital, and with appro-

priate treatment blood glucose can return to normal. In-

terestingly, in the earliest phases of diabetes a dramatic

drop in blood sugar can follow very high blood glucose

levels after a meal. Anyone who says that they have low

blood glucose may in fact have diabetes.

Effects on body lipids Most diabetics have elevated cholesterol, with

increases in the level of bad or LDL cholesterol and

reductions in the good or HDL cholesterol. Diabetes

also causes very high triglyceride levels, as unused

Lifelong Healthwith Dr. David

David A. Lipschitz, M.D., Ph.D.

11


glucose is converted to fat in the liver. These changes

lead to widespread vascular disease affecting the heart,

brain, abdomen and lower limbs. Not only are heart

attacks and strokes more common, but their severity is

increased as well.

Effect of diabetes on tiny arteries in the body

For reasons that are poorly understood, the tiniest ar-

teries become totally blocked in patients with diabetes.

Called diabetic microangiopathy, this change virtually

affects every organ in the body. Here are some of the

most critical:

• Eyes — Blockage of tiny vessels

in the eye leads to a condition

called diabetic retinopathy. The

retina is that part of the eye

that sees and interprets

light. As blockage occurs,

blood supply to the retina

becomes impaired. To

overcome this, the body

produces new tiny and fragile

blood vessels. This overgrowth

can lead to retinal detachments

and bleeding, two major causes of

blindness in adults.

• Lower Limbs — Here impaired supply to nerves

causes a condition called peripheral neuropathy. This

causes severe pain, burning and tingling that can be

most distressing. Weakness impairs gait and balance

and loss of sensation means that a patient will not

recognize an injury. Even worse because of compro-

mise in these small vessels, the ability of any injury

to heal is compromised leading to progressive and

devastating foot and leg problems.

• Kidneys — Small vessel disease leads to progres-

sive loss of kidney tissue eventually causing them to

fail and require dialysis. Today, adult onset diabetes

is the most common cause of chronic renal failure.

Kidney damage also causes high blood pressure

increasing the risk of heart attack and stroke.

What should be doneFirst and foremost, we as a nation must recognize

the serious nature of the obesity and seden-

tary lifestyle epidemic. Through new

mandates, Medi-Pak and Medi-Pak

Advantage plans and most other

plans offered by Arkansas Blue

Cross and Blue Shield are

focusing on promoting health

and screening for disease.

Counseling on nutrition and

exercise must be a critical com-

ponent of patient care. There

must be a strong emphasis assur-

ing that overweight individuals learn

how to become fit and healthy through

a prudent diet and exercise. Just as important is

screening tests to diagnose either prediabetes or diabe-

tes. Appropriate lifestyle and medication treatment can

guarantee a lower rate of complications and a longer

and better life.

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.

First and

foremost, we as a nation

must recognize the

serious nature of the

obesity and sedentary

lifestyle epidemic.

12


The Healthy Weigh! Education

Program is free for members of

Arkansas Blue Cross and Blue Shield,

Health Advantage (except ARHealth

members*), Blue Cross and Blue

Shield Service Benefit Plan (Federal

Employee Program), Medi-Pak Advan-

tage (PFFS), Medi-Pak Advantage •

St. Vincent PPO 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 pro-

gram 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.

* Arkansas state and public school employees and retirees can access the “Nourish” program through LifeSynch.

Simply complete, sign and return the attached enrollment form in the self-addressed, postage-paid envelope to join The Healthy Weigh!

Lose weight

The Healthy Weigh!


According to a recent study in the Journal of Pediatrics, three-

quarters of children ages 5 to 12 consume caffeine. The study found

that children ages 5 to 7 consumed around 52 milligrams of caffeine

per day, and children 8 to 12 consumed approximately 109 milligrams,

which is equivalent to 36 ounces of soda.

But what does this mean? The study suggests that this caffeine

consumption is keeping kids up at night. Lack of sleep can affect school

performance and also is associated with obesity. Moreover, the con-

sumption of excess soda amounts also is linked to obesity as well as

high blood pressure.

Source: WebMD

Kids and

caffeine overload

12

13


It is estimated that between 2000 and 2006, 50,000

hospitalizations were prevented thanks to the chicken-

pox (varicella) vaccine says a recent study published in

the February 2011 issue of Pediatrics. This equates to a

71 percent reduction in hospitalization due to varicella.

