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Blue & You - Winter 2009

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

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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Winter 09

• See what’s replacing the Explanation of Benefits, Page 4

• Keep your young adults covered, Page 6

• Develop a relationship with your doctor, Page 18

Ruben Rodriguez of Greene

County, Ark., is back to

helping others after heart

surgery. See his story on

Page 10.

A publication for the policyholders of the Arkansas

Blue Cross and Blue Shield family of companies


Jason Green and Tona Schmidt

discuss the Fit4Life program

at the Baldor Electric Company

headquarters in Fort Smith.

on Page 30

14 A SilverSneakers

competition winner

23 Medicare benefits for 2010

24 Online Health Tools

INSIDE

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Out of the Blue

Personal Health Statement keeps members

“up to date”

Keeping your young adult covered

Are you taking prescription antacids?

Healthy lifestyle may reduce Alzheimer’s risk

Let the sunshine in — for your health

Treating gestational diabetes reduces health risks

Heart attacks on the rise in women

Healing a giving heart

SilverSneakers competition winner logs

more than 1,000 miles

Behavioral health services now available

Lose weight The Healthy Weigh!

Babies born to obese women at greater risk

Mammogram wellness benefits continue

Costs Matter: Developing a relationship with

your doctor

Senior Moments with Dr. David

From the Pharmacist —

Paying for your medications

Happy New Year to our Medi-Pak and

Medi-Pak Advantage members

Online Health Tools

Blue & You Fitness Challenge registration under way

The Doctor’s Corner

Good for Your Community

What is a hospitalist?

Baldor — Building a lean machine

Customer Service telephone numbers

Good for you

Winter 09

is published four times a year by

Arkansas Blue Cross and Blue Shield for

the company’s members, health-care

professionals and other persons

interested in health care and wellness.

Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com

Designer: Gio Bruno Photographer: Chip Bayer

Contributors: Chip Bayer, Matthew Creasman, Damona Fisher, Kristy Fleming,

Jennifer Gordon, Trey Hankins, Heather Iacobacci-Miller, Ryan Kravitz, Kathy

Luzietti and Mark Morehead

Vice President, Communications and Product Development: Karen Raley


Out of the

Blue

A message from our

CEO and President,

Mark White

Employees who care

The beginning of a new year is a time in which many

of us pause to reflect on the blessings we’ve enjoyed

during the past year. As I stop to consider the things I

am most grateful for, the men and women who work

at Arkansas Blue Cross and Blue Shield are always near

the top of the list. I am grateful for their concern for

you, our valued customers. I am grateful for the energy

and dedication with which they approach their jobs here

at Arkansas Blue Cross. But above all, I am grateful for

the kinds of citizens they are; the kind of compassionate,

engaged and accountable people that every community

can use.

With so many comments in the media today vilifying

those of us who work in the insurance industry, I

hope you will allow me a moment to tell you about the

people that walk the halls of this insurance company

every day. Although we have a few employees out of

state, our employees are largely Arkansans. Many are

your friends, your neighbors, your children’s coaches

and your Sunday school teachers. Because they count

themselves fortunate to have good jobs during these

difficult times, they always are mindful of those whose

paths have been more challenging.

And they walk the talk. Collectively, they contribute

thousands of volunteer hours to communities all across

the state. And they open their pocketbooks to help the

causes they believe in as well. In fact, just the contributions

our employees made to nonprofit organizations

through Arkansas Blue Cross totaled more than

$100,000 in 2009. That doesn’t count what they did on

their own.

Because of their generosity, tornado victims got a

helping hand. Cures for diabetes and sickle cell anemia

and cystic fibrosis are a little closer to reality. They

donated to hospice organizations and humane societies

and helped children with disabilities. Our employees

provided money to feed the hungry and shelter the

homeless. They were there for the victims of fires and

accidents and poverty. They are people of value contributing

to organizations of value. And I am grateful for

them every day.

At Arkansas Blue Cross, we know that being a good

corporate citizen begins with employing productive

and responsible citizens. I’m proud to work with such

a community-minded group of men and women. And

you’ll be glad to know they bring that same spirit of service

to the workplace as they serve you, our members,

every day.

3

Blue & You Winter 2009


4

A new view of your claims

Personal Health Statement keeps members “up to date”

At Arkansas Blue Cross and Blue Shield, we want

the conversations we have with our members to be

helpful, clear and complete, whether we’re talking by

telephone, on our Web sites or in writing.

One of our most frequent member communications

— the Explanation of Benefits (EOB) — is getting a new

look and content, and, a new name.

The EOB is the health-care benefit statement generated

every time your doctor or hospital files a claim. The

EOB notifies you that we received a claim and how we

handled that claim. Beginning in March, many Arkansas

Blue Cross members will begin receiving a Personal

Health Statement (PHS) in place of their EOB.

The PHS is more comprehensive than the EOB and

designed to make claims processing easier to understand.

The PHS also gives more information about

health benefits.

“Health insurance is a complex industry with lots of

moving parts and a language all its own,” said Karen

Raley, vice president of Communications and Product

Development. “We want to simplify industry terms into

everyday language, clearly explain claims, and help our

members know exactly where they are with their outof-pocket

costs (deductibles,

copayments, coinsurance

and more).”

The new PHS is the result

of feedback from member

focus groups. “First and

foremost, members told us

they want to know ‘what do I

owe?’” Raley said. “So we’ve

put this information in red

on the first page. We’ve also

added a ‘Benefits at a Glance’ section, so members are

reminded of their health benefits. Charts and graphs,

hopefully, will make the information displayed easier to

understand.”

Members also asked for:

• A better description of the discounts they receive

on their health-care services.

• Information on how to get in touch with us.

• A quick understanding of how much they owe and

to whom.

• Help in understanding the benefits they have and

how they work.

A Benefit Summary section shows members their

personal health benefits and tracks where they are in

meeting deductibles and out-of-pocket maximums.

Pharmacy information has been added, including

generic medication recommendations. Another new

feature on the PHS will be personal health messages

and reminders to get health screenings.

Members still have the option to confidentially view

their PHS electronically. To sign up for a notification

e-mail, members can go online and sign up through the

My Blueprint member self-service center. Then, when a

Blue & You Winter 2009


new PHS is generated, you will receive an e-mail.

The new PHS will be issued two times a month

instead of every time a claim is filed. If a member only

has pharmacy claims during a month, the PHS will be

issued quarterly.

The PHS was piloted with three groups in Arkansas

to get member reaction to the new format and content.

“We love the new statements!” said Sharon

Burdine, vice president and assistant director of Human

Resources with Simmons First.

“We think the “Our associates are finding

new PHS will the new Personal Health

Statement is easy to understand.

The statement

be a valuable tool for

helping us to become shows several things

better consumers that were not available

of health care.” — before, such as prescriptions.

