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Blue & You - Winter 2009

See what’s replacing the Explanation of Benefits, Page 4 Ruben Rodriguez of Greene County, Ark., is back to helping others after heart surgery. See his story on Page 10.

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<strong>Winter</strong> 09<br />

• See what’s replacing the Explanation of Benefits, Page 4<br />

• Keep your young adults covered, Page 6<br />

• Develop a relationship with your doctor, Page 18<br />

Ruben Rodriguez of Greene<br />

County, Ark., is back to<br />

helping others after heart<br />

surgery. See his story on<br />

Page 10.<br />

A publication for the policyholders of the Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield family of companies


Jason Green and Tona Schmidt<br />

discuss the Fit4Life program<br />

at the Baldor Electric Company<br />

headquarters in Fort Smith.<br />

on Page 30<br />

14 A SilverSneakers<br />

competition winner<br />

23 Medicare benefits for 2010<br />

24 Online Health Tools<br />

INSIDE<br />

3<br />

4<br />

6<br />

7<br />

8<br />

9<br />

10<br />

14<br />

16<br />

17<br />

18<br />

20<br />

22<br />

23<br />

24<br />

25<br />

26<br />

28<br />

30<br />

31<br />

32<br />

Out of the <strong>Blue</strong><br />

Personal Health Statement keeps members<br />

“up to date”<br />

Keeping your young adult covered<br />

Are you taking prescription antacids?<br />

Healthy lifestyle may reduce Alzheimer’s risk<br />

Let the sunshine in — for your health<br />

Treating gestational diabetes reduces health risks<br />

Heart attacks on the rise in women<br />

Healing a giving heart<br />

SilverSneakers competition winner logs<br />

more than 1,000 miles<br />

Behavioral health services now available<br />

Lose weight The Healthy Weigh!<br />

Babies born to obese women at greater risk<br />

Mammogram wellness benefits continue<br />

Costs Matter: Developing a relationship with<br />

your doctor<br />

Senior Moments with Dr. David<br />

From the Pharmacist —<br />

Paying for your medications<br />

Happy New Year to our Medi-Pak and<br />

Medi-Pak Advantage members<br />

Online Health Tools<br />

<strong>Blue</strong> & <strong>You</strong> Fitness Challenge registration under way<br />

The Doctor’s Corner<br />

Good for <strong>You</strong>r Community<br />

What is a hospitalist?<br />

Baldor — Building a lean machine<br />

Customer Service telephone numbers<br />

Good for you<br />

<strong>Winter</strong> 09<br />

is published four times a year by<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield for<br />

the company’s members, health-care<br />

professionals and other persons<br />

interested in health care and wellness.<br />

Editor: Kelly Whitehorn — BN<strong>You</strong>-Ed@arkbluecross.com<br />

Designer: Gio Bruno Photographer: Chip Bayer<br />

Contributors: Chip Bayer, Matthew Creasman, Damona Fisher, Kristy Fleming,<br />

Jennifer Gordon, Trey Hankins, Heather Iacobacci-Miller, Ryan Kravitz, Kathy<br />

Luzietti and Mark Morehead<br />

Vice President, Communications and Product Development: Karen Raley


Out of the<br />

<strong>Blue</strong><br />

A message from our<br />

CEO and President,<br />

Mark White<br />

Employees who care<br />

The beginning of a new year is a time in which many<br />

of us pause to reflect on the blessings we’ve enjoyed<br />

during the past year. As I stop to consider the things I<br />

am most grateful for, the men and women who work<br />

at Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield are always near<br />

the top of the list. I am grateful for their concern for<br />

you, our valued customers. I am grateful for the energy<br />

and dedication with which they approach their jobs here<br />

at Arkansas <strong>Blue</strong> Cross. But above all, I am grateful for<br />

the kinds of citizens they are; the kind of compassionate,<br />

engaged and accountable people that every community<br />

can use.<br />

With so many comments in the media today vilifying<br />

those of us who work in the insurance industry, I<br />

hope you will allow me a moment to tell you about the<br />

people that walk the halls of this insurance company<br />

every day. Although we have a few employees out of<br />

state, our employees are largely Arkansans. Many are<br />

your friends, your neighbors, your children’s coaches<br />

and your Sunday school teachers. Because they count<br />

themselves fortunate to have good jobs during these<br />

difficult times, they always are mindful of those whose<br />

paths have been more challenging.<br />

And they walk the talk. Collectively, they contribute<br />

thousands of volunteer hours to communities all across<br />

the state. And they open their pocketbooks to help the<br />

causes they believe in as well. In fact, just the contributions<br />

our employees made to nonprofit organizations<br />

through Arkansas <strong>Blue</strong> Cross totaled more than<br />

$100,000 in <strong>2009</strong>. That doesn’t count what they did on<br />

their own.<br />

Because of their generosity, tornado victims got a<br />

helping hand. Cures for diabetes and sickle cell anemia<br />

and cystic fibrosis are a little closer to reality. They<br />

donated to hospice organizations and humane societies<br />

and helped children with disabilities. Our employees<br />

provided money to feed the hungry and shelter the<br />

homeless. They were there for the victims of fires and<br />

accidents and poverty. They are people of value contributing<br />

to organizations of value. And I am grateful for<br />

them every day.<br />

At Arkansas <strong>Blue</strong> Cross, we know that being a good<br />

corporate citizen begins with employing productive<br />

and responsible citizens. I’m proud to work with such<br />

a community-minded group of men and women. And<br />

you’ll be glad to know they bring that same spirit of service<br />

to the workplace as they serve you, our members,<br />

every day.<br />

3<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


4<br />

A new view of your claims<br />

Personal Health Statement keeps members “up to date”<br />

At Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield, we want<br />

the conversations we have with our members to be<br />

helpful, clear and complete, whether we’re talking by<br />

telephone, on our Web sites or in writing.<br />

One of our most frequent member communications<br />

— the Explanation of Benefits (EOB) — is getting a new<br />

look and content, and, a new name.<br />

The EOB is the health-care benefit statement generated<br />

every time your doctor or hospital files a claim. The<br />

EOB notifies you that we received a claim and how we<br />

handled that claim. Beginning in March, many Arkansas<br />

<strong>Blue</strong> Cross members will begin receiving a Personal<br />

Health Statement (PHS) in place of their EOB.<br />

The PHS is more comprehensive than the EOB and<br />

designed to make claims processing easier to understand.<br />

The PHS also gives more information about<br />

health benefits.<br />

“Health insurance is a complex industry with lots of<br />

moving parts and a language all its own,” said Karen<br />

Raley, vice president of Communications and Product<br />

Development. “We want to simplify industry terms into<br />

everyday language, clearly explain claims, and help our<br />

members know exactly where they are with their outof-pocket<br />

costs (deductibles,<br />

copayments, coinsurance<br />

and more).”<br />

The new PHS is the result<br />

of feedback from member<br />

focus groups. “First and<br />

foremost, members told us<br />

they want to know ‘what do I<br />

owe?’” Raley said. “So we’ve<br />

put this information in red<br />

on the first page. We’ve also<br />

added a ‘Benefits at a Glance’ section, so members are<br />

reminded of their health benefits. Charts and graphs,<br />

hopefully, will make the information displayed easier to<br />

understand.”<br />

Members also asked for:<br />

• A better description of the discounts they receive<br />

on their health-care services.<br />

• Information on how to get in touch with us.<br />

• A quick understanding of how much they owe and<br />

to whom.<br />

• Help in understanding the benefits they have and<br />

how they work.<br />

A Benefit Summary section shows members their<br />

personal health benefits and tracks where they are in<br />

meeting deductibles and out-of-pocket maximums.<br />

Pharmacy information has been added, including<br />

generic medication recommendations. Another new<br />

feature on the PHS will be personal health messages<br />

and reminders to get health screenings.<br />

Members still have the option to confidentially view<br />

their PHS electronically. To sign up for a notification<br />

e-mail, members can go online and sign up through the<br />

My <strong>Blue</strong>print member self-service center. Then, when a<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


new PHS is generated, you will receive an e-mail.<br />

The new PHS will be issued two times a month<br />

instead of every time a claim is filed. If a member only<br />

has pharmacy claims during a month, the PHS will be<br />

issued quarterly.<br />

The PHS was piloted with three groups in Arkansas<br />

to get member reaction to the new format and content.<br />

“We love the new statements!” said Sharon<br />

Burdine, vice president and assistant director of Human<br />

Resources with Simmons First.<br />

“We think the “Our associates are finding<br />

new PHS will the new Personal Health<br />

Statement is easy to understand.<br />

The statement<br />

be a valuable tool for<br />

helping us to become shows several things<br />

better consumers that were not available<br />

of health care.” — before, such as prescriptions.<br />

The information<br />

shown is more<br />

Barb Gordon,<br />

Northwest Arkansas descriptive of what our<br />

Community benefits are, of services<br />

received, what the health<br />

College<br />

plan pays for and what the<br />

member’s portion is going to be. We’re seeing how the<br />

PHS also can serve as a backup for a flexible spending<br />

account (cafeteria plan) — all services are listed in case<br />

you lose a receipt or forget to include an expense to<br />

be filed.”<br />

“We think the new PHS will be a valuable tool for<br />

helping us become better consumers of health care,”<br />

said Barb Gordon, benefits specialist with Northwest<br />

Arkansas Community College in Fayetteville. “The PHS<br />

gives employees a great snapshot of where they are at<br />

a given time and is backed up with all the details they<br />

need to be informed about their benefits. For employees<br />

who have spouses with other insurance coverage,<br />

the PHS is a great tool for coordination of benefits<br />

— it’s easy to see what has been paid to whom and<br />

what is owed. The discounts on health-care<br />

services are easier to see, and, wow,<br />

what a difference in cost! I don’t think<br />

many employees realized the true cost<br />

of prescription drugs until the new format.<br />

Once you become familiar with the<br />

new format, it is more understandable<br />

overall.”<br />

Ann Freeman, vice president<br />

of Benefits with First<br />

National Bank and Trust of<br />

Mountain Home, said,<br />

“Our employees are<br />

finding the new Personal<br />

Health Statement<br />

easier to read. The<br />

language is better<br />

and doesn’t sound<br />

so ‘insurance-y’<br />

and the charts<br />

provide a good<br />

picture of where<br />

the employees<br />

are with their<br />

deductibles and<br />

out-of-pocket<br />

maximums.”<br />

The new PHS will be available<br />

to many Arkansas <strong>Blue</strong><br />

Cross members beginning in the<br />

spring of 2010 and later in the<br />

year for Health Advantage. “We<br />

love to hear from our members,” said<br />

Raley. “Feedback always is welcome<br />

on how the PHS can be improved.”<br />

5<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Keeping your young adult<br />