This is a timeframe known as the one-dose chicken-

pox vaccination era. Today, the CDC recommends two

doses of the vaccine. Thus, further declines in hospital-

ization are predicted.

Source: WebMD

Breast cancer risk increases among women who

start hormone therapy around menopause, according to

findings from a recent study that appeared in the Journal of

the National Cancer Institute.

In a follow-up to a 2003 report, researchers in the “Million

Women Study” examined outcomes in some 1.1 million postmeno-

pausal women.

The findings include the following:

• Both current and past users were at significantly higher cancer risk than

those who had never used hormone therapy, and risk increased

with duration of use.

• The risk was greater among current users if therapy

started before or soon after menopause, compared

with starting later.

• The greatest risk was among current users of

estrogen-progestin formulations.

• Risk declined rapidly after stopping use, falling to

that of non-users within three years.

Is there a link between breast cancer risk and when women begin hormone therapy?

Chickenpox vaccine cuts hospitalizations

14


Parents who have children with asthma often have

an ongoing battle. You hear that dreaded wheeze, but

your child hates the inhaler, and you wonder if the

medication is even getting into his or her lungs.

Good news! Even if your child refuses to take more

than a few breaths from their inhaler through a spacer

(a chamber that the child breathes through), they still

are probably getting enough aerosolized medication.

A recent study in Australia found that children ages 2

to 7 inhaled as much aerosolized medication through

a spacer with two or three regular breaths as they did

with more inhalations.

Instructions from the medication’s manufacturers

have recommended that children inhale from five to

“several” times, using normal breathing — or in some

situations taking one big breath — when receiving a

dose of medication from a pressurized metered dose

inhaler (MDI) attached to a spacer. But parents know

this can be a difficult task. The Australian investigators

set out to determine how much medication the children

were getting in each breath.

To do the study, investigators created a device to sim-

ulate the breathing patterns of 118 children with asthma

as if they were actually taking their inhaled medication.

The device then recorded the amount of medication be-

ing delivered. The device simulated the children taking

medication both with normal breathing and with one

big breath. The device also was used to determine if

there was a difference in medication delivery when us-

ing smaller spacers and larger spacers.

What the investigators found was that the children

received an adequate amount of medication in their

lungs using normal breathing. The big breaths in some

cases actually lowered the amount of medication de-

livered. They also determined that a maximum amount

of medication is received through two normal breaths

for small-volume spacers and three normal breaths for

large-volume spacers.

For frustrated moms and dads, this means less time

battling over taking medications and more confidence

that the medication that your child does get is actually

enough to do some good.

Source: The medical journal Pediatrics

Kids with asthma: The

battle to

breathe14


15


The Institute of Medicine (IOM) recently updated

its recommendations for the amount of vitamin D and

calcium Americans should be taking, and noted that,

with a few exceptions, all Americans are receiving

enough calcium and vitamin D. The IOM also pointed

out that taking higher levels have not been shown to of-

fer greater benefits, and in fact, they have been linked

to other health problems, challenging the concept that

“more is better.”

The report’s recommendations take into account

nearly 1,000 published studies as well as testimony

from scientists and others. Evidence confirms the

roles of calcium and vitamin D in promoting skeletal

growth and maintenance and the amounts needed

to avoid poor bone health. The IOM’s calcium

recommendations, based on age, range from 700 to

1300 milligrams (mg) daily.

The science on calcium’s role in bone health shows

that 700 milligrams per day meets the needs of almost

all children ages 1 through 3, and 1,000 milligrams daily

is appropriate for almost all children ages 4 through 8.

Adolescents ages 9 through 18 require no more than

1,300 milligrams per day. For practically all adults ages

19 through 50 and for men until age 71, 1,000 mil-

ligrams covers daily calcium needs. Women starting

at age 51 and both men and women age 71 and older

need no more than 1,200

milligrams per day.

As for vitamin D, 600 international units (IUs) daily

meets the needs of almost everyone in the United

States, although people 71 and older may require as

much as 800 IUs per day because of potential physical

and behavioral changes related to aging.

The majority of Americans are getting enough vitamin

D and calcium, however, some adolescent girls may not

get quite enough calcium, and there is a greater chance

that elderly individuals may fall short of the neces-

sary amounts of calcium and

vitamin D. These individuals

should increase their intake

of foods containing these

nutrients and possibly take

a supplement.