The information

shown is more

Barb Gordon,

Northwest Arkansas descriptive of what our

Community benefits are, of services

received, what the health

College

plan pays for and what the

member’s portion is going to be. We’re seeing how the

PHS also can serve as a backup for a flexible spending

account (cafeteria plan) — all services are listed in case

you lose a receipt or forget to include an expense to

be filed.”

“We think the new PHS will be a valuable tool for

helping us become better consumers of health care,”

said Barb Gordon, benefits specialist with Northwest

Arkansas Community College in Fayetteville. “The PHS

gives employees a great snapshot of where they are at

a given time and is backed up with all the details they

need to be informed about their benefits. For employees

who have spouses with other insurance coverage,

the PHS is a great tool for coordination of benefits

— it’s easy to see what has been paid to whom and

what is owed. The discounts on health-care

services are easier to see, and, wow,

what a difference in cost! I don’t think

many employees realized the true cost

of prescription drugs until the new format.

Once you become familiar with the

new format, it is more understandable

overall.”

Ann Freeman, vice president

of Benefits with First

National Bank and Trust of

Mountain Home, said,

“Our employees are

finding the new Personal

Health Statement

easier to read. The

language is better

and doesn’t sound

so ‘insurance-y’

and the charts

provide a good

picture of where

the employees

are with their

deductibles and

out-of-pocket

maximums.”

The new PHS will be available

to many Arkansas Blue

Cross members beginning in the

spring of 2010 and later in the

year for Health Advantage. “We

love to hear from our members,” said

Raley. “Feedback always is welcome

on how the PHS can be improved.”

5

Blue & You Winter 2009


Keeping your young adult

covered

(one less thing to worry about!)

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Parents with young adults know

they can’t protect them at every

turn, but now they can have peace

of mind about their health-care

coverage. Arkansas Blue Cross and

Blue Shield and Health Advantage

are changing the dependent coverage

requirements under our fully

insured group health plans to help

more families continue covering their

young adults.

Beginning Jan. 1, 2010, Arkansas

Blue Cross and Health Advantage

will no longer require dependents 19

and older to be in an accredited college

or university in order to remain

a dependent under their parents’

group health plan. Dependents who

are unmarried, whose parents provide

the majority of their financial

support and whose parents’ home

is their primary residence can remain

on their health-care plan until

they reach the maximum dependent

age on the policy. The maximum

dependent age varies based on the

plan selected by the employer. This

change also applies to groups that

have Arkansas Blue Cross dental

coverage plans.

Arkansas Blue Cross and Health

Advantage will no longer request

verification of a dependent’s status

as a student and will no longer

cancel coverage for those who do

not meet the previous student status

requirements. Dependents under

the maximum dependent age who

currently are not covered, (due to

attending non-accredited education

facilities, etc.) and who meet the

criteria, now can be added to their

parents’ coverage.

If you wish to have a dependent

covered, you may complete an

employee application asking that the

dependent be enrolled. Dependents

not currently covered will not be

subject to late enrollment rules, nor

deferred to open enrollment, as long

as the application is submitted by

Feb. 28, 2010. Groups may submit

applications anytime between now

and February 28. The first effective

date will be Jan. 1, 2010. Applications

received in January will get

February 1 effective dates, and

those received in February will have

March 1 effective dates.

Dependents do not have to apply

upon reaching the age of 19; as long

as they remain dependents, coverage

will continue until they reach

the maximum dependent age. If you

have questions, please don’t hesitate

to contact us using the Customer

Service number on your member

ID card.

Blue & You Winter 2009


Are you

taking

prescription

antacids?

If you take the Proton Pump Inhibitors

(PPI) Prevacid, Prilosec

or Nexium, you should be aware

that some upcoming changes in the

PPI class of medications might save

you money.

PPIs are medications, often called

antacids, that are taken for conditions

such as heartburn or acid

reflux. In the past, the Arkansas

Blue Cross and Blue Shield standard

formulary (drug list) has covered

Prevacid and Nexium on its highest

cost level. However, there have

been three significant changes in

the PPI class of medications, and

because of these changes, we

are changing our drug list. The

changes are:

1. In November, Prevacid became

available for purchase over the

counter (OTC).

2. Prescription-strength Omeprazole,

a generic version of

Prilosec, previously was not

priced as a generic medication

but now is priced as a generic.

OTC versions (lower strength) of

these medications are available.

3. A new PPI — Kapidex — has

proven to be effective anytime,

even if taken during or following

meals. All other PPIs have to be

taken one hour ahead of meals.

Whenever there are multiple

changes in a class of medications,

Arkansas Blue Cross reviews its

drug list to ensure members are

receiving the best therapy and value

for their prescription drugs. The following

changes have occurred:

Prevacid was removed from the

formulary when available OTC.

Kapidex now is available on our

highest cost level of the drug plan.

Omeprazole, the generic for

Prilosec, now is available on the

lowest cost level of the drug plan for

those members requiring prescription

strength.

Nexium has been removed from

the drug plan altogether as it lacks

the advantages of – and is priced

30 percent higher (retail) – than

Kapidex.

Arkansas Blue Cross takes the

importance of making safe, affordable

prescription medications available

to our members seriously. Our

staff pharmacists seek advice from

a Pharmacy and Therapeutics (P&T)

Committee comprised of independent

physicians and pharmacists

(who practice in both retail and

hospital environments) throughout

Arkansas to ensure our formularies

are complete and current. For a drug

to be included in our formulary, the

P&T Committee members consider

(in order of importance) safety and

efficacy, then uniqueness, then

cost. After additional review, our

P&T Committee reaffirmed that

there is no clinical difference between

any of the PPIs.

7

Blue & You Winter 2009


Healthy lifestyle may

reduce Alzheimer’s risk

Based on data from two separate studies, research concludes that

people who follow diets resembling a Mediterranean diet, which is rich in

fruits, vegetables, legumes and healthy fats, and who remain physically

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

does conclude that one of these behaviors may not be enough, and it may

be best to focus on both eating well and staying active.

8

Sources: WebMD and Medline Plus

Let the sunshine in —

for your health!

More and more research is pointing to vitamin D deficiency

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

The American Heart Association found that vitamin D

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

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

in 1993 had three times the risk of developing high

It also occurs naturally in some foods (oily fish, egg

yolks and beef liver) and in fortified dairy and grain products.

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

blood pressure 15 years later.

helps the body use calcium. Extreme vitamin D deficiency

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

people by improving muscle strength. In clinical trials,

and skeletal deformities. But subtle vitamin D deficiency

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

between 700 and 1000 IU per day reduced falls by

across all ages, than once realized.

ment.

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

with the following:

6.3 million children in the United States — almost one

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

vitamin D in their systems. The amount of deficiency • Cognitive impairment in older adults

was even higher in black and Hispanic children.