covered<br />

(one less thing to worry about!)<br />

6<br />

Parents with young adults know<br />

they can’t protect them at every<br />

turn, but now they can have peace<br />

of mind about their health-care<br />

coverage. Arkansas <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield and Health Advantage<br />

are changing the dependent coverage<br />

requirements under our fully<br />

insured group health plans to help<br />

more families continue covering their<br />

young adults.<br />

Beginning Jan. 1, 2010, Arkansas<br />

<strong>Blue</strong> Cross and Health Advantage<br />

will no longer require dependents 19<br />

and older to be in an accredited college<br />

or university in order to remain<br />

a dependent under their parents’<br />

group health plan. Dependents who<br />

are unmarried, whose parents provide<br />

the majority of their financial<br />

support and whose parents’ home<br />

is their primary residence can remain<br />

on their health-care plan until<br />

they reach the maximum dependent<br />

age on the policy. The maximum<br />

dependent age varies based on the<br />

plan selected by the employer. This<br />

change also applies to groups that<br />

have Arkansas <strong>Blue</strong> Cross dental<br />

coverage plans.<br />

Arkansas <strong>Blue</strong> Cross and Health<br />

Advantage will no longer request<br />

verification of a dependent’s status<br />

as a student and will no longer<br />

cancel coverage for those who do<br />

not meet the previous student status<br />

requirements. Dependents under<br />

the maximum dependent age who<br />

currently are not covered, (due to<br />

attending non-accredited education<br />

facilities, etc.) and who meet the<br />

criteria, now can be added to their<br />

parents’ coverage.<br />

If you wish to have a dependent<br />

covered, you may complete an<br />

employee application asking that the<br />

dependent be enrolled. Dependents<br />

not currently covered will not be<br />

subject to late enrollment rules, nor<br />

deferred to open enrollment, as long<br />

as the application is submitted by<br />

Feb. 28, 2010. Groups may submit<br />

applications anytime between now<br />

and February 28. The first effective<br />

date will be Jan. 1, 2010. Applications<br />

received in January will get<br />

February 1 effective dates, and<br />

those received in February will have<br />

March 1 effective dates.<br />

Dependents do not have to apply<br />

upon reaching the age of 19; as long<br />

as they remain dependents, coverage<br />

will continue until they reach<br />

the maximum dependent age. If you<br />

have questions, please don’t hesitate<br />

to contact us using the Customer<br />

Service number on your member<br />

ID card.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Are you<br />

taking<br />

prescription<br />

antacids?<br />

If you take the Proton Pump Inhibitors<br />

(PPI) Prevacid, Prilosec<br />

or Nexium, you should be aware<br />

that some upcoming changes in the<br />

PPI class of medications might save<br />

you money.<br />

PPIs are medications, often called<br />

antacids, that are taken for conditions<br />

such as heartburn or acid<br />

reflux. In the past, the Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield standard<br />

formulary (drug list) has covered<br />

Prevacid and Nexium on its highest<br />

cost level. However, there have<br />

been three significant changes in<br />

the PPI class of medications, and<br />

because of these changes, we<br />

are changing our drug list. The<br />

changes are:<br />

1. In November, Prevacid became<br />

available for purchase over the<br />

counter (OTC).<br />

2. Prescription-strength Omeprazole,<br />

a generic version of<br />

Prilosec, previously was not<br />

priced as a generic medication<br />

but now is priced as a generic.<br />

OTC versions (lower strength) of<br />

these medications are available.<br />

3. A new PPI — Kapidex — has<br />

proven to be effective anytime,<br />

even if taken during or following<br />

meals. All other PPIs have to be<br />

taken one hour ahead of meals.<br />

Whenever there are multiple<br />

changes in a class of medications,<br />

Arkansas <strong>Blue</strong> Cross reviews its<br />

drug list to ensure members are<br />

receiving the best therapy and value<br />

for their prescription drugs. The following<br />

changes have occurred:<br />

Prevacid was removed from the<br />

formulary when available OTC.<br />

Kapidex now is available on our<br />

highest cost level of the drug plan.<br />

Omeprazole, the generic for<br />

Prilosec, now is available on the<br />

lowest cost level of the drug plan for<br />

those members requiring prescription<br />

strength.<br />

Nexium has been removed from<br />

the drug plan altogether as it lacks<br />

the advantages of – and is priced<br />

30 percent higher (retail) – than<br />

Kapidex.<br />

Arkansas <strong>Blue</strong> Cross takes the<br />

importance of making safe, affordable<br />

prescription medications available<br />

to our members seriously. Our<br />

staff pharmacists seek advice from<br />

a Pharmacy and Therapeutics (P&T)<br />

Committee comprised of independent<br />

physicians and pharmacists<br />

(who practice in both retail and<br />

hospital environments) throughout<br />

Arkansas to ensure our formularies<br />

are complete and current. For a drug<br />

to be included in our formulary, the<br />

P&T Committee members consider<br />

(in order of importance) safety and<br />

efficacy, then uniqueness, then<br />

cost. After additional review, our<br />

P&T Committee reaffirmed that<br />

there is no clinical difference between<br />

any of the PPIs.<br />

7<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Healthy lifestyle may<br />

reduce Alzheimer’s risk<br />

Based on data from two separate studies, research concludes that<br />

people who follow diets resembling a Mediterranean diet, which is rich in<br />

fruits, vegetables, legumes and healthy fats, and who remain physically<br />

active had a 61-67 percent lower risk of Alzheimer’s disease. The research<br />

does conclude that one of these behaviors may not be enough, and it may<br />

be best to focus on both eating well and staying active.<br />

8<br />

Sources: WebMD and Medline Plus<br />

Let the sunshine in —<br />

for your health!<br />

More and more research is pointing to vitamin D deficiency<br />

as the culprit for a number of conditions, and the deficiency in premenopausal women may increase the<br />

The American Heart Association found that vitamin D<br />

quickest way to improve your levels is to step outside! risk of developing high blood pressure later in life. The<br />

The body produces vitamin D in response to sunlight. study showed that women who had vitamin D deficiency<br />

in 1993 had three times the risk of developing high<br />

It also occurs naturally in some foods (oily fish, egg<br />

yolks and beef liver) and in fortified dairy and grain products.<br />

Vitamin D is essential for strong bones because it Taking vitamin D also may reduce falls in older<br />

blood pressure 15 years later.<br />

helps the body use calcium. Extreme vitamin D deficiency<br />

causes rickets, an illness resulting in soft bones people older than 65 who took vitamin D supplements<br />

people by improving muscle strength. In clinical trials,<br />

and skeletal deformities. But subtle vitamin D deficiency<br />

is harder to trace and may affect more people, about a fifth within two to five months of starting treat-<br />

between 700 and 1000 IU per day reduced falls by<br />

across all ages, than once realized.<br />

ment.<br />

A recent Harvard Medical School study found that Low vitamin D blood levels also have been associated<br />

with the following:<br />

6.3 million children in the United States — almost one<br />

in five — have less than the recommended amount of • Increased risk of death from cardiovascular disease<br />

vitamin D in their systems. The amount of deficiency • Cognitive impairment in older adults<br />

was even higher in black and Hispanic children.<br />

• Severe asthma in children<br />

A study by Johns Hopkins School of Public Health • Cancer<br />

found that teens with low vitamin D levels were more • Diabetes<br />

likely to have high blood pressure and high blood sugar • Glucose intolerance<br />

and were at greater risk for diabetes and heart disease. • Multiple sclerosis<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Treating even mild gestational<br />

diabetes reduces health risks<br />

According to a National Institutes of Health network study, treating even mild gestational<br />

diabetes appears to have advantages for both infant and mother. It was found that<br />

women who received treatment were:<br />

• Half as likely to have a large baby at risk for health problems later in life.<br />

• Half as likely to deliver a baby with shoulder dystocia, an emergency condition in<br />

which the baby’s shoulder becomes stuck during delivery.<br />

• Less likely to deliver by Cesarean.<br />

• Less likely to develop high blood pressure.<br />

Source: National Institutes of Health<br />

Good news,<br />

bad news:<br />

Heart attacks on<br />

the rise in women<br />

9<br />

The bad news is that the heart attack<br />

gap between men and women<br />

is narrowing. A study of more than<br />

8,000 men and women aged 35 to<br />

54 shows that while men still have<br />

more heart attacks, heart attacks<br />

among women is on the rise.<br />

So what’s the good news? The<br />

good news is that while heart<br />

attacks in women are rising, the<br />

risk of death after a heart attack is<br />

improving more for women than for<br />

men under the age of 55.<br />

With heart attacks for women on<br />

the rise, it’s important for<br />

women to know the symptoms.<br />

While some may be similar to those<br />

for men, many, like chest pain, are<br />

not as common for women. So pay<br />

attention to your body and know the<br />

different symptoms:<br />

• Shortness of breath<br />

• Weakness<br />

• Unusual fatigue<br />

• Nausea<br />

• Dizziness<br />

• Lower chest discomfort<br />

• Upper abdominal pressure that<br />

may resemble indigestion<br />

• Back pain<br />

Source: WebMD<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Healing<br />

a giving heart<br />

10<br />

Ruben Rodriguez, 58, has a generous and giving<br />

heart. As an associate pastor at Stonewall Community<br />

Church outside the little community of Lafe in Greene<br />

County, Ark., he and his wife Martha help with the<br />

church’s outreach activities, take and teach classes<br />

through Integrity Bible College and share their faith<br />

through music and ministry. But on July 14, Ruben’s<br />

giving heart started giving out.<br />

It started as a pressure in Ruben’s chest while he<br />

was working at his day job at Emerson Electric Co. in<br />

Paragould, but eased off after he took one of the nitroglycerin<br />

tablets he’d been keeping with him since his<br />

first heart attack 12 years earlier. He’d already had three<br />

stents put in the arteries leading to his heart at two<br />

different times, but in the last decade he’d been feeling<br />

pretty good, so good he hadn’t bothered with the cholesterol<br />

medication he was supposed to be taking.<br />

That evening Ruben met Martha at the house and<br />

they discussed going into Paragould for pizza, but he<br />

confessed that he was having some discomfort in his<br />

chest. Ruben tried to reassure Martha that it didn’t hurt<br />

much and it was probably indigestion. The two headed<br />

for Paragould, but instead of getting pizza they went<br />

straight to the emergency room at Arkansas Methodist<br />

Medical Center. “We don’t fool with that,” was Martha’s<br />

steadfast response.<br />

Doctors quickly confirmed that Ruben was having<br />

pain associated with a lack of blood to his heart and<br />

sent the two to St. Bernards Medical Center in Jonesboro,<br />

about 25 miles away. Through an agreement<br />

between the two hospitals, heart patients at Arkansas<br />

Methodist Medical Center often are referred to St. Bernards<br />

for their excellent care. That high quality is one<br />

reason St. Bernards has been named a <strong>Blue</strong> Distinction<br />

Center of Excellence for Cardiac Care by the <strong>Blue</strong> Cross<br />

and <strong>Blue</strong> Shield Association.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