Source: Institute of

Medicine

Updated Vitamin D and Calcium Recommendations …

You are probably getting enough!

16


Here’s the rub … vapor rub.

From the Pharmacist

A recent clinical trial article in

the journal Pediatrics presented

some information that might be use-

ful for those of us who have children

or know someone who has children.

What I liked most about it was that

the data showed it was beneficial for

the child and the parent.

The article describes a clinical trial

with children ages 2 to 11 who were

suffering at night from cough, con-

gestion and runny nose. The children

were placed into one of three groups

— overnight treatment with topi-

cal vapor rub, overnight treatment

with topical plain petroleum jelly, or

no treatment at all. Thirty minutes

before the children went to bed, the

rubs (vapor rub and petroleum jelly)

were applied by the parents to the

upper chest and neck area of the chil-

dren and massaged in for one min-

ute. The next morning, the parents

were asked to describe the effects

of the treatments on the children’s

symptoms (cough, stuffy nose and

runny nose) and on the child’s and

the parent’s ability to sleep.

The results indicated that vapor

rub showed the great-

est improvement on all

of the symptoms except

runny nose. The article

then states that the most

profound results were for

the outcomes related to

child and parent sleep. As rated

by parents, children with the vapor

rub slept better than the children

receiving topical petroleum jelly or

no treatment. Similarly, the parents

of children treated with topical vapor

rub said they slept much better.

When the symptoms and ability to

sleep were combined for analysis,

vapor rub was proven superior.

Any good clinical trial also looks

at safety and adverse effects. In this

case, nearly half of the children who

received the vapor rub treatment

experienced some sort of expected

mild burning sensation, but the

article says the burning sensation

was short lived and didn’t appear to

impact the results.

This trial also limited the patients

to children 2 years old or older.

If you’ll take the time to read

the back label of the vapor rub

products — and you should

always read the label of any

over-the-counter product —

you will see that vapor rub

only is approved for treatment

of children who are at least 2 years

old. The label also warns about the

danger of eating vapor rub, and as

with any medication, you should be

sure to keep this out of the reach of

children.

So, vapor rub, when used safely,

applied appropriately and applied to

the appropriately aged patient, helps

relieve cough and cold symptoms

leading to a better night’s sleep for

both the child and the parent. To me,

that is good news.

Just remember, if you choose to

use vapor rub on your child, always

read the label and follow the direc-

tions as they are listed.

by Brandon Griffin, Pharm D.,Arkansas Blue Cross and Blue Shield

Source: Pediatrics, December 2010

17


by Ray Bredfeldt, M.D.,Regional Medical DirectorNorthwest Region, Fayetteville

TheDoctor’s Corner

Tell your dentist if you take a medication for bone loss

Medications known as “bispho-

sphonates” are commonly used to

treat bone loss due to osteoporosis

(the thinning of bone tissue and loss

of bone density over time). These

drugs are heavily advertised and the

names may sound familiar: Boniva

(think the Sally Field “endorsement”

commercial), Fosomax, Reclast and

Actonel. These drugs have been

shown to cause a rare but potential-

ly very serious and painful condition

known as osteonecrosis of the jaw.

Although this condition is rare, it is

more likely to happen to someone

taking these medications if they

have dental work such as a tooth

extraction. Women who take these

medications need to inform their

dentist before any dental procedure

is performed. In a recent study, 80

percent of women taking these

drugs were not aware they should

let their dentist know they take

these medications.

Poor oral hygiene means a greater risk of heart disease

Previous research has shown that

inflammation of the gums (gingivitis)

is associated with heart disease.

It’s been theorized that chronic

inflammation (swelling) from dental

disease causes a reaction by the

body, which has negative effects

on the arteries of the heart. Recent

evidence indicates that people who

brush their teeth less than two

times per day are as much as 70

percent more likely to develop heart

disease. It appears that people who

brush twice a day and floss daily

significantly reduce their risk of

heart disease.

Hearing loss increasing sharply in adolescents

If you have a teenager (or can

remember being a teen), you know

they like their music loud. How-

ever, you may want to encourage

your teen to turn the music down.

Research shows that repeated

exposure to loud music will cause

permanent hearing loss. A new

study has found that 19 percent of

young people between the ages

of 12 and 19 suffer from significant

hearing loss. One good rule of

thumb is that if someone else in

the room can hear the music when

earphones or headphones are being

used, the volume is probably too

high. Encourage the teen in your life

to keep the volume of their favorite

music artists down to a normal level

to protect their hearing (so they

can keep listening for many years

to come).