• Severe asthma in children

A study by Johns Hopkins School of Public Health • Cancer

found that teens with low vitamin D levels were more • Diabetes

likely to have high blood pressure and high blood sugar • Glucose intolerance

and were at greater risk for diabetes and heart disease. • Multiple sclerosis

Blue & You Winter 2009


Treating even mild gestational

diabetes reduces health risks

According to a National Institutes of Health network study, treating even mild gestational

diabetes appears to have advantages for both infant and mother. It was found that

women who received treatment were:

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

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

which the baby’s shoulder becomes stuck during delivery.

• Less likely to deliver by Cesarean.

• Less likely to develop high blood pressure.

Source: National Institutes of Health

Good news,

bad news:

Heart attacks on

the rise in women

9

The bad news is that the heart attack

gap between men and women

is narrowing. A study of more than

8,000 men and women aged 35 to

54 shows that while men still have

more heart attacks, heart attacks

among women is on the rise.

So what’s the good news? The

good news is that while heart

attacks in women are rising, the

risk of death after a heart attack is

improving more for women than for

men under the age of 55.

With heart attacks for women on

the rise, it’s important for

women to know the symptoms.

While some may be similar to those

for men, many, like chest pain, are

not as common for women. So pay

attention to your body and know the

different symptoms:

• Shortness of breath

• Weakness

• Unusual fatigue

• Nausea

• Dizziness

• Lower chest discomfort

• Upper abdominal pressure that

may resemble indigestion

• Back pain

Source: WebMD

Blue & You Winter 2009


Healing

a giving heart

10

Ruben Rodriguez, 58, has a generous and giving

heart. As an associate pastor at Stonewall Community

Church outside the little community of Lafe in Greene

County, Ark., he and his wife Martha help with the

church’s outreach activities, take and teach classes

through Integrity Bible College and share their faith

through music and ministry. But on July 14, Ruben’s

giving heart started giving out.

It started as a pressure in Ruben’s chest while he

was working at his day job at Emerson Electric Co. in

Paragould, but eased off after he took one of the nitroglycerin

tablets he’d been keeping with him since his

first heart attack 12 years earlier. He’d already had three

stents put in the arteries leading to his heart at two

different times, but in the last decade he’d been feeling

pretty good, so good he hadn’t bothered with the cholesterol

medication he was supposed to be taking.

That evening Ruben met Martha at the house and

they discussed going into Paragould for pizza, but he

confessed that he was having some discomfort in his

chest. Ruben tried to reassure Martha that it didn’t hurt

much and it was probably indigestion. The two headed

for Paragould, but instead of getting pizza they went

straight to the emergency room at Arkansas Methodist

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

steadfast response.

Doctors quickly confirmed that Ruben was having

pain associated with a lack of blood to his heart and

sent the two to St. Bernards Medical Center in Jonesboro,

about 25 miles away. Through an agreement

between the two hospitals, heart patients at Arkansas

Methodist Medical Center often are referred to St. Bernards

for their excellent care. That high quality is one

reason St. Bernards has been named a Blue Distinction

Center of Excellence for Cardiac Care by the Blue Cross

and Blue Shield Association.

Blue & You Winter 2009


Blue Distinction Centers of Excellence must meet

He added that Ruben was much like his father in that

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

of physicians, surgeons and other health-care professionals.

When a hospital has been designated a Blue the opportunity to speak Spanish with Dr. Stevenson

the steps needed to get there. And both men enjoyed

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

for opportunities to brush up his skills.

that specialty, that they focus on quality and that they

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

Hospitals provide care differently, and Blue Cross has a cardiac program that has gone to great lengths to be

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

their expertise.

the nation.

If you are looking for a hospital with a Blue Distinction

designation, go to our Web sites and visit our same environment and offer the same technology you

“If you are in our hospital, we want to provide the

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

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

care commensurate with any top cardiac facility.”

In the St. Bernards emergency room, Ruben was

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

begins even before patients get to the operating

pain, but the results from the tests brought some

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

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

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

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

10-year-old pill. He later learned that nitroglycerin tablets

are only good for about six months.

recovery. “It’s a compendium of care across a continuone

is referred to outpatient rehabilitation to continue

Ruben requested

Richard Stevenson, M.D.,

medical director of the

cardiovascular program

at St. Bernards to do the

surgery. For Dr. Stevenson,

the request was an

honor; he had performed

a successful heart surgery

on Ruben’s father, Eusebio

“E.S.” Rodriguez, years

earlier.

“That is the highest

compliment I could have

Ruben and Martha Rodriguez sit in front of flags

received,” Dr. Stevenson representing the countries helped by their church.

said of Ruben’s request.

11

Blue & You Winter 2009


Richard Stevenson, M.D., (also in inset photo) performs surgery at

St. Bernards Medical Center.

12

um of care,” he explained.

Dr. Stevenson said the cardiac care physicians and

hospital leaders have collaborated on training the nurses

in cardiac care. “I’m extremely proud of our heart

care nurses,” he said. “We told them, ‘We will train you

to take care of any complication and manage it until a

doctor can get there.’” The nurses are empowered to

take actions they know will help their patients. “‘No

Fear’ is our motto.”

Dr. Stevenson has a special tie with St. Bernards —

he was born there, back when many of the nurses were

Catholic nuns. He left Jonesboro to pursue his medical

career and ended up at Louisiana State University

Medical Center in Shreveport, La., but found himself

wanting to return to his family and his roots, and to

provide care that could make a difference in Northeast

Arkansas.

The high level of care Dr. Stevenson described is

exactly what qualifies St. Bernards as a Blue Distinction

Center of Excellence. Each Blue Distinction Center

for Cardiac Care must meet stringent clinical criteria

recommended by expert physicians and medical organizations,

including the American College of Cardiology

and the Society of Thoracic Surgeons. Blue Distinction

Centers for Cardiac Care provide a full range of cardiac

care services, including inpatient cardiac care, cardiac

rehabilitation, cardiac catheterization and cardiac surgery

(including coronary artery bypass graft surgery),

and each center is re-evaluated regularly.

The cardiac program at St. Bernards seeks to be

the tertiary care center for the area, only taking cases

when needed. Dr. Stevenson said that when it comes

to working with the other hospitals, the heart surgeons

try to be available. Most of all, Dr. Stevenson said, he

is grateful to St. Bernards for allowing the physicians

to look beyond the scope of what an average hospital

does to truly make it a center of excellence. That

excellence is what brought Ruben Rodriguez to Dr. Ste-

Blue & You Winter 2009


He said he has learned not to ignore the warning signs his body may give

him and to continue on his medications even when he is feeling well.

venson in July, trusting in his skills, St. Bernards and, as

always, God.