<strong>Blue</strong> Distinction Centers of Excellence must meet<br />

He added that Ruben was much like his father in that<br />

high quality standards established by an expert panel he was determined to get well and was willing to take<br />

of physicians, surgeons and other health-care professionals.<br />

When a hospital has been designated a <strong>Blue</strong> the opportunity to speak Spanish with Dr. Stevenson<br />

the steps needed to get there. And both men enjoyed<br />

Distinction Center, you know they have expertise in who is conversational in the language but always looking<br />

for opportunities to brush up his skills.<br />

that specialty, that they focus on quality and that they<br />

have a history of patients with positive outcomes. Dr. Stevenson said it also helped that Ruben was in<br />

Hospitals provide care differently, and <strong>Blue</strong> Cross has a cardiac program that has gone to great lengths to be<br />

created a process where hospitals can demonstrate comparable with some of the top cardiac programs in<br />

their expertise.<br />

the nation.<br />

If you are looking for a hospital with a <strong>Blue</strong> Distinction<br />

designation, go to our Web sites and visit our same environment and offer the same technology you<br />

“If you are in our hospital, we want to provide the<br />

“Member” section. We do the work for you, so you can would see at Mount Sinai in New York or Vanderbilt<br />

be assured you are receiving the best care possible. Medical Center in Nashville,” he said. “We strive to offer<br />

care commensurate with any top cardiac facility.”<br />

In the St. Bernards emergency room, Ruben was<br />

fussing more about his missed pizza than his heart Dr. Stevenson said that the excellent care at St. Bernards<br />

begins even before patients get to the operating<br />

pain, but the results from the tests brought some<br />

somber news; blockage in Ruben’s heart arteries had room. This care then continues through the operating<br />

caused a small heart attack. He needed a triple bypass. staff to the ICU staff and on to the progressive care<br />

Had the nitroglycerin tablet that afternoon helped? “It staff. In the progressive care unit the patient-to-nurse<br />

wasn’t any good,” he said laughing, thinking about that ratio is four to one. And before a patient leaves, each<br />

10-year-old pill. He later learned that nitroglycerin tablets<br />

are only good for about six months.<br />

recovery. “It’s a compendium of care across a continuone<br />

is referred to outpatient rehabilitation to continue<br />

Ruben requested<br />

Richard Stevenson, M.D.,<br />

medical director of the<br />

cardiovascular program<br />

at St. Bernards to do the<br />

surgery. For Dr. Stevenson,<br />

the request was an<br />

honor; he had performed<br />

a successful heart surgery<br />

on Ruben’s father, Eusebio<br />

“E.S.” Rodriguez, years<br />

earlier.<br />

“That is the highest<br />

compliment I could have<br />

Ruben and Martha Rodriguez sit in front of flags<br />

received,” Dr. Stevenson representing the countries helped by their church.<br />

said of Ruben’s request.<br />

11<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Richard Stevenson, M.D., (also in inset photo) performs surgery at<br />

St. Bernards Medical Center.<br />

12<br />

um of care,” he explained.<br />

Dr. Stevenson said the cardiac care physicians and<br />

hospital leaders have collaborated on training the nurses<br />

in cardiac care. “I’m extremely proud of our heart<br />

care nurses,” he said. “We told them, ‘We will train you<br />

to take care of any complication and manage it until a<br />

doctor can get there.’” The nurses are empowered to<br />

take actions they know will help their patients. “‘No<br />

Fear’ is our motto.”<br />

Dr. Stevenson has a special tie with St. Bernards —<br />

he was born there, back when many of the nurses were<br />

Catholic nuns. He left Jonesboro to pursue his medical<br />

career and ended up at Louisiana State University<br />

Medical Center in Shreveport, La., but found himself<br />

wanting to return to his family and his roots, and to<br />

provide care that could make a difference in Northeast<br />

Arkansas.<br />

The high level of care Dr. Stevenson described is<br />

exactly what qualifies St. Bernards as a <strong>Blue</strong> Distinction<br />

Center of Excellence. Each <strong>Blue</strong> Distinction Center<br />

for Cardiac Care must meet stringent clinical criteria<br />

recommended by expert physicians and medical organizations,<br />

including the American College of Cardiology<br />

and the Society of Thoracic Surgeons. <strong>Blue</strong> Distinction<br />

Centers for Cardiac Care provide a full range of cardiac<br />

care services, including inpatient cardiac care, cardiac<br />

rehabilitation, cardiac catheterization and cardiac surgery<br />

(including coronary artery bypass graft surgery),<br />

and each center is re-evaluated regularly.<br />

The cardiac program at St. Bernards seeks to be<br />

the tertiary care center for the area, only taking cases<br />

when needed. Dr. Stevenson said that when it comes<br />

to working with the other hospitals, the heart surgeons<br />

try to be available. Most of all, Dr. Stevenson said, he<br />

is grateful to St. Bernards for allowing the physicians<br />

to look beyond the scope of what an average hospital<br />

does to truly make it a center of excellence. That<br />

excellence is what brought Ruben Rodriguez to Dr. Ste-<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


He said he has learned not to ignore the warning signs his body may give<br />

him and to continue on his medications even when he is feeling well.<br />

venson in July, trusting in his skills, St. Bernards and, as<br />

always, God.<br />

Asked if he was concerned at all about the procedure,<br />

Ruben thought back to the moment the hugs<br />

and kisses from family ended and he was being rolled<br />

into the operating room. In that quiet moment, he said,<br />

he reached out to God and<br />

heard, “Fear not, for I am<br />

with you,” and he was at<br />

peace. At the same time,<br />

Martha said she had also put<br />

her faith in God. A gospel<br />

song, “I’ve Been Through<br />

Enough to Know that He’ll<br />

be Enough for Me,” ran<br />

through her mind as Ruben<br />

was wheeled away.<br />

Ruben’s surgery was successful,<br />

and within hours<br />

he was up and walking. He<br />

said the breathing treatments<br />

were painful, but he<br />

knew the more he did them<br />

the easier it would become.<br />

Within the week, Dr. Stevenson<br />

told him, “I take care<br />

of sick people, and you’re<br />

not sick.” Martha cared for<br />

him at home, grateful to be a teacher and be out for the<br />

summer. She and other family members drove Ruben<br />

to Paragould to meet with Dr. Stevenson for his follow<br />

up appointments and rehabilitation.<br />

While the Rodriguez family was very focused<br />

on Ruben’s health, they didn’t have to<br />

worry about his health-care coverage. Ruben’s<br />

insurance was through <strong>Blue</strong> Cross and <strong>Blue</strong><br />

Shield of Alabama, but through <strong>Blue</strong>Card ® , his medical<br />

care was coordinated between their office and Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield.<br />

<strong>Blue</strong>Card is a national program that enables members<br />

of one <strong>Blue</strong> Plan to obtain health-care services<br />

while traveling or living in another <strong>Blue</strong> Plan’s service<br />

area. The program links<br />

The Heartcare Center participating health-care<br />

at St. Bernards<br />

Medical Center is a providers with the independent<br />

<strong>Blue</strong> Plans worldwide<br />

<strong>Blue</strong> Distinction<br />

Center of<br />

Excellence. through a single electronic<br />

network for claims processing<br />

and reimbursement.<br />

The Alabama <strong>Blue</strong> Cross<br />

Plan took care of Ruben’s<br />

needs, and Arkansas <strong>Blue</strong><br />

Cross made sure the<br />

doctors, specialists and<br />

hospital received the quick<br />

service they needed.<br />

Ruben is back to work<br />

and sharing his faith with<br />

others. He said he has<br />

learned not to ignore the<br />

warning signs his body may<br />

give him and to continue on<br />

his medications even when<br />

he is feeling well. His giving<br />

heart has been given another chance.<br />

Go to <strong>Blue</strong> & <strong>You</strong> Online on our Arkansas<br />

<strong>Blue</strong> Cross and Health Advantage Web sites<br />

for more on our <strong>Blue</strong> Distinction Centers.<br />

13<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


SilverSneakers<br />

competition<br />

winner logs more<br />

than 1,000 miles<br />

14<br />

Dorothy Straub on<br />

the stationary bicycle<br />

and in the Rogers<br />

Adult Wellness Center<br />

garden.<br />

Go to <strong>Blue</strong> & <strong>You</strong> Online on our Arkansas<br />

<strong>Blue</strong> Cross and Health Advantage Web sites for<br />

more on SilverSneakers.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Dorothy Straub is a fierce competitor. As the oldest<br />

