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.
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 />
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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>