Asked if he was concerned at all about the procedure,

Ruben thought back to the moment the hugs

and kisses from family ended and he was being rolled

into the operating room. In that quiet moment, he said,

he reached out to God and

heard, “Fear not, for I am

with you,” and he was at

peace. At the same time,

Martha said she had also put

her faith in God. A gospel

song, “I’ve Been Through

Enough to Know that He’ll

be Enough for Me,” ran

through her mind as Ruben

was wheeled away.

Ruben’s surgery was successful,

and within hours

he was up and walking. He

said the breathing treatments

were painful, but he

knew the more he did them

the easier it would become.

Within the week, Dr. Stevenson

told him, “I take care

of sick people, and you’re

not sick.” Martha cared for

him at home, grateful to be a teacher and be out for the

summer. She and other family members drove Ruben

to Paragould to meet with Dr. Stevenson for his follow

up appointments and rehabilitation.

While the Rodriguez family was very focused

on Ruben’s health, they didn’t have to

worry about his health-care coverage. Ruben’s

insurance was through Blue Cross and Blue

Shield of Alabama, but through BlueCard ® , his medical

care was coordinated between their office and Arkansas

Blue Cross and Blue Shield.

BlueCard is a national program that enables members

of one Blue Plan to obtain health-care services

while traveling or living in another Blue Plan’s service

area. The program links

The Heartcare Center participating health-care

at St. Bernards

Medical Center is a providers with the independent

Blue Plans worldwide

Blue Distinction

Center of

Excellence. through a single electronic

network for claims processing

and reimbursement.

The Alabama Blue Cross

Plan took care of Ruben’s

needs, and Arkansas Blue

Cross made sure the

doctors, specialists and

hospital received the quick

service they needed.

Ruben is back to work

and sharing his faith with

others. He said he has

learned not to ignore the

warning signs his body may

give him and to continue on

his medications even when

he is feeling well. His giving

heart has been given another chance.

Go to Blue & You Online on our Arkansas

Blue Cross and Health Advantage Web sites

for more on our Blue Distinction Centers.

13

Blue & You Winter 2009


SilverSneakers

competition

winner logs more

than 1,000 miles

14

Dorothy Straub on

the stationary bicycle

and in the Rogers

Adult Wellness Center

garden.

Go to Blue & You Online on our Arkansas

Blue Cross and Health Advantage Web sites for

more on SilverSneakers.

Blue & You Winter 2009


Dorothy Straub is a fierce competitor. As the oldest

of six children and the mother of three boys, she

quickly learned to dust herself off and keep going when

faced with a challenge. So when the SilverSneakers ®

100 Miles, 100 Days Challenge kicked off, she said, “I

can do that,” and she did. When her grown sons shared

their doubts that she could log more (1,000 miles in 100

days), she didn’t quit until she had logged 1,145 miles

— winning the statewide contest.

For Dorothy, the contest wasn’t Dorothy

just a race against her buddies retired and joined the

at the Adult Wellness Center Adult Wellness Center,

in Rogers, Ark., it was also a benefit provided to

a way to get her out of the her through Medi-Pak

house after losing her loving Advantage as part of the

husband, Donald Straub, to SilverSneakers

Alzheimer’s disease in April.

Program.

“It’s easy to sit and feel sorry for

yourself, and I did that for awhile,” Dorothy

remembered, but after a few weeks she said she

started looking for things to do — about the same time

flyers showed up at the Wellness Center advertising the

contest. Dorothy decided, “why not,” and proceeded to

log in five miles at a time, several times a day.

After the first month, Dorothy already had logged 300

miles, so she made it her goal to reach 1,000 miles,

putting off a trip to Florida until after the contest, and

working in extra sessions on the stationary bike or on

the track if she had to miss a day.

Lucky for Dorothy, the Adult Wellness Center in

Rogers has state-of-the-art exercise equipment and

a beautiful walking trail that wraps around a waterfall

and fishpond and includes several exercise stations. As

Dorothy got closer and closer to her goal, she realized

that the walking and biking did wonders for her blood

pressure. “It has gone down tremendously,” she said.

Dorothy has used exercise to ease tension for years.

After a whirlwind life, living in more than 10 states and

raising their boys to appreciate the wonders of the

world, Dorothy and Don settled on a 20-acre cattle farm

in Summers, Ark., just miles from the Oklahoma border.

Dorothy worked for the Fayetteville Prosecutor’s Office

and helped Don on the farm, but in 2003 she had to

take time off as Don’s memory became clouded from

the Alzheimer’s. She measured out a small track on

the farm so she could walk and keep an eye on Don.

When Don’s disease progressed to the point where he

needed more care than she could give him at home,

Dorothy moved him to a nursing home and in

2005 went back to work full time, but shifted

her hours so she could leave in the afternoon

to spend the rest of the day with Don, often

walking with him in the park. “It was very

good for him,” she said.

In May 2008, Dorothy retired to spend more

time with Don and joined the Adult Wellness

Center, a benefit provided to her through Medi-Pak

Advantage (PFFS) as part of the SilverSneakers Program.

To enroll in SilverSneakers, Medi-Pak and Medi-

Pak Advantage (PFFS) members can go to a participating

fitness center near them and show their ID card. Fitness

center staff will assist with enrollment and provide

tours of the locations. Because new fitness centers are

being added to the program regularly, members can

go online to silversneakers.com to find all participating

locations in Arkansas.

Even though Don has passed away, Dorothy continues

to visit the nursing home where he stayed because

she has developed so many friendships there. She even

has become a volunteer ombudsman for the home

through the Arkansas Area Agencies on Aging. She still

volunteers one day a week at the prosecutor’s office.

And she still logs her miles on the track and the stationary

bikes at the Adult Wellness Center. Because Dorothy

Straub doesn’t give up.

Healthways, Inc. administers the SilverSneakers Fitness Program for

Arkansas Blue Cross Medi-Pak and Medi-Pak Advantage (PFFS) policyholders.

Healthways, Inc. is an independent company that operates

separately from Arkansas Blue Cross.

15

Blue & You Winter 2009


16

Behavioral health services

now available

Behavioral health referral and management services now are available

to some employer group health plans with Arkansas Blue Cross and

Blue Shield and Health Advantage, and a number of plans administered

by BlueAdvantage Administrators of Arkansas. If you receive a new

ID card with a mental health assistance telephone number, your plan

includes these services.

A customer service staff trained to help with the special requirements

of accessing behavioral health services is available from 7 a.m. to

7 p.m., Monday through Friday, to assist in explaining benefits and available

services, selecting a mental health provider and gaining access to

needed services.

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

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

available to you.)

Please be aware that you have some new responsibilities in order

to make best use of your behavioral health benefits. These responsibilities

are:

• Calling 1-877-801-1159 (or ensuring that your mental health provider

has made the call) for prior authorization of any outpatient mental

health visits after the eighth session.

• Calling the number above (or ensuring that the inpatient facility

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

inpatient stay.

• Check your benefits certificate for full details on any excluded mental

health/substance abuse services.