of six children and the mother of three boys, she<br />

quickly learned to dust herself off and keep going when<br />

faced with a challenge. So when the SilverSneakers ®<br />

100 Miles, 100 Days Challenge kicked off, she said, “I<br />

can do that,” and she did. When her grown sons shared<br />

their doubts that she could log more (1,000 miles in 100<br />

days), she didn’t quit until she had logged 1,145 miles<br />

— winning the statewide contest.<br />

For Dorothy, the contest wasn’t Dorothy<br />

just a race against her buddies retired and joined the<br />

at the Adult Wellness Center Adult Wellness Center,<br />

in Rogers, Ark., it was also a benefit provided to<br />

a way to get her out of the her through Medi-Pak<br />

house after losing her loving Advantage as part of the<br />

husband, Donald Straub, to SilverSneakers<br />

Alzheimer’s disease in April.<br />

Program.<br />

“It’s easy to sit and feel sorry for<br />

yourself, and I did that for awhile,” Dorothy<br />

remembered, but after a few weeks she said she<br />

started looking for things to do — about the same time<br />

flyers showed up at the Wellness Center advertising the<br />

contest. Dorothy decided, “why not,” and proceeded to<br />

log in five miles at a time, several times a day.<br />

After the first month, Dorothy already had logged 300<br />

miles, so she made it her goal to reach 1,000 miles,<br />

putting off a trip to Florida until after the contest, and<br />

working in extra sessions on the stationary bike or on<br />

the track if she had to miss a day.<br />

Lucky for Dorothy, the Adult Wellness Center in<br />

Rogers has state-of-the-art exercise equipment and<br />

a beautiful walking trail that wraps around a waterfall<br />

and fishpond and includes several exercise stations. As<br />

Dorothy got closer and closer to her goal, she realized<br />

that the walking and biking did wonders for her blood<br />

pressure. “It has gone down tremendously,” she said.<br />

Dorothy has used exercise to ease tension for years.<br />

After a whirlwind life, living in more than 10 states and<br />

raising their boys to appreciate the wonders of the<br />

world, Dorothy and Don settled on a 20-acre cattle farm<br />

in Summers, Ark., just miles from the Oklahoma border.<br />

Dorothy worked for the Fayetteville Prosecutor’s Office<br />

and helped Don on the farm, but in 2003 she had to<br />

take time off as Don’s memory became clouded from<br />

the Alzheimer’s. She measured out a small track on<br />

the farm so she could walk and keep an eye on Don.<br />

When Don’s disease progressed to the point where he<br />

needed more care than she could give him at home,<br />

Dorothy moved him to a nursing home and in<br />

2005 went back to work full time, but shifted<br />

her hours so she could leave in the afternoon<br />

to spend the rest of the day with Don, often<br />

walking with him in the park. “It was very<br />

good for him,” she said.<br />

In May 2008, Dorothy retired to spend more<br />

time with Don and joined the Adult Wellness<br />

Center, a benefit provided to her through Medi-Pak<br />

Advantage (PFFS) as part of the SilverSneakers Program.<br />

To enroll in SilverSneakers, Medi-Pak and Medi-<br />

Pak Advantage (PFFS) members can go to a participating<br />

fitness center near them and show their ID card. Fitness<br />

center staff will assist with enrollment and provide<br />

tours of the locations. Because new fitness centers are<br />

being added to the program regularly, members can<br />

go online to silversneakers.com to find all participating<br />

locations in Arkansas.<br />

Even though Don has passed away, Dorothy continues<br />

to visit the nursing home where he stayed because<br />

she has developed so many friendships there. She even<br />

has become a volunteer ombudsman for the home<br />

through the Arkansas Area Agencies on Aging. She still<br />

volunteers one day a week at the prosecutor’s office.<br />

And she still logs her miles on the track and the stationary<br />

bikes at the Adult Wellness Center. Because Dorothy<br />

Straub doesn’t give up.<br />

Healthways, Inc. administers the SilverSneakers Fitness Program for<br />

Arkansas <strong>Blue</strong> Cross Medi-Pak and Medi-Pak Advantage (PFFS) policyholders.<br />

Healthways, Inc. is an independent company that operates<br />

separately from Arkansas <strong>Blue</strong> Cross.<br />

15<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


16<br />

Behavioral health services<br />

now available<br />

Behavioral health referral and management services now are available<br />

to some employer group health plans with Arkansas <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield and Health Advantage, and a number of plans administered<br />

by <strong>Blue</strong>Advantage Administrators of Arkansas. If you receive a new<br />

ID card with a mental health assistance telephone number, your plan<br />

includes these services.<br />

A customer service staff trained to help with the special requirements<br />

of accessing behavioral health services is available from 7 a.m. to<br />

7 p.m., Monday through Friday, to assist in explaining benefits and available<br />

services, selecting a mental health provider and gaining access to<br />

needed services.<br />

For assistance, please call toll free 1-877-801-1159. (This telephone<br />

number will be on the back of your health plan ID card if this service is<br />

available to you.)<br />

Please be aware that you have some new responsibilities in order<br />

to make best use of your behavioral health benefits. These responsibilities<br />

are:<br />

• Calling 1-877-801-1159 (or ensuring that your mental health provider<br />

has made the call) for prior authorization of any outpatient mental<br />

health visits after the eighth session.<br />

• Calling the number above (or ensuring that the inpatient facility<br />

does so) prior to any inpatient mental health/substance abuse<br />

inpatient stay.<br />

• Check your benefits certificate for full details on any excluded mental<br />

health/substance abuse services.<br />

To find out if your health plan includes modifications for behavioral<br />

health, you can contact your human resources administrator, check our<br />

Web sites and review your benefits information on My <strong>Blue</strong>print, or call<br />

the customer service number on your health plan ID card. We love to<br />

hear from you!<br />

Lose<br />

weight<br />

The Healthy<br />

Weigh!<br />

The Healthy Weigh! Education<br />

Program is free for members of Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield,<br />

Health Advantage, <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield Service Benefit Plan<br />

(Federal Employee Program), and<br />

eligible members of <strong>Blue</strong>Advantage<br />

Administrators of Arkansas.<br />

To enroll, complete the attached<br />

enrollment form and return it in the<br />

self-addressed, postage-paid envelope<br />

included in this magazine. The<br />

program starts when you enroll.<br />

After enrollment, you will begin<br />

to receive information through the<br />

mail, which you can read in the<br />

privacy of your own home and at<br />

your own pace. The program is<br />

completely voluntary, and you may<br />

leave the program at any time. If<br />

you have further questions about<br />

the program, call the Health Education<br />

Program’s toll-free number at<br />

1-800-686-2609.<br />

Simply complete, sign and return<br />

the attached enrollment form in<br />

the self-addressed, postage-paid<br />

envelope.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Obese women at<br />

greater risks of<br />

giving birth to babies<br />

with heart defects<br />

Women who are overweight or obese<br />

before they become pregnant have approximately<br />

an 18 percent higher chance of having<br />

a baby with certain heart defects as compared<br />

to women who were not overweight while<br />

severely obese women have approximately a<br />

30 percent higher chance — this, according to<br />

a study by the Centers for Disease Control and<br />

Prevention.<br />

The study, which is the largest study ever<br />

conducted in the United States to identify risk<br />

factors for birth defects, found a significant<br />

increase in several types of heart defects in<br />

babies born to overweight or obese women.<br />

Members continue<br />

to receive screening<br />

mammograms as<br />

a wellness benefit<br />

Although the U.S. Preventive<br />

Services Task Force<br />

announced recently that<br />

routine mammograms are<br />

no longer recommended for<br />

women 40 to 49, Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

and its wholly owned subsidiary,<br />

Health Advantage, will<br />

continue to cover screening<br />

mammograms as a part of our wellness benefit.<br />

“We understand there is concern among our members<br />

about the new recommendations from the U.S. Preventive<br />

Services Task Force, but we want to assure our members<br />

that we will continue to cover annual screening mammograms<br />

for all Arkansas <strong>Blue</strong> Cross and Health Advantage<br />

female members age 40 and above who have our wellness<br />

benefit and who have the service performed by an in-network<br />

physician and facility,” said James Adamson, M.D., Arkansas<br />

<strong>Blue</strong> Cross senior vice president and chief medical officer.<br />

The U.S. Preventive Services Task Force recently reversed<br />

a 2002 recommendation by eliminating the recommendation<br />

for screening for women ages 40 to 49, and increasing the<br />

screening interval to every two years for women 50 to 74.<br />

The American Cancer Society and the American College of<br />

Radiology have expressed significant concerns over the new<br />

recommendations of the U.S. Preventive Services Task Force,<br />

and these two organizations continue to recommend screening<br />

mammography on an annual basis to all women beginning<br />

at age 40. Recommendations vary for those who are considered<br />

at higher risk.<br />

17<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Costs Matter:<br />

Developing a<br />

relationship<br />

with your<br />

doctor<br />

18<br />

<strong>You</strong> might not think about it in financial terms, but<br />

having a good relationship with your primary care physician<br />

(PCP) can save you money. How?<br />

Studies show that people who have a trusting relationship<br />

with their PCP, and regularly go for wellness screenings<br />

and checkups, are less likely to develop chronic<br />

illness later in life. Chronic illness can lead to missed<br />

work, paying for high-priced medications, trips to the<br />

emergency room, inpatient hospital costs and more.<br />

Even if you seldom get sick, it is good to have a relationship<br />

with your doctor. PCPs are trained to<br />

help you prevent health problems. They can point out<br />

choices you may be making today that can affect your<br />

health tomorrow.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Developing the relationship<br />