18


Foundation grant helps save children’s livesN atasha Crosby had a concern.

She was the only person in her

organization certified in first aid and

Cardio Pulmonary Resuscitation

(CPR). The facility where she works,

the Helen R. Walton Children’s

Enrichment Center in Bentonville, is

rather large, serving 240 children.

If a child needed help on one end

of the facility while she was on

the other end, it could be too late.

Others needed to be trained, too.

That got her thinking.

“If we have this problem then

I know other daycare centers do,

too,” Natasha said. “The question

was ‘how can we serve the

greatest number of children in

our area?’”

They decided to write a

grant application to the Blue &

You Foundation for a Healthier

Arkansas to fund a program

that would teach early childhood

professionals first aid and CPR —

and not just to their own employees

but to early childhood professionals

in childcare centers all across

Arkansas.

“We decided to apply for a grant

because, in our field, it is so vitally

important to save children’s lives,”

said Natasha. “Especially with the

age groups that we serve.”

Early childhood centers usually

care for children from as young as

six weeks old to five years old.

“This is typically the time when

they start to eat solid foods and

when they start to feed themselves,”

Natasha said. “This makes choking

a real possibility. These little lives

are in our hands. That’s why it’s so

important we have training in

this area.”

The Blue & You Foundation

agreed and awarded grants to fund

a training program for 2009 and

again in 2010. In that time, 869 early

childhood professionals in Arkansas

were trained in first aid and certified

in CPR. And, just as soon as the

training began, it paid off.

“The employees of a childcare

center in Bentonville attended the

training on a Saturday,” said Natasha.

“The following Monday a child

started choking in their center and

one of the employees, who had

been certified, was able to save that

child’s life.”

Andrea Pearson was that

employee.

“If I had not taken this class, I

might have panicked,” she said.

“But because I did, I was able to

save someone.”

Natasha pointed out that

Andrea’s experience was not the

only one. “There have definitely

been more,” she said.

Probably the most dire

situation, according to Michelle

Stephens, the executive director

of the Helen R. Walton Children’s

Enrichment Center, occurred

when a toddler in Siloam Springs

accidentally hanged herself on a

piece of classroom equipment.

“When the teacher reached her,

the toddler had turned blue and

was not breathing. The teacher,

who had recently gone through

training, began CPR and continued

rescue breathing until EMS

arrived,” Stephens said. “The EMS

technician said if it had not been

for the teacher, the child may have

18


Employees learning cardio pulmonary

resuscitation (CPR).

19


Foundation grant helps save children’s livesdied. Everything we invested in this

program in the past two years paid

for itself tenfold in just that one

child. The first aid and CPR funding

from the Blue & You Foundation

saved a child’s life. There’s no doubt

in my mind.”

And the benefits have gone well

beyond the classroom.

“Some who have received the

training have come back and said,

‘I haven’t had to use it in our center

yet, thank God,’ but they’ve had

to use it in their home,” Natasha

said. “One woman saved her

husband from choking. So it’s not

only benefitted our centers but our

communities as well.”

Even if the training is never used,

it provides a peace of mind.

“Having all of my employees CPR-

trained gives me a better peace of

mind,” said Tonie Scaife, director of

Cotton Candie Childcare, Inc. in Fort

Smith. “We are a 24-hour facility,

and this allows parents to be more

comfortable with leaving their prized

possessions, their children, in the

care of my staff. It allows me to rest

easier knowing that if something

did happen — God forbid — I

have a competent, trained, CPR-

certified staff in place to handle any

emergency situation.”

“Funding this program has been

like dropping a pebble in a pond,

creating ripples that have extended

outward across Arkansas,” said

Patrick O’Sullivan, executive director

of the Blue & You Foundation.

“By training more than 800 child-

care workers from more than 50

communities in Arkansas, we have

helped ensure the health and safety

of approximately 20,000 children.”

Based on the success of this

program, the Walton Children’s

Enrichment Center applied for

and received a new grant for

2011. According to Stephens, their

2011 work will train 1,000 early

childhood professionals in northwest

Arkansas in child and playground

safety, provide playground safety

improvements for child-care centers,

and administer tuberculosis clinics

and testing.

Beyond that, the relationship the

center has established with the Blue

& You Foundation is paving the way

for additional funding.