To find out if your health plan includes modifications for behavioral

health, you can contact your human resources administrator, check our

Web sites and review your benefits information on My Blueprint, or call

the customer service number on your health plan ID card. We love to

hear from you!

Lose

weight

The Healthy

Weigh!

The Healthy Weigh! Education

Program is free for members of Arkansas

Blue Cross and Blue Shield,

Health Advantage, Blue Cross and

Blue Shield Service Benefit Plan

(Federal Employee Program), and

eligible members of BlueAdvantage

Administrators of Arkansas.

To enroll, complete the attached

enrollment form and return it in the

self-addressed, postage-paid envelope

included in this magazine. The

program starts when you enroll.

After enrollment, you will begin

to receive information through the

mail, which you can read in the

privacy of your own home and at

your own pace. The program is

completely voluntary, and you may

leave the program at any time. If

you have further questions about

the program, call the Health Education

Program’s toll-free number at

1-800-686-2609.

Simply complete, sign and return

the attached enrollment form in

the self-addressed, postage-paid

envelope.

Blue & You Winter 2009


Obese women at

greater risks of

giving birth to babies

with heart defects

Women who are overweight or obese

before they become pregnant have approximately

an 18 percent higher chance of having

a baby with certain heart defects as compared

to women who were not overweight while

severely obese women have approximately a

30 percent higher chance — this, according to

a study by the Centers for Disease Control and

Prevention.

The study, which is the largest study ever

conducted in the United States to identify risk

factors for birth defects, found a significant

increase in several types of heart defects in

babies born to overweight or obese women.

Members continue

to receive screening

mammograms as

a wellness benefit

Although the U.S. Preventive

Services Task Force

announced recently that

routine mammograms are

no longer recommended for

women 40 to 49, Arkansas

Blue Cross and Blue Shield

and its wholly owned subsidiary,

Health Advantage, will

continue to cover screening

mammograms as a part of our wellness benefit.

“We understand there is concern among our members

about the new recommendations from the U.S. Preventive

Services Task Force, but we want to assure our members

that we will continue to cover annual screening mammograms

for all Arkansas Blue Cross and Health Advantage

female members age 40 and above who have our wellness

benefit and who have the service performed by an in-network

physician and facility,” said James Adamson, M.D., Arkansas

Blue Cross senior vice president and chief medical officer.

The U.S. Preventive Services Task Force recently reversed

a 2002 recommendation by eliminating the recommendation

for screening for women ages 40 to 49, and increasing the

screening interval to every two years for women 50 to 74.

The American Cancer Society and the American College of

Radiology have expressed significant concerns over the new

recommendations of the U.S. Preventive Services Task Force,

and these two organizations continue to recommend screening

mammography on an annual basis to all women beginning

at age 40. Recommendations vary for those who are considered

at higher risk.

17

Blue & You Winter 2009


Costs Matter:

Developing a

relationship

with your

doctor

18

You might not think about it in financial terms, but

having a good relationship with your primary care physician

(PCP) can save you money. How?

Studies show that people who have a trusting relationship

with their PCP, and regularly go for wellness screenings

and checkups, are less likely to develop chronic

illness later in life. Chronic illness can lead to missed

work, paying for high-priced medications, trips to the

emergency room, inpatient hospital costs and more.

Even if you seldom get sick, it is good to have a relationship

with your doctor. PCPs are trained to

help you prevent health problems. They can point out

choices you may be making today that can affect your

health tomorrow.

Blue & You Winter 2009


Developing the relationship

Communication is a two-way street, but sometimes

it can be hard to start the conversation with your doctor.

According to the Annals of Family Medicine, the

average face-to-face time with a doctor during an appointment

is about 15 minutes. That means you have to

be prepared with your concerns and questions right off

the bat. Writing information down ahead of time, and

bringing a family member with you to write information

down during the visit, can help keep the conversation

on course.

Getting started

As soon as the appointment starts, be sure to tell

your doctor the main reason for your visit, including any

symptoms you are having, or have had recently. Don’t

leave out symptoms that seem unrelated; they may be

important. Keeping a health journal can give a day-today

log of symptoms and be valuable in your diagnosis.

Let your doctor know if your personal life has changed

since you last came in. Did you change jobs? Are you

stressed?

Bring any medications, vitamins and supplements

you may be taking with you, or make a list. Be sure you

include the strength of the medication and how often it

is taken. Let your doctor know of any side effects you

have had from your past or present medications. If you

have any medical records or test results from other

locations, bring them with you.

Ask questions

Ask your doctor if you don’t understand something. If

you don’t, your doctor will think you understand everything

he or she has told you. The following are some

tips on asking your doctor questions during the exam:

• Write down questions before the appointment and

ask them during the exam. Be sure to ask the most

important questions first.

• Bring a family member with you to take notes

and have them write down the answers to

your questions.

• Let the doctor know if you don’t understand

something.

• Tell your doctor if you need more information or

assistance to understand your condition. He or she

may get a physician assistant or nurse to help you.

• If your doctor prescribed a medicine, ask if there are

generics available.

Take it home

Take the following information home:

• Notes taken during the appointment by you or your

family member.

• Written instructions from your doctor.

• Brochures or other educational materials.

Follow up

Make sure to follow any instructions your doctor gave

you during the appointment, like taking medicine, going

for a test or going to an appointment with a specialist.

Contact your doctor:

• If you have questions after the appointment. Ask

to leave a message for the doctor or speak with a

nurse.

• If you start to feel worse or have problems with your

medicine.

• If you haven’t gotten the results of tests.

Source: American Academy of Family Physicians

… the average face-toface

time with a doctor

during an appointment

is about 15 minutes.

That means you have to

be prepared with your

concerns and questions

right off the bat.

19

Blue & You Winter 2009


Senior Moments

with Dr. David

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

Every 70 seconds an American is diagnosed with

Alzheimer’s disease. In the coming years, as the 72 million

baby boomers reach the age of 80 and beyond, the

burden of this illness could single-handedly overwhelm

our health-care system.

There are many myths and misconceptions about

memory loss. The evaluation and care of those who suffer

from memory loss and their families leaves much to

be desired. Most see their primary care physician who,

sadly, if a problem is suspected, prescribes a medication

to treat Alzheimer’s disease instead of directing

them to a specialist. This is the least important component

of the evaluation. If you suspect that you or a

loved one may have a memory problem, it is important

to be seen by a doctor who specializes in memory

disorders.

20

Making the diagnosis

The first step in the evaluation is to confirm that a

memory problem exists. Mild decreases in intellectual

function, often referred to as benign forgetfulness (you

may have difficulty remembering names), is not significant.