Communication is a two-way street, but sometimes<br />

it can be hard to start the conversation with your doctor.<br />

According to the Annals of Family Medicine, the<br />

average face-to-face time with a doctor during an appointment<br />

is about 15 minutes. That means you have to<br />

be prepared with your concerns and questions right off<br />

the bat. Writing information down ahead of time, and<br />

bringing a family member with you to write information<br />

down during the visit, can help keep the conversation<br />

on course.<br />

Getting started<br />

As soon as the appointment starts, be sure to tell<br />

your doctor the main reason for your visit, including any<br />

symptoms you are having, or have had recently. Don’t<br />

leave out symptoms that seem unrelated; they may be<br />

important. Keeping a health journal can give a day-today<br />

log of symptoms and be valuable in your diagnosis.<br />

Let your doctor know if your personal life has changed<br />

since you last came in. Did you change jobs? Are you<br />

stressed?<br />

Bring any medications, vitamins and supplements<br />

you may be taking with you, or make a list. Be sure you<br />

include the strength of the medication and how often it<br />

is taken. Let your doctor know of any side effects you<br />

have had from your past or present medications. If you<br />

have any medical records or test results from other<br />

locations, bring them with you.<br />

Ask questions<br />

Ask your doctor if you don’t understand something. If<br />

you don’t, your doctor will think you understand everything<br />

he or she has told you. The following are some<br />

tips on asking your doctor questions during the exam:<br />

• Write down questions before the appointment and<br />

ask them during the exam. Be sure to ask the most<br />

important questions first.<br />

• Bring a family member with you to take notes<br />

and have them write down the answers to<br />

your questions.<br />

• Let the doctor know if you don’t understand<br />

something.<br />

• Tell your doctor if you need more information or<br />

assistance to understand your condition. He or she<br />

may get a physician assistant or nurse to help you.<br />

• If your doctor prescribed a medicine, ask if there are<br />

generics available.<br />

Take it home<br />

Take the following information home:<br />

• Notes taken during the appointment by you or your<br />

family member.<br />

• Written instructions from your doctor.<br />

• Brochures or other educational materials.<br />

Follow up<br />

Make sure to follow any instructions your doctor gave<br />

you during the appointment, like taking medicine, going<br />

for a test or going to an appointment with a specialist.<br />

Contact your doctor:<br />

• If you have questions after the appointment. Ask<br />

to leave a message for the doctor or speak with a<br />

nurse.<br />

• If you start to feel worse or have problems with your<br />

medicine.<br />

• If you haven’t gotten the results of tests.<br />

Source: American Academy of Family Physicians<br />

… the average face-toface<br />

time with a doctor<br />

during an appointment<br />

is about 15 minutes.<br />

That means you have to<br />

be prepared with your<br />

concerns and questions<br />

right off the bat.<br />

19<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Senior Moments<br />

with Dr. David<br />

David A. Lipschitz, M.D., Ph.D.<br />

Every 70 seconds an American is diagnosed with<br />

Alzheimer’s disease. In the coming years, as the 72 million<br />

baby boomers reach the age of 80 and beyond, the<br />

burden of this illness could single-handedly overwhelm<br />

our health-care system.<br />

There are many myths and misconceptions about<br />

memory loss. The evaluation and care of those who suffer<br />

from memory loss and their families leaves much to<br />

be desired. Most see their primary care physician who,<br />

sadly, if a problem is suspected, prescribes a medication<br />

to treat Alzheimer’s disease instead of directing<br />

them to a specialist. This is the least important component<br />

of the evaluation. If you suspect that you or a<br />

loved one may have a memory problem, it is important<br />

to be seen by a doctor who specializes in memory<br />

disorders.<br />

20<br />

Making the diagnosis<br />

The first step in the evaluation is to confirm that a<br />

memory problem exists. Mild decreases in intellectual<br />

function, often referred to as benign forgetfulness (you<br />

may have difficulty remembering names), is not significant.<br />

In order to diagnose the problem, a person must<br />

have a decline in memory that is of sufficient severity<br />

to interfere with his or her ability to function in the community<br />

or interact with others (work, shop, remember<br />

appointments). Family members may raise concerns<br />

that a loved one is repeating information, seems confused,<br />

cannot accomplish familiar tasks and is obviously<br />

forgetful. The diagnosis is made through extensive<br />

memory testing to determine the extent of the problem<br />

and assist in identifying the cause.<br />

Is it Alzheimer’s disease?<br />

Identifying the cause<br />

The earliest sign of Alzheimer’s disease is loss of<br />

short-term memory. Other causes, such as multiple<br />

strokes or vascular disease, depression and medication<br />

use can lead to different patterns of memory loss. To<br />

confirm the diagnosis, blood tests and imaging studies<br />

of the brain are done. Eighty percent of the time,<br />

the cause is Alzheimer’s disease or multiple small or<br />

larger strokes. In the remainder, a potentially treatable<br />

cause may be found. This includes certain medications,<br />

depression (a common treatable cause of significant<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Editor’s Note: David A. Lipschitz, M.D, Ph.D., is nationally<br />

recognized as a leader in the field of geriatrics.<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield is honored to have<br />

him as a contributor to <strong>Blue</strong> & <strong>You</strong> magazine.<br />

sure, depression, sleep problems<br />

or inappropriate medication use can<br />

make memory loss worse. Treating<br />

these conditions can improve health<br />

and slow the rate at which the disease<br />

progresses.<br />

Paying attention to the caregiver<br />

and family education<br />

Taking care of a family member<br />

If you suspect that you<br />

or a loved one may have<br />

a memory problem, it is<br />

important to be seen by a<br />

doctor who specializes in<br />

memory disorders.<br />

forgetfulness), Vitamin B12 deficiency, sleep disorders, delusions, aggressive behavior, agitation and difficulties<br />

Parkinson’s disease and a condition called Normal Pressure<br />

Hydrocephalus in which memory loss is accom-<br />

of health-care providers is critical to optimally deal with<br />

with sleep become common. Having access to a team<br />

panied by problems with walking, balance and bowel these problems. It does indeed take a village to care for<br />

and bladder incontinence. Identifying and treating these someone with Alzheimer’s disease and their family.<br />

conditions on occasion can lead to dramatic improvements<br />

in memory.<br />

Medications to treat Alzheimer’s<br />

Several drugs have been shown to slow the progression<br />

of memory loss. They include Aricept, Exelon,<br />

Treating conditions that can make memory<br />

loss worse<br />

Reminyl and Namenda. None of these drugs will lead to<br />

Even if the diagnosis is Alzheimer’s disease, other dramatic improvements in memory, but they should be<br />

medical conditions such as diabetes, high blood pres-<br />

considered based on evidence that slowing the progression<br />

of the disease may provide<br />

a number of additional years of independent<br />

life and reduce the need<br />

for placement in a nursing home.<br />

The future<br />

While we do not know the cause<br />

and cannot prevent Alzheimer’s<br />

disease, there is much we can do to<br />

reduce the rate at which the illness<br />

with memory loss is an overwhelming burden. Caregivers,<br />

often spouses or children, often do not take care exercising your mind and your body can delay the age<br />

progresses. Living a stress free, heart-healthy lifestyle,<br />

of themselves, are severely stressed, are at great risk at which Alzheimer’s disease presents by 10 or more<br />

of becoming ill and are desperate for help. Understanding<br />

the condition and how to approach someone with stand the fundamental cause of this serious disease.<br />

years. We also must commit to more research to under-<br />

Alzheimer’s disease is essential. Caregivers must be There is hope that through research, new approaches to<br />

encouraged to meet their own needs, have regular care will become available, and that in our lifetime there<br />

medical checkups and spend some time alone.<br />

will be a cure.<br />

21<br />

Treating complications of the disease<br />

As Alzheimer’s progresses to other areas of the<br />

brain, unusual additional symptoms may develop.<br />

Personality changes are common, hallucinations and<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Paying for your medications<br />

22<br />

“Why do I pay for some medications<br />

through my insurance<br />

differently?”<br />

If you are on several medications,<br />

you may have noticed that the<br />

claims for some of your medications<br />

may be filed under your medical<br />

benefit, and others may be filed<br />

under your retail pharmacy benefit.<br />

<strong>You</strong> may even see the same medication<br />

filed differently under both<br />

benefits. Why?<br />

Where did you get it?<br />

The first thing to look at is where<br />

the medication is given. If you<br />

received a medication while in a<br />

hospital or in an outpatient surgical<br />

center, it is included in the allowable<br />

charge for the hospital services. If<br />

you received a medication in your<br />

physician’s office, your payment is<br />

based upon allowable charges under<br />

your medical benefit. That means<br />

you may have to pay toward your<br />

calendar-year deductible and<br />

coinsurance.<br />

If you went to your pharmacy to<br />

receive your medication, how much<br />

you pay is determined by the allowable<br />

charge for the medication and<br />

the type of retail pharmacy benefit<br />

plan you have. When you receive<br />

medications from a retail pharmacy,<br />

you may have to pay a prescription<br />

drug copayment. Finally, if you need<br />

home infusion therapy and you get<br />

it from a designated provider, your<br />

medication is covered under your<br />

medical benefit based upon the allowable<br />

charge for the medication.<br />

How did you get it?<br />

Another situation to consider is<br />

how the medication is administered.<br />

If you can take the medication yourself,<br />

orally or through an injection<br />

under the skin (subcutaneous), it is<br />

filed through your retail pharmacy<br />

benefit, and you pay a copayment.<br />

If your medication must be given<br />

by injection into the muscle, or in<br />

a vein, then it is intended to be<br />

administered only by a health-care<br />

professional, and is considered part<br />

of your medical benefit. If covered,<br />

you may have to pay toward your<br />

calendar-year deductible and<br />

coinsurance.<br />

<strong>You</strong>r Benefit Certificate lists<br />

self-administered medications as<br />

“A” medications and professionally<br />

administered medications as “B”<br />

medications. If you need to know if<br />

a medication is an “A” or “B” medication<br />

you can contact Customer<br />

Service.<br />

From the<br />

Pharmacist<br />

by Trey Gardner, Pharm D.,<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Medi-Pak and Medi-Pak Advantage (PFFS)<br />