“It has helped us become a stable

influence in our community,” said

Stephens. “Instead of just being a

start-up organization, we now have

two years of data to fall back on.

In fact, in another grant application

we received a letter asking for

the history of our organization

because they did not fund start-up

organizations. Blue & You Foundation

funding has given credibility to our

program and opened up a new

funding source we were never able

to tap into before.”

In its nine years of operation, the

Blue & You Foundation has awarded

nearly $12 million to 185 health

improvement programs in Arkansas.

Arkansas Blue Cross and Blue

Shield established the Foundation

in 2001 to promote better health in

Arkansas. The Foundation awards

grants annually to non-profit or

governmental organizations and

programs that positively affect the

health of Arkansans.

The application deadline for the

Foundation’s next funding cycle is

July 15, 2011. For more information

about the grant application process,

visit the foundation Web site at

blueandyoufoundationarkansas.org.

19


“The first aid and CPR funding from

the Blue & You Foundation saved a

child’s life. There’s no doubt in my mind.” — Michelle Stephens,

the executive director of the Helen R. Walton Children’s Enrichment Center

CPR, first-aid training program funded

20


good for you starts with …

At Arkansas Blue Cross and Blue Shield, w e recognize that every one of us is in

Customer Service, and we have a saying — “good for you starts with me.” For many

of our employees, serving others doesn’t e nd with the workday or the workplace.

20


Christmas is long since over,

but the generosity shared by one

division at Arkansas Blue Cross and

Blue Shield continues in the lives

of two families — people they have

never met.

For three years, the Pharmacy

Division has adopted families

to help during the holidays. The

tradition began with Stephanie

Carpenter, pharmacy analyst, who

credits her mother with making it a

part of her Christmas as a child.

“My mom always did this when

we were younger,” she said,

explaining that for her it was a

part of the celebration. The first

family the Pharmacy team helped

was someone they knew who

needed help, but the last two years

they picked families through Big

Brothers Big Sisters of Central

Arkansas. This year, they decided to

expand their generosity by helping

two families with a total of four

children.

“So many families are

struggling, but their kids

shouldn’t go without at Christmas

time,” said Sherrill Montgomery,

rebate administrator. Karen Bragg,

prior authorization coordinator,

said the experience puts her life in

perspective. “We are so blessed,

and if we can put a smile on

the face of a child — that’s the

whole point.”

Toward the end of November,

after the families have been picked,

the 15 team members start their

shopping. They receive a detailed

list that includes each child’s age

and size, and “pretty much they get

everything on their list,” said Sherrill.

If they have information on the

parents, they give them gift cards

and household items.

“When you’re out shopping for

them, you think about what they

are like,” said Stephanie. She said

her daughter Jasmine, 12, goes

shopping with her for the children

and helps pick the gifts. Sherrill

agreed, adding that one girl this

year “loves to read and wants to

be a lawyer.”

Pharmacy

21


good for you starts with …

At Arkansas Blue Cross and Blue Shield, w e recognize that every one of us is in

Customer Service, and we have a saying — “good for you starts with me.” For many

of our employees, serving others doesn’t e nd with the workday or the workplace.


After the gifts are selected, the

Pharmacy team members have a

potluck and wrapping party. The

time together is important because

the team’s jobs are very diverse,

but during the holidays they are all

working toward one goal. “And, I’ve

actually learned how to wrap gifts!”

said Sherrill.

While the Pharmacy team

members don’t actually get to

meet the families they help, they

are committed to continuing their

tradition of generosity.

“We love being Santa,”

Sherrill said.

Employees of the Arkansas Blue Cross Pharmacy Division prepare to ship Christmas gifts to a family in need. For the third consecutive year, Pharmacy employees brought in gifts, wrapped them and sent them to needy families.

22


Operation Woolly MittensIt was cold this winter, but Arkansas Blue Cross and

Blue Shield’s Operation Woolly Mittens warmed many

Arkansans in need.

More than 1,400 warm gloves, coats, scarves and

other winter-weather items were collected during

Operation Woolly Mittens, which was held in December

at the ARVEST River Market on Ice (a temporary, public

ice skating rink) in downtown Little Rock. The donated

items were distributed through five Central Arkansas

charities: Little Rock Compassion Center, Women and

Children First, Our House, Dorcas House/Union Rescue

Mission and the Salvation Army (Benton, Hot Springs,

Jacksonville, Little Rock, North Little Rock and Pine Bluff

shelters).