In order to diagnose the problem, a person must

have a decline in memory that is of sufficient severity

to interfere with his or her ability to function in the community

or interact with others (work, shop, remember

appointments). Family members may raise concerns

that a loved one is repeating information, seems confused,

cannot accomplish familiar tasks and is obviously

forgetful. The diagnosis is made through extensive

memory testing to determine the extent of the problem

and assist in identifying the cause.

Is it Alzheimer’s disease?

Identifying the cause

The earliest sign of Alzheimer’s disease is loss of

short-term memory. Other causes, such as multiple

strokes or vascular disease, depression and medication

use can lead to different patterns of memory loss. To

confirm the diagnosis, blood tests and imaging studies

of the brain are done. Eighty percent of the time,

the cause is Alzheimer’s disease or multiple small or

larger strokes. In the remainder, a potentially treatable

cause may be found. This includes certain medications,

depression (a common treatable cause of significant

Blue & You Winter 2009


Editor’s Note: David A. Lipschitz, M.D, Ph.D., is nationally

recognized as a leader in the field of geriatrics.

Arkansas Blue Cross and Blue Shield is honored to have

him as a contributor to Blue & You magazine.

sure, depression, sleep problems

or inappropriate medication use can

make memory loss worse. Treating

these conditions can improve health

and slow the rate at which the disease

progresses.

Paying attention to the caregiver

and family education

Taking care of a family member

If you suspect that you

or a loved one may have

a memory problem, it is

important to be seen by a

doctor who specializes in

memory disorders.

forgetfulness), Vitamin B12 deficiency, sleep disorders, delusions, aggressive behavior, agitation and difficulties

Parkinson’s disease and a condition called Normal Pressure

Hydrocephalus in which memory loss is accom-

of health-care providers is critical to optimally deal with

with sleep become common. Having access to a team

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

and bladder incontinence. Identifying and treating these someone with Alzheimer’s disease and their family.

conditions on occasion can lead to dramatic improvements

in memory.

Medications to treat Alzheimer’s

Several drugs have been shown to slow the progression

of memory loss. They include Aricept, Exelon,

Treating conditions that can make memory

loss worse

Reminyl and Namenda. None of these drugs will lead to

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

medical conditions such as diabetes, high blood pres-

considered based on evidence that slowing the progression

of the disease may provide

a number of additional years of independent

life and reduce the need

for placement in a nursing home.

The future

While we do not know the cause

and cannot prevent Alzheimer’s

disease, there is much we can do to

reduce the rate at which the illness

with memory loss is an overwhelming burden. Caregivers,

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

progresses. Living a stress free, heart-healthy lifestyle,

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

of becoming ill and are desperate for help. Understanding

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

years. We also must commit to more research to under-

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

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

medical checkups and spend some time alone.

will be a cure.

21

Treating complications of the disease

As Alzheimer’s progresses to other areas of the

brain, unusual additional symptoms may develop.

Personality changes are common, hallucinations and

Blue & You Winter 2009


Paying for your medications

22

“Why do I pay for some medications

through my insurance

differently?”

If you are on several medications,

you may have noticed that the

claims for some of your medications

may be filed under your medical

benefit, and others may be filed

under your retail pharmacy benefit.

You may even see the same medication

filed differently under both

benefits. Why?

Where did you get it?

The first thing to look at is where

the medication is given. If you

received a medication while in a

hospital or in an outpatient surgical

center, it is included in the allowable

charge for the hospital services. If

you received a medication in your

physician’s office, your payment is

based upon allowable charges under

your medical benefit. That means

you may have to pay toward your

calendar-year deductible and

coinsurance.

If you went to your pharmacy to

receive your medication, how much

you pay is determined by the allowable

charge for the medication and

the type of retail pharmacy benefit

plan you have. When you receive

medications from a retail pharmacy,

you may have to pay a prescription

drug copayment. Finally, if you need

home infusion therapy and you get

it from a designated provider, your

medication is covered under your

medical benefit based upon the allowable

charge for the medication.

How did you get it?

Another situation to consider is

how the medication is administered.

If you can take the medication yourself,

orally or through an injection

under the skin (subcutaneous), it is

filed through your retail pharmacy

benefit, and you pay a copayment.

If your medication must be given

by injection into the muscle, or in

a vein, then it is intended to be

administered only by a health-care

professional, and is considered part

of your medical benefit. If covered,

you may have to pay toward your

calendar-year deductible and

coinsurance.

Your Benefit Certificate lists

self-administered medications as

“A” medications and professionally

administered medications as “B”

medications. If you need to know if

a medication is an “A” or “B” medication

you can contact Customer

Service.

From the

Pharmacist

by Trey Gardner, Pharm D.,

Arkansas Blue Cross and Blue Shield

Blue & You Winter 2009


Medi-Pak and Medi-Pak Advantage (PFFS)

Members: Resolve to Have a Healthy 2010

Happy New Year means resolutions; and in 2010,

Arkansas Blue Cross and Blue Shield will make it easier

for our Medi-Pak and Medi-Pak Advantage (PFFS) members

to keep them — if one of your New Year’s resolutions

is to have a Healthy 2010.

As a Medi-Pak or Medi-Pak Advantage (PFFS) member

you may enroll — or continue your enrollment — in

SilverSneakers ® at no cost to you. As a member of

SilverSneakers, you have access to amenities such

as treadmills, weights and — in some cases — even

heated pools at no additional cost. As a SilverSneakers

member, you can take advantage of all the equipment

and services available with a basic membership at a SilverSneakers

participating fitness center. Many of these

fitness centers also offer the signature SilverSneakers

exercise classes, designed for older adults and taught

by SilverSneakers-certified instructors. Don’t know

which fitness centers in your area participate? Simply

go to the SilverSneakers Web site at silversneakers.

com. The SilverSneakers Web site also offers fabulous

resources such as great new recipes and tools to create

shopping lists and design your own exercise plans.

Another benefit available to both Medi-Pak and

Medi-Pak Advantage (PFFS) members is our online

Personal Health Record. This tool combines information

from your medical claims and information you enter

yourself to provide a clear medical history. By keeping

this record current, it will make visits to your doctor go

more smoothly and efficiently. You simply can hand your

doctor a printout of your Personal Health Record (PHR)

from our Web site at arkansasbluecross.com (you must

register with My Blueprint to access your PHR). And,

speaking of doctor’s visits — don’t forget — as a Medi-

Pak Advantage (PFFS) member, you get an annual exam

with no copayment!

If you are a Medi-Pak Advantage (PFFS) member,

throughout the year, you will receive helpful newsletters

offering sound advice on staying healthy. And if you have

the holiday blues, we have a new depression hotline.

With all of these resources available to you, keeping

your New Year’s resolution of working to maintain your

health should be easier!

If you have questions, we’re here to help. Please call

the appropriate toll-free customer service telephone

number listed below:

Medi-Pak Customer Service

1-800-338-2312

Medi-Pak Advantage (PFFS) Customer Service

1-877-233-7022

If you’re not a Medi-Pak or Medi-Pak Advantage

(PFFS) member but want to learn more, call our licensed,

certified agents toll free at 1-800-392-2583.