Members: Resolve to Have a Healthy 2010<br />

Happy New Year means resolutions; and in 2010,<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield will make it easier<br />

for our Medi-Pak and Medi-Pak Advantage (PFFS) members<br />

to keep them — if one of your New Year’s resolutions<br />

is to have a Healthy 2010.<br />

As a Medi-Pak or Medi-Pak Advantage (PFFS) member<br />

you may enroll — or continue your enrollment — in<br />

SilverSneakers ® at no cost to you. As a member of<br />

SilverSneakers, you have access to amenities such<br />

as treadmills, weights and — in some cases — even<br />

heated pools at no additional cost. As a SilverSneakers<br />

member, you can take advantage of all the equipment<br />

and services available with a basic membership at a SilverSneakers<br />

participating fitness center. Many of these<br />

fitness centers also offer the signature SilverSneakers<br />

exercise classes, designed for older adults and taught<br />

by SilverSneakers-certified instructors. Don’t know<br />

which fitness centers in your area participate? Simply<br />

go to the SilverSneakers Web site at silversneakers.<br />

com. The SilverSneakers Web site also offers fabulous<br />

resources such as great new recipes and tools to create<br />

shopping lists and design your own exercise plans.<br />

Another benefit available to both Medi-Pak and<br />

Medi-Pak Advantage (PFFS) members is our online<br />

Personal Health Record. This tool combines information<br />

from your medical claims and information you enter<br />

yourself to provide a clear medical history. By keeping<br />

this record current, it will make visits to your doctor go<br />

more smoothly and efficiently. <strong>You</strong> simply can hand your<br />

doctor a printout of your Personal Health Record (PHR)<br />

from our Web site at arkansasbluecross.com (you must<br />

register with My <strong>Blue</strong>print to access your PHR). And,<br />

speaking of doctor’s visits — don’t forget — as a Medi-<br />

Pak Advantage (PFFS) member, you get an annual exam<br />

with no copayment!<br />

If you are a Medi-Pak Advantage (PFFS) member,<br />

throughout the year, you will receive helpful newsletters<br />

offering sound advice on staying healthy. And if you have<br />

the holiday blues, we have a new depression hotline.<br />

With all of these resources available to you, keeping<br />

your New Year’s resolution of working to maintain your<br />

health should be easier!<br />

If you have questions, we’re here to help. Please call<br />

the appropriate toll-free customer service telephone<br />

number listed below:<br />

Medi-Pak Customer Service<br />

1-800-338-2312<br />

Medi-Pak Advantage (PFFS) Customer Service<br />

1-877-233-7022<br />

If you’re not a Medi-Pak or Medi-Pak Advantage<br />

(PFFS) member but want to learn more, call our licensed,<br />

certified agents toll free at 1-800-392-2583.<br />

<strong>You</strong> can also use the Medi-Pak Choice Plan Finder on<br />

our Web site at arkansasbluecross.com/MedicarePlans<br />

to help you determine which of our Medi-Pak Choice<br />

products works best for you.<br />

23<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Online Health Tools<br />

A healthier life is only keystrokes away with online<br />

health tools available to Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />

Shield and Health Advantage members and eligible<br />

members of <strong>Blue</strong>Advantage Administrators of Arkansas<br />

through My <strong>Blue</strong>print.<br />

Our online programs can provide support on a variety<br />

of topics, including:<br />

• Getting active<br />

• Healthy eating<br />

• Healthy weight<br />

• Healthy thinking<br />

• Quitting smoking<br />

• Dealing with low back pain<br />

• Sleeping well<br />

To access these programs, go to My <strong>Blue</strong>print on<br />

the Arkansas <strong>Blue</strong> Cross, Health Advantage or <strong>Blue</strong>Advantage<br />

Web sites, select HealthConnect <strong>Blue</strong>, choose<br />

the HealthyLiving tab from the Dialog Center and then<br />

choose a “Healthy Conversation.” The name of these<br />

tools has changed, but the ability to create a plan as<br />

unique as you are has not!<br />

To start a program, all you need to do is answer a<br />

questionnaire about yourself and the way you live,<br />

which takes about 15 minutes. The health-care professionals<br />

will use that information to create a one-of-akind<br />

just plan for you.<br />

24<br />

<strong>Blue</strong> & <strong>You</strong> Fitness Challenge<br />

group registration under way<br />

Need help waking from a long<br />

winter’s nap back into the “fit”<br />

of things? Then move from hibernation<br />

to becoming part of the<br />

“hyper”nation with the 2010 <strong>Blue</strong><br />

& <strong>You</strong> Fitness Challenge exercise<br />

contest.<br />

Although spring is months away,<br />

now is the time to plan for the Challenge.<br />

All you have to do get 10 of<br />

your friends together, pick one of<br />

you to sign up your group and keep<br />

up with the details (the group<br />

administrator) and register on blueandyoufitnesschallenge-ark.com.<br />

The <strong>Blue</strong> & <strong>You</strong> Fitness Challenge<br />

is an exercise contest that encourages<br />

participants to work toward<br />

the public health recommendation<br />

of adult physical activity 30 minutes<br />

each day, most days of the week.<br />

A total of 167 groups — large and<br />

small — with more than 11,500<br />

participants took part in the <strong>2009</strong><br />

Challenge.<br />

The Web site is live, and there’s<br />

still time to sign up for the contest.<br />

Whether your group has 10 or 1,000<br />

members, you have until January<br />

31 to sign up. Individuals who will<br />

be participating in Challenge groups<br />

will begin registration in February.<br />

Schools, companies and organizations<br />

and others may form teams<br />

within their larger body of participants,<br />

too. Students ages 13 and<br />

older can form teams and challenge<br />

other schools or other teams within<br />

their schools. (Note: Group administrators<br />

must be 18 or older.) All<br />

individuals must be registered on a<br />

team by Feb. 28, 2010.<br />

We will begin exercising on our<br />

virtual tour on March 1. For more<br />

information, call toll free 1-800-686-<br />

2609. <strong>You</strong> may download a planning<br />

kit in PDF form from the Web site.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


The<br />

Doctor’s<br />

Corner<br />

Drinking hot liquids associated<br />

with throat cancer<br />

Smoking and heavy alcohol use<br />

kids about the danger of permanent<br />

hearing loss from excessive noise.<br />

Encourage them to turn down the<br />

by Ray Bredfeldt, M.D.,<br />

Regional Medical Director<br />

Northwest Region, Fayetteville<br />

are both associated with throat<br />

cancer. Now, another risk factor has<br />

been identified — very hot beverag-<br />

music and to use earplugs when<br />

they operate loud machinery such<br />

as lawnmowers.<br />

the shoulders or back from the<br />

backpack.<br />

es. Researchers<br />

recently found<br />

that people<br />

who drink very<br />

hot beverages<br />

increase their risk of developing<br />

throat cancer. The study found that<br />

people who drink tea within two<br />

minutes after boiling were five<br />

times more likely to develop throat<br />

cancer than those who waited four<br />

minutes or more to drink their tea.<br />

Is your child’s backpack<br />

too heavy?<br />

Backpacks, if stuffed<br />

too full, can be so<br />

heavy that they can<br />

cause back pain<br />

and injury. Here<br />

are some warning<br />

signs that your<br />

child’s backpack<br />

is too heavy,<br />

courtesy of<br />

Surfing the Web can keep<br />

your brain young<br />

Surfing the Internet just might be<br />

a way to preserve your mental skills<br />

as you age. A new study suggests<br />

that Internet activity can help keep<br />

older people alert. Researchers<br />

found that older adults who started<br />

browsing the Web experienced<br />

improved brain function after only a<br />

few days.<br />

Have your medical proce-<br />

25<br />

Kids losing hearing from<br />

the U.S. Na-<br />

dures done early!<br />

loud noise exposure<br />

tional Safety<br />

Doctors are just like everyone<br />

Do your kids like loud music or<br />

Council:<br />

else – they get tired after a long day<br />

loud computer games? <strong>You</strong> may<br />

• <strong>You</strong>r child’s posture changes<br />

at work. A recent study found that<br />

want them to turn it down a notch.<br />

when the backpack is on.<br />

for people undergoing a colonos-<br />

Studies indicate 12 percent or more<br />

• <strong>You</strong>r child has difficulty putting<br />

copy, doctors do a better job of<br />

of children between the ages of 6<br />

the backpack on or taking it off.<br />

finding abnormalities in the morning<br />

and 19 already have suffered some<br />

• <strong>You</strong>r child has pain while the<br />

than in the afternoon. What is true<br />

degree of irreparable hearing loss.<br />

backpack is on.<br />

for colonoscopies may be true for<br />

The major culprit is the loud noise<br />

• <strong>You</strong>r child feels a sensation of<br />

other medical procedures. It makes<br />

they experience listening to music<br />

numbness or tingling while wear-<br />

sense, therefore, to ask for a morn-<br />

using headphones or while driving<br />

ing the backpack.<br />

ing procedure rather than one later<br />

in vehicles. Be sure to talk to your<br />

• <strong>You</strong>r child has red marks on<br />

in the day.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Arkansas <strong>Blue</strong> Cross<br />

and <strong>Blue</strong> Shield and<br />

asked if <strong>Blue</strong>Ann<br />

could be Ethan’s<br />

buddy at Texarkana’s<br />

26<br />

<strong>Blue</strong>Ann Ewe<br />

makes a Buddy!<br />

<strong>Blue</strong>Ann Ewe was checking her<br />

e-mail one day and came across<br />

a special request. The e-mail was<br />

from Jenni Smith, who is the<br />

mother of a 2-year-old boy affected<br />

by Down syndrome, a genetic disorder<br />

caused by the presence of too<br />

many chromosomes.<br />

Each year, Texarkana hosts a<br />

National Down Syndrome Society<br />

Buddy Walk ® , and Jenni’s son,<br />

Ethan, asked his mom if <strong>Blue</strong>Ann<br />

could come and participate. Jenni,<br />

a registered nurse at CHRISTUS<br />

St. Michael, immediately contacted<br />

<strong>2009</strong> National<br />

Buddy Walk.<br />

Traci Gatlin, R.N.,<br />

medical affairs<br />

manager, and Hillary<br />

Cross, R.N., regional<br />

case manager from<br />

the Arkansas <strong>Blue</strong><br />

Cross Southwest<br />

Regional Office, gladly volunteered<br />

to take <strong>Blue</strong>Ann to the walk to meet<br />

Ethan. More than 500 people, along<br />

with <strong>Blue</strong>Ann, walked around Buddy<br />

Ferguson Park on October 31, to help<br />

raise money for families and individuals<br />

affected by Down syndrome.<br />

Mothers of children with Down syndrome<br />

hope the National Buddy Walk<br />

Jenni Smith, R.N.<br />

and her son, Ethan<br />

will help raise awareness about the<br />

condition and build support systems,<br />

both of which last long after the onemile<br />

walk is over.<br />

<strong>Blue</strong>Ann participated in the walk<br />

and played games that helped raise<br />

$15,000 for those locally born with<br />

Down syndrome.<br />

Ethan Smith was delighted to<br />

have <strong>Blue</strong>Ann’s support!<br />

<strong>Blue</strong>Ann goes back to school<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield’s Southeast<br />

Regional Office in Pine Bluff accompanied<br />

<strong>Blue</strong>Ann Ewe to the Back-to-School Festival in<br />

McGehee, Ark., on August 24. <strong>Blue</strong>Ann and Debi<br />

Attwood greeted kids and handed out <strong>Blue</strong>Ann<br />

coloring books to more than 100 children.<br />

<strong>Blue</strong>Ann, along with Arkansas <strong>Blue</strong> Cross’ Central<br />