“We are so pleased with the success of Operation

Woolly Mittens and would like to thank all of the people

who donated to help those in need this winter,” said

Mark White, president and chief executive officer of

Arkansas Blue Cross. “The outpouring of donations was

heart warming and all of the items collected certainly

helped keep men, women and children in Central

Access, continued from Page 3physicians in the state. Arkansas Blue Cross contribut-

ed $1 million to the University of Arkansas for Medical

Sciences (UAMS) Foundation Fund to provide scholar-

ships to students in the College of Medicine who are

planning to practice in Arkansas, with an emphasis on

those who indicate a desire to practice in rural areas.

Many medical students find it difficult to get through

medical school without staggering student loan bal-

ances. Primary care physicians, in particular, find it hard

to justify that investment with what they can expect

to earn once out of medical school compared to other

medical specialties. By helping to defray the cost of

medical school, we can encourage more medical stu-

Skaters enjoy time on the ice “purchased” with donations of “woolly” items to Operation Woolly Mittens.

dents to choose primary care as their specialty and help

to refill the pipeline of primary care students graduating

from Arkansas’ medical school. The gift to UAMS for

primary care scholarships is a good start and we hope

others will contribute to it eventually.

These initiatives are coming not a moment too soon.

In 2014, many Arkansans who will receive additional

help through health insurance reform live in the same

rural communities already struggling to provide health

care services. It is vital that we do everything we can to

support the medical professionals already serving these

communities and provide incentives to recruit more

physicians to rural Arkansas.


23


Arkansas a little warmer during the winter months.”

For each winter accessory donated, individuals

received a voucher to redeem at the ice skating rink for

one hour of skating.

BlueAnn Ewe attends health fair in Fort Smith

BlueAnn was a star at the Central Mall health fair

held in Fort Smith on Jan. 29, 2011. The West Central

Regional Office staff made popcorn, and handed out

heart-health literature to more than 250 adults that at-

tended the health fair. They also handed out BlueAnn’s

“Wild and Woolly Health Tips for Kids” coloring books.

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


BlueAdvantage members 378-3600 1-888-872-2531


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? Call or visit one of our regional offices:

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

Visit our Web sites for more information: arkansasbluecross.com

healthadvantage-hmo.comblueadvantagearkansas.com

blueandyoufoundationarkansas.org

BlueAnn Ewe greets health fair visitors in Fort Smith’s Central Mall.

With change comes opportunity. And health insur-

ance reform brings numerous changes. For this reason

— we are excited. We are looking for ways to help Ar-

kansans live healthier lives, have better access to care

and have more resources to make smart health care

decisions. We believe the future of health care will be

one where the best of technology, medical research,

health insurance and compassionate care join together,

and where hometowns can be healthy places to live.

At Arkansas Blue Cross, we are striving to be good for

you, and good for Arkansas.

BlueAnn Ewe greets health fair visitors in Fort Smith’s Central Mall.

24


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.

Blue & You Fitness Challenge rebootsThe 2011 Blue & You Fitness Challenge is under way!

If you are one of the thousands participating in

the 2011 Blue & You Fitness Challenge, you should

be well on your way to exercising (virtually) across

the United States. More than 260 groups with an

eligible population of 75,100 registered for the Chal-

lenge this year.

The Blue & You Fitness Challenge is an exercise

contest held March through May each year that

encourages participants to work toward the public

health recommendation of adult physical activity

30 minutes each day, most days of the week. Each

day that a participant completes a cardiovascular-

oriented exercise session, he/she logs the exercise

online to advance “virtually” one checkpoint on a

national map. The winning entity is determined by

whose group members score the highest in four

categories. Arkansas Blue Cross and Blue Shield,

the Arkansas Department of Health and the Depart-

ment of Human Services host the Challenge.

If you missed the Challenge this year, you can

go to arkansasbluecross.com, select “Members,”

go to the “Popular Links” section and select “Blue

& You Fitness Challenge.” Then encourage your

co-workers, friends or people in your community to

participate next year!

Arkansas Blue Cross Web site makeoverOur flagship Web site has gotten a facial! The home

page of arkansasbluecross.com now looks similar to

its younger sister site, healthadvantage-hmo.com.

Don’t be confused; the same great Arkansas Blue

Cross information is still just a click away and is

always good for you!

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