You can also use the Medi-Pak Choice Plan Finder on

our Web site at arkansasbluecross.com/MedicarePlans

to help you determine which of our Medi-Pak Choice

products works best for you.

23

Blue & You Winter 2009


Online Health Tools

A healthier life is only keystrokes away with online

health tools available to Arkansas Blue Cross and Blue

Shield and Health Advantage members and eligible

members of BlueAdvantage Administrators of Arkansas

through My Blueprint.

Our online programs can provide support on a variety

of topics, including:

• Getting active

• Healthy eating

• Healthy weight

• Healthy thinking

• Quitting smoking

• Dealing with low back pain

• Sleeping well

To access these programs, go to My Blueprint on

the Arkansas Blue Cross, Health Advantage or BlueAdvantage

Web sites, select HealthConnect Blue, choose

the HealthyLiving tab from the Dialog Center and then

choose a “Healthy Conversation.” The name of these

tools has changed, but the ability to create a plan as

unique as you are has not!

To start a program, all you need to do is answer a

questionnaire about yourself and the way you live,

which takes about 15 minutes. The health-care professionals

will use that information to create a one-of-akind

just plan for you.

24

Blue & You Fitness Challenge

group registration under way

Need help waking from a long

winter’s nap back into the “fit”

of things? Then move from hibernation

to becoming part of the

“hyper”nation with the 2010 Blue

& You Fitness Challenge exercise

contest.

Although spring is months away,

now is the time to plan for the Challenge.

All you have to do get 10 of

your friends together, pick one of

you to sign up your group and keep

up with the details (the group

administrator) and register on blueandyoufitnesschallenge-ark.com.

The Blue & You Fitness Challenge

is an exercise contest that encourages

participants to work toward

the public health recommendation

of adult physical activity 30 minutes

each day, most days of the week.

A total of 167 groups — large and

small — with more than 11,500

participants took part in the 2009

Challenge.

The Web site is live, and there’s

still time to sign up for the contest.

Whether your group has 10 or 1,000

members, you have until January

31 to sign up. Individuals who will

be participating in Challenge groups

will begin registration in February.

Schools, companies and organizations

and others may form teams

within their larger body of participants,

too. Students ages 13 and

older can form teams and challenge

other schools or other teams within

their schools. (Note: Group administrators

must be 18 or older.) All

individuals must be registered on a

team by Feb. 28, 2010.

We will begin exercising on our

virtual tour on March 1. For more

information, call toll free 1-800-686-

2609. You may download a planning

kit in PDF form from the Web site.

Blue & You Winter 2009


The

Doctor’s

Corner

Drinking hot liquids associated

with throat cancer

Smoking and heavy alcohol use

kids about the danger of permanent

hearing loss from excessive noise.

Encourage them to turn down the

by Ray Bredfeldt, M.D.,

Regional Medical Director

Northwest Region, Fayetteville

are both associated with throat

cancer. Now, another risk factor has

been identified — very hot beverag-

music and to use earplugs when

they operate loud machinery such

as lawnmowers.

the shoulders or back from the

backpack.

es. Researchers

recently found

that people

who drink very

hot beverages

increase their risk of developing

throat cancer. The study found that

people who drink tea within two

minutes after boiling were five

times more likely to develop throat

cancer than those who waited four

minutes or more to drink their tea.

Is your child’s backpack

too heavy?

Backpacks, if stuffed

too full, can be so

heavy that they can

cause back pain

and injury. Here

are some warning

signs that your

child’s backpack

is too heavy,

courtesy of

Surfing the Web can keep

your brain young

Surfing the Internet just might be

a way to preserve your mental skills

as you age. A new study suggests

that Internet activity can help keep

older people alert. Researchers

found that older adults who started

browsing the Web experienced

improved brain function after only a

few days.

Have your medical proce-

25

Kids losing hearing from

the U.S. Na-

dures done early!

loud noise exposure

tional Safety

Doctors are just like everyone

Do your kids like loud music or

Council:

else – they get tired after a long day

loud computer games? You may

Your child’s posture changes

at work. A recent study found that

want them to turn it down a notch.

when the backpack is on.

for people undergoing a colonos-

Studies indicate 12 percent or more

Your child has difficulty putting

copy, doctors do a better job of

of children between the ages of 6

the backpack on or taking it off.

finding abnormalities in the morning

and 19 already have suffered some

Your child has pain while the

than in the afternoon. What is true

degree of irreparable hearing loss.

backpack is on.

for colonoscopies may be true for

The major culprit is the loud noise

Your child feels a sensation of

other medical procedures. It makes

they experience listening to music

numbness or tingling while wear-

sense, therefore, to ask for a morn-

using headphones or while driving

ing the backpack.

ing procedure rather than one later

in vehicles. Be sure to talk to your

Your child has red marks on

in the day.

Blue & You Winter 2009


Arkansas Blue Cross

and Blue Shield and

asked if BlueAnn

could be Ethan’s

buddy at Texarkana’s

26

BlueAnn Ewe

makes a Buddy!

BlueAnn Ewe was checking her

e-mail one day and came across

a special request. The e-mail was

from Jenni Smith, who is the

mother of a 2-year-old boy affected

by Down syndrome, a genetic disorder

caused by the presence of too

many chromosomes.

Each year, Texarkana hosts a

National Down Syndrome Society

Buddy Walk ® , and Jenni’s son,

Ethan, asked his mom if BlueAnn

could come and participate. Jenni,

a registered nurse at CHRISTUS

St. Michael, immediately contacted

2009 National

Buddy Walk.

Traci Gatlin, R.N.,

medical affairs

manager, and Hillary

Cross, R.N., regional

case manager from

the Arkansas Blue

Cross Southwest

Regional Office, gladly volunteered

to take BlueAnn to the walk to meet

Ethan. More than 500 people, along

with BlueAnn, walked around Buddy

Ferguson Park on October 31, to help

raise money for families and individuals

affected by Down syndrome.

Mothers of children with Down syndrome

hope the National Buddy Walk

Jenni Smith, R.N.

and her son, Ethan

will help raise awareness about the

condition and build support systems,

both of which last long after the onemile

walk is over.

BlueAnn participated in the walk

and played games that helped raise

$15,000 for those locally born with

Down syndrome.

Ethan Smith was delighted to

have BlueAnn’s support!

BlueAnn goes back to school

Arkansas Blue Cross and Blue Shield’s Southeast

Regional Office in Pine Bluff accompanied

BlueAnn Ewe to the Back-to-School Festival in

McGehee, Ark., on August 24. BlueAnn and Debi

Attwood greeted kids and handed out BlueAnn

coloring books to more than 100 children.

BlueAnn, along with Arkansas Blue Cross’ Central

Regional Office, also attended the first annual

Back-to-School Community Health Fair at Trinity

Worship Center in Conway, Ark., on August 15.

Blue & You Winter 2009


The 2009 Arkansas Blue Cross

JDRF “Walk for a Cure” team

Arkansas Blue Cross raises $10,000 for JDRF

Mark White, president and chief

executive officer for Arkansas Blue

Cross and Blue Shield, was named

the corporate walk chair for the

Greater Arkansas Chapter of the

Juvenile Diabetes Research Foundation

(JDRF). In support of Mark and

JDRF, more than 500 Arkansas Blue

Cross employees joined him at Murray

Park on September 19.

In addition to walking for a

cure, Arkansas Blue Cross hosts

an annual corporate fundraiser to

raise money for JDRF. Our leadership

team in past years has been

dunked, called Bingo and fought obstacles,

all to help juvenile diabetes

research. There only was one thing

they had not done — sing!

This year, our fundraiser theme

was, “Arkansas Blue Cross Idol:

Karaoke for a Cure,” styled after

the No. 1 hit television show,

“American Idol.”

Arkansas Blue Cross executives

agreed to be Idol contestants — but

only if the price was right. Each executive

agreed to sing “karaoke style”

if $1,000 was raised in his or her

name through employee pledges.

The employees of Arkansas Blue

Cross raised more than $10,000

for JDRF!

27

Blue & You Foundation awards $1.5 million in grants

to improve health

The Blue & You Foundation for a

Healthier Arkansas has awarded a

total of $1,574,691 in grants to 33

health improvement programs in

Arkansas.

“Our grants this year went to programs

across the state that address

such issues as obesity, diabetes,

healthy lifestyle choices, medical

care for low-income individuals,

dental health, safety and worksite

wellness,” said Patrick O’Sullivan,

executive director of the Blue & You

Foundation.

Arkansas Blue Cross and Blue

Shield established the Blue & You

Foundation in 2001 as a charitable

foundation to promote better health

in Arkansas. The Blue & You Foundation

awards grants annually to nonprofit

or governmental organizations

and programs that positively affect

the health of Arkansans.

In its eight years of operation, the

Blue & You Foundation has awarded

more than $10 million to 162 health

improvement programs in Arkansas.

The grants awarded for 2010 are:

• American Diabetes Association,

Bentonville ($35,000)

• Area Agency on Aging of Southeast

Arkansas, Pine Bluff ($25,876)

• Arkansas Hunger Relief Alliance,

Little Rock ($110,000)

• Arkansas Mission of Mercy, Sherwood

($50,000)

• Arkansas Quality Foundation,

Little Rock ($43,262)

• Baptist Health Foundation, Little

Rock ($149,940)

• Cedarville Schools, Cedarville

($62,160)

• Chicot Memorial Hospital Foundation,

Lake Village ($60,182)

Grants, continued on Page 29

Blue & You Winter 2009


28

What is a hospitalist?

A hospitalist is a physician whose

primary professional focus is the care

of hospitalized patients, so if you or

someone in your family is ever hospitalized

— there are doctors right there

when you need them to answer your

questions and coordinate hospital

care. These physicians have dedicated

their careers to the care of hospitalized

patients.

In the past, if you were hospitalized,

you could expect to see your primary

care physician (PCP) at the hospital coordinating

all your hospital care. Many

physicians continue to admit their

own patients to the hospital, and this

system works well for them.

Today, however, most PCPs focus

their attention on patients in their clinic

and entrust the care of their hospitalized

patients to the specialist who admitted

the patient (such as a surgeon

or cardiologist) or to the hospitalist.

The hospitalist usually is a general

medicine physician who is trained on

a wide variety of medical problems,

and who takes responsibility for the

patient during the hospitalization. The

hospitalist calls in other doctors as

needed, but primarily is in charge of

the hospitalization and communication

among all the doctors, the patient and

the family.

Hospitalists provide valuable

services by:

• Being available to quickly meet the

needs of hospitalized patients and

by Randal F. Hundley, M.D., FACC

Special Guest Contributor

their families.

• Handling situations quickly by

having an in-depth knowledge of

the hospital and its staff.

• Allowing PCPs to focus on patients

in their clinics.

• Providing a report of the hospitalization

with any treatment

changes to the PCP.

The possible downside of working

with a hospitalist is that he or she

may not know you as well as your

PCP. With thorough communication,

however, this issue can be avoided.

If your care (or a family member’s)

is coordinated by a hospitalist, you

should expect your PCP and the

hospitalist to communicate at the

beginning and end of the hospitalization,

and if any big issues arise. It

is especially important for your PCP

to have all the important information

from the hospitalization.

You can help the process by asking

the hospitalist whether there

has been or will be communication

with your PCP. If unsure, you can

call your physician’s office to be

sure they know that you (or a loved

one) are in the hospital. Although

the hospitalist will be able to obtain

your office records as needed, it is

extremely helpful to hospital admission

staff to give your doctors and

nurses a list of:

Your current medications.

• Any allergies.

Blue & You Winter 2009


• Previous operations and medical

• Know when you will visit with

from the hospital without adequate

conditions.

your PCP and any specialists you

follow-up arrangements, leading to

• All your physicians’ names and

saw in the hospital.

complications at home and readmis-

telephone numbers.

• Know if you need to schedule ap-

sion to the hospital.

• The name and telephone num-

pointments with other providers

At Arkansas Blue Cross and Blue

ber of a family member or other

such as physical therapists.

Shield, experiences with most

contact person.

• Ask that a report of your hospi-

hospitalists have been excellent.

At discharge, several things are

talization, with any changes in

When there has been a problem,

important:

medications or other treatment,

it is often because the patient did

• Have a clear list of all your medi-

be forwarded to your PCP.

not have a PCP before going into

cations. Be sure you understand

Gener-

The hospitalist

the hospital, making it difficult to

which medicines have been

started, stopped or changed, as

well as any instructions on diet

or other issues.

ally, the

hospitalist

will not see

you again

takes responsibility

for the patient

during

hospitalization.

arrange good follow-up care after

hospital discharge. Arkansas Blue

Cross strongly recommends having

a relationship with a PCP before

• Know if you will have home

unless you come back into the

needing to go into the hospital. This

health visits and know when to

expect a visit.

hospital. A recent study showed

that many patients are discharged

is the best way to ensure a smooth

transition from hospital to home.

29

Grants, continued from Page 27

• Crawford-Sebastian Community

Development Council, Fort Smith

($5,032)

• Dallas County Alliance Supporting

Health, Fordyce ($8,805)

• FoodShare and Opportunity Network,

Prescott ($11,250)

• Friendship Community Care, Russellville

($41,528)

• Group Living, Arkadelphia ($4,107)

• Harding University College of

Pharmacy