Regional Office, also attended the first annual<br />

Back-to-School Community Health Fair at Trinity<br />

Worship Center in Conway, Ark., on August 15.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


The <strong>2009</strong> Arkansas <strong>Blue</strong> Cross<br />

JDRF “Walk for a Cure” team<br />

Arkansas <strong>Blue</strong> Cross raises $10,000 for JDRF<br />

Mark White, president and chief<br />

executive officer for Arkansas <strong>Blue</strong><br />

Cross and <strong>Blue</strong> Shield, was named<br />

the corporate walk chair for the<br />

Greater Arkansas Chapter of the<br />

Juvenile Diabetes Research Foundation<br />

(JDRF). In support of Mark and<br />

JDRF, more than 500 Arkansas <strong>Blue</strong><br />

Cross employees joined him at Murray<br />

Park on September 19.<br />

In addition to walking for a<br />

cure, Arkansas <strong>Blue</strong> Cross hosts<br />

an annual corporate fundraiser to<br />

raise money for JDRF. Our leadership<br />

team in past years has been<br />

dunked, called Bingo and fought obstacles,<br />

all to help juvenile diabetes<br />

research. There only was one thing<br />

they had not done — sing!<br />

This year, our fundraiser theme<br />

was, “Arkansas <strong>Blue</strong> Cross Idol:<br />

Karaoke for a Cure,” styled after<br />

the No. 1 hit television show,<br />

“American Idol.”<br />

Arkansas <strong>Blue</strong> Cross executives<br />

agreed to be Idol contestants — but<br />

only if the price was right. Each executive<br />

agreed to sing “karaoke style”<br />

if $1,000 was raised in his or her<br />

name through employee pledges.<br />

The employees of Arkansas <strong>Blue</strong><br />

Cross raised more than $10,000<br />

for JDRF!<br />

27<br />

<strong>Blue</strong> & <strong>You</strong> Foundation awards $1.5 million in grants<br />

to improve health<br />

The <strong>Blue</strong> & <strong>You</strong> Foundation for a<br />

Healthier Arkansas has awarded a<br />

total of $1,574,691 in grants to 33<br />

health improvement programs in<br />

Arkansas.<br />

“Our grants this year went to programs<br />

across the state that address<br />

such issues as obesity, diabetes,<br />

healthy lifestyle choices, medical<br />

care for low-income individuals,<br />

dental health, safety and worksite<br />

wellness,” said Patrick O’Sullivan,<br />

executive director of the <strong>Blue</strong> & <strong>You</strong><br />

Foundation.<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />

Shield established the <strong>Blue</strong> & <strong>You</strong><br />

Foundation in 2001 as a charitable<br />

foundation to promote better health<br />

in Arkansas. The <strong>Blue</strong> & <strong>You</strong> Foundation<br />

awards grants annually to nonprofit<br />

or governmental organizations<br />

and programs that positively affect<br />

the health of Arkansans.<br />

In its eight years of operation, the<br />

<strong>Blue</strong> & <strong>You</strong> Foundation has awarded<br />

more than $10 million to 162 health<br />

improvement programs in Arkansas.<br />

The grants awarded for 2010 are:<br />

• American Diabetes Association,<br />

Bentonville ($35,000)<br />

• Area Agency on Aging of Southeast<br />

Arkansas, Pine Bluff ($25,876)<br />

• Arkansas Hunger Relief Alliance,<br />

Little Rock ($110,000)<br />

• Arkansas Mission of Mercy, Sherwood<br />

($50,000)<br />

• Arkansas Quality Foundation,<br />

Little Rock ($43,262)<br />

• Baptist Health Foundation, Little<br />

Rock ($149,940)<br />

• Cedarville Schools, Cedarville<br />

($62,160)<br />

• Chicot Memorial Hospital Foundation,<br />

Lake Village ($60,182)<br />

Grants, continued on Page 29<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


28<br />

What is a hospitalist?<br />

A hospitalist is a physician whose<br />

primary professional focus is the care<br />

of hospitalized patients, so if you or<br />

someone in your family is ever hospitalized<br />

— there are doctors right there<br />

when you need them to answer your<br />

questions and coordinate hospital<br />

care. These physicians have dedicated<br />

their careers to the care of hospitalized<br />

patients.<br />

In the past, if you were hospitalized,<br />

you could expect to see your primary<br />

care physician (PCP) at the hospital coordinating<br />

all your hospital care. Many<br />

physicians continue to admit their<br />

own patients to the hospital, and this<br />

system works well for them.<br />

Today, however, most PCPs focus<br />

their attention on patients in their clinic<br />

and entrust the care of their hospitalized<br />

patients to the specialist who admitted<br />

the patient (such as a surgeon<br />

or cardiologist) or to the hospitalist.<br />

The hospitalist usually is a general<br />

medicine physician who is trained on<br />

a wide variety of medical problems,<br />

and who takes responsibility for the<br />

patient during the hospitalization. The<br />

hospitalist calls in other doctors as<br />

needed, but primarily is in charge of<br />

the hospitalization and communication<br />

among all the doctors, the patient and<br />

the family.<br />

Hospitalists provide valuable<br />

services by:<br />

• Being available to quickly meet the<br />

needs of hospitalized patients and<br />

by Randal F. Hundley, M.D., FACC<br />

Special Guest Contributor<br />

their families.<br />

• Handling situations quickly by<br />

having an in-depth knowledge of<br />

the hospital and its staff.<br />

• Allowing PCPs to focus on patients<br />

in their clinics.<br />

• Providing a report of the hospitalization<br />

with any treatment<br />

changes to the PCP.<br />

The possible downside of working<br />

with a hospitalist is that he or she<br />

may not know you as well as your<br />

PCP. With thorough communication,<br />

however, this issue can be avoided.<br />

If your care (or a family member’s)<br />

is coordinated by a hospitalist, you<br />

should expect your PCP and the<br />

hospitalist to communicate at the<br />

beginning and end of the hospitalization,<br />

and if any big issues arise. It<br />

is especially important for your PCP<br />

to have all the important information<br />

from the hospitalization.<br />

<strong>You</strong> can help the process by asking<br />

the hospitalist whether there<br />

has been or will be communication<br />

with your PCP. If unsure, you can<br />

call your physician’s office to be<br />

sure they know that you (or a loved<br />

one) are in the hospital. Although<br />

the hospitalist will be able to obtain<br />

your office records as needed, it is<br />

extremely helpful to hospital admission<br />

staff to give your doctors and<br />

nurses a list of:<br />

• <strong>You</strong>r current medications.<br />

• Any allergies.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


• Previous operations and medical<br />

• Know when you will visit with<br />

from the hospital without adequate<br />

conditions.<br />

your PCP and any specialists you<br />

follow-up arrangements, leading to<br />

• All your physicians’ names and<br />

saw in the hospital.<br />

complications at home and readmis-<br />

telephone numbers.<br />

• Know if you need to schedule ap-<br />

sion to the hospital.<br />

• The name and telephone num-<br />

pointments with other providers<br />

At Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />

ber of a family member or other<br />

such as physical therapists.<br />

Shield, experiences with most<br />

contact person.<br />

• Ask that a report of your hospi-<br />

hospitalists have been excellent.<br />

At discharge, several things are<br />

talization, with any changes in<br />

When there has been a problem,<br />

important:<br />

medications or other treatment,<br />

it is often because the patient did<br />

• Have a clear list of all your medi-<br />

be forwarded to your PCP.<br />

not have a PCP before going into<br />

cations. Be sure you understand<br />

Gener-<br />

The hospitalist<br />

the hospital, making it difficult to<br />

which medicines have been<br />

started, stopped or changed, as<br />

well as any instructions on diet<br />

or other issues.<br />

ally, the<br />

hospitalist<br />

will not see<br />

you again<br />

takes responsibility<br />

for the patient<br />

during<br />

hospitalization.<br />

arrange good follow-up care after<br />

hospital discharge. Arkansas <strong>Blue</strong><br />

Cross strongly recommends having<br />

a relationship with a PCP before<br />

• Know if you will have home<br />

unless you come back into the<br />

needing to go into the hospital. This<br />

health visits and know when to<br />

expect a visit.<br />

hospital. A recent study showed<br />

that many patients are discharged<br />

is the best way to ensure a smooth<br />

transition from hospital to home.<br />

29<br />

Grants, continued from Page 27<br />

• Crawford-Sebastian Community<br />

Development Council, Fort Smith<br />

($5,032)<br />

• Dallas County Alliance Supporting<br />

Health, Fordyce ($8,805)<br />

• FoodShare and Opportunity Network,<br />

Prescott ($11,250)<br />

• Friendship Community Care, Russellville<br />

($41,528)<br />

• Group Living, Arkadelphia ($4,107)<br />

• Harding University College of<br />

Pharmacy, Searcy ($50,447)<br />

• Harmony Health Clinic, Little Rock<br />

($50,000)<br />

• Helen R. Walton Children’s Enrichment<br />

Center, Bentonville ($58,255)<br />

• Hospice of Texarkana, Texarkana<br />

($11,505)<br />

• Kimmons Junior High and Sutton<br />

Elementary, Fort Smith ($104,860)<br />

• Lawrence Memorial Health Foundation,<br />

Walnut Ridge ($42,270)<br />

• Madison County Health Coalition,<br />

Huntsville ($66,360)<br />

• NEA Clinic Charitable Foundation,<br />

Jonesboro ($30,400)<br />

• North Arkansas Partnership<br />

for Health Education, Harrison<br />

($117,371)<br />

• Northwest Arkansas Free Health<br />

Center, Fayetteville ($50,000)<br />

• Northwest Arkansas Women’s<br />

Resources, Rogers ($49,756)<br />

• Paragould Light, Water and Cable<br />

Employees, Paragould ($17,000)<br />

• Parenting and Childbirth Education<br />

Services, Jonesboro ($33,617)<br />

• Pulaski County <strong>You</strong>th Services,<br />

Little Rock ($16,050)<br />

• River City Ministry of Pulaski<br />

County, North Little Rock ($24,000)<br />

• Shepherd’s Hope Neighborhood<br />

Health Clinic, Little Rock ($25,000)<br />

• University of Arkansas at Little<br />

Rock (UALR), Little Rock ($50,100)<br />

• University of Arkansas for Medical<br />

Sciences (UAMS), Little Rock<br />

($34,397)<br />

• University of Arkansas for Medical<br />

Sciences (UAMS), Little Rock<br />

($80,961)<br />

• Van Buren County Schools, Clinton<br />

($55,200)<br />

The <strong>Blue</strong> & <strong>You</strong> Foundation<br />

received 94 grant applications requesting<br />

$5.7 million in support.<br />

The <strong>Blue</strong> & <strong>You</strong> Foundation will<br />

accept proposals for its next funding<br />

cycle any time between Jan. 1 and<br />

July 15, 2010. For more information,<br />

visit the foundation Web site at<br />

blueandyoufoundationarkansas.org.<br />

The foundation is an independent<br />

licensee of the <strong>Blue</strong> Cross and <strong>Blue</strong><br />

Shield Association and serves the<br />

state of Arkansas. The foundation is<br />

a 501(c)(3) organization.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


30<br />

Baldor — Building a lean machine<br />

At Baldor Electric Company, employees are encouraged<br />

to look for innovation — whether it is creating<br />

new products and work processes, finding ways to trim<br />

excess costs, developing and implementing leading<br />

edge information technology or developing and promoting<br />

wellness initiatives. Baldor’s leadership knows<br />

that when everyone contributes, everyone wins. And,<br />

when you want to both lower costs and improve health,<br />

visionary companies like Baldor look to themselves and<br />

their employees to lead the way.<br />

In 2008, Baldor chose to switch all employees nationwide<br />

to one source for the administration of its group<br />

health insurance, and <strong>Blue</strong>Advantage Administrators of<br />

Arkansas — a subsidiary of Arkansas <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield — was a perfect fit. Baldor, whose world<br />

headquarters is located in Fort Smith, Ark., wanted a<br />

health plan administrator that understood their longterm<br />

objectives around creating a healthy workplace<br />

and had the resources to assist them in creating a<br />

culture of health.<br />

So in early <strong>2009</strong>, the Baldor Wellness Council, comprised<br />

of employees from each of<br />

its 22 U.S. locations, was formed<br />

to promote the new “Fit4Life”<br />

wellness program nationwide and<br />

engage all 6,500 employees in<br />

healthier lifestyles. The Fit4Life<br />

program encourages employees to<br />

get involved in workplace wellness<br />

educational activities and initiatives,<br />

while focusing on improving<br />

their overall health and well being.<br />

Martha Carlson, regional executive for the Arkansas<br />

<strong>Blue</strong> Cross West Central Regional Office in Fort Smith,<br />

started discussing the concept of wellness with Jason<br />

Green, the vice-president of human resources at Baldor,<br />

and Tona Schmidt, the staffing manager and coordinator<br />

A Baldor<br />

employee<br />

gets his<br />

blood pressure<br />

checked during a<br />

health screening.<br />

I think Arkansas <strong>Blue</strong><br />

Cross has as much<br />

of a vested interest in<br />

not only the success<br />

of the program but<br />

in the health of our<br />

employees as we do.<br />

of the Baldor Wellness Council.<br />

“Martha helped us understand the resources that<br />

were available to us through our relationship with Arkansas<br />

<strong>Blue</strong> Cross,” Green said, referring to HealthConnect<br />

<strong>Blue</strong>, Arkansas <strong>Blue</strong> Cross’ multi-faceted integrated<br />

health resource that provides a wide variety of tools<br />

for healthy living.<br />

Get <strong>You</strong>r Motor Running<br />

As a start to their Fit4Life companywide wellness<br />

efforts, Baldor encouraged all employees, not just those<br />

on the company’s insurance plan, to<br />

complete the online Personal Health<br />

Assessment available through<br />

HealthConnect <strong>Blue</strong>. This was not<br />

an easy accomplishment in an environment<br />

where most employees<br />

work on a production line.<br />

Baldor began the process by<br />

providing onsite biometric screenings<br />

(blood pressure, blood sugar,<br />

cholesterol and weight) for employees<br />

to assess their health. Arkansas <strong>Blue</strong> Cross<br />

representatives then walked Baldor employees through<br />

the registration process for My <strong>Blue</strong>print using onsite<br />

computers and instructed them on how to complete<br />

the Personal Health Assessment. By participating in the<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


Personal Health Assessments, Baldor will establish a<br />

benchmark on their employee’s current health status.<br />

While individual results are strictly confidential, aggregate<br />

data (overall results combined) can be used to help<br />

the Wellness Council define activities and support the<br />

needs of Baldor employees in the future. Additionally,<br />

after completing the Personal Health Assessment,<br />

each employee received a copy of personalized information<br />

on how they can improve their health and, if<br />

needed, were guided to health education programs provided<br />

by <strong>Blue</strong>Advantage to help them care for chronic<br />

conditions.<br />

“Baldor is a great company,” Carlson said. “They<br />

are very focused on treating their team members with<br />

respect and dignity. That certainly shows through the<br />

investment they’ve made in their employee’s health<br />

and wellness. This is a top down initiative with a solid<br />

company wellness team focused on a multi-year wellness<br />

plan. We enjoyed working side by side with Baldor<br />

during these onsite events, and it’s just the beginning.”<br />

“We are working together to make the program successful<br />

and ultimately improve the health of our employees,”<br />

Green said. “I think Arkansas <strong>Blue</strong> Cross has<br />

as much of a vested interest in not only the success of<br />

the program but in the health of our employees as we<br />

do. So I think that makes a big difference. It isn’t just<br />

another wellness program, it’s our vision for the future.”<br />

We love to hear from you!<br />

May we help? For customer service, please call:<br />

Little Rock Toll-free<br />

Number (501) Number<br />

Medi-Pak members 378-3062 1-800-338-2312<br />

Medi-Pak Advantage members 1-877-233-7022<br />

Medi-Pak Rx members 1-866-390-3369<br />

Arkansas <strong>Blue</strong> Cross members 378-2010 1-800-238-8379<br />

Pharmacy questions 1-800-863-5561<br />

Specialty Rx Pharmacy questions 1-866-295-2779<br />

Health Advantage members 378-2363 1-800-843-1329<br />

Pharmacy questions 1-800-863-5567<br />

<strong>Blue</strong>Advantage members 378-3600 1-888-872-2531<br />

Pharmacy questions 1-888-293-3748<br />

State and Public School members 378-2364 1-800-482-8416<br />

Federal Employee members 378-2531 1-800-482-6655<br />

Looking for health or dental insurance? We can help!<br />

For individuals, families<br />

and those age 65 or older 378-2937 1-800-392-2583<br />

For employer groups 378-3070 1-800-421-1112<br />

(Arkansas <strong>Blue</strong> Cross Group Services, which includes<br />

Health Advantage and <strong>Blue</strong>Advantage Administrators<br />

of Arkansas)<br />

Prefer to speak with someone close to home? Regional Office<br />

telephone numbers:<br />

Pine Bluff/Southeast Region 1-800-236-0369<br />

1800 West 73rd St.<br />

Jonesboro/Northeast Region 1-800-299-4124<br />

707 East Matthews Ave.<br />

Hot Springs/South Central Region 1-800-588-5733<br />

100 Greenwood Ave., Suite C<br />

Texarkana/Southwest Region 1-800-470-9621<br />

1710 Arkansas Boulevard<br />

Fayetteville/Northwest Region 1-800-817-7726<br />

516 East Milsap Rd., Suite 103<br />

Fort Smith/West Central Region 1-866-254-9117<br />

3501 Old Greenwood Rd., Suite 5<br />

Little Rock/Central Region 1-800-421-1112<br />

320 West Capitol Ave., Suite 900<br />

31<br />

Go to <strong>Blue</strong> & <strong>You</strong> Online on our Arkansas<br />

<strong>Blue</strong> Cross and Health Advantage Web sites<br />

for more on Baldor’s Fit 4 Life Program.<br />

Web sites:<br />

arkansasbluecross.com<br />

healthadvantage-hmo.com<br />

blueadvantagearkansas.com<br />

blueandyoufoundationarkansas.org<br />

blueannewe-ark.com<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>


32<br />

At Arkansas <strong>Blue</strong> Cross<br />

and <strong>Blue</strong> Shield, we are<br />

always looking for new<br />

ways to be "Good for <strong>You</strong>."<br />

Here are some of our<br />

latest accomplishments.<br />

Information is good for you! Especially information from<br />

your member magazine, <strong>Blue</strong> & <strong>You</strong>! That’s why we’ve<br />

created <strong>Blue</strong> & <strong>You</strong> Online. It’s an online version of our<br />

magazine with more information about our featured<br />

stories, more photos and links to more information on<br />

plans, products and information to help you better manage<br />

your health and your health plan. Go to our Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield and Health Advantage<br />

Web sites and enjoy even more information that’s good<br />

for you!<br />

Want to get fit and need a good deal?<br />

We offer both! If you are a member, visit our Web sites<br />

and receive a discount to a fitness center near you! Go<br />

to arkansasbluecross.com or healthadvantage-hmo.com,<br />

select the “Discount Wellness Program” in the <strong>Blue</strong> &<br />

<strong>You</strong> Online section or visit the “Members” section and<br />

select the “Member Discount Programs” under the<br />

Popular Links heading. Either way, find a gym, start saving<br />

money and get fit!<br />

Prepare for a Pandemic<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield wants you to be<br />

prepared during a pandemic or other emergency, so we<br />

have updated a special publication to help you and your<br />

family. “Preparing for a Pandemic,” is available in the<br />

“Members” section of all of our Web sites, or you can<br />

find a link to the publication in the <strong>Blue</strong> & <strong>You</strong> Online<br />

section on the home page of the Arkansas <strong>Blue</strong> Cross<br />

and Health Advantage Web sites.<br />

In Preparing for a Pandemic, you will find:<br />

• Tips on how to avoid spreading germs and how communities<br />

may respond during an emergency.<br />

• Instructions on caring for sick family members and<br />

when to seek medical help.<br />

• Key local and national pandemic resources, how to<br />

access your personal health information, and a place<br />

to assemble critical information about your family.<br />

• Information on how your benefits may change during<br />

a declared pandemic and how to reach us during an<br />

emergency.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>Winter</strong> <strong>2009</strong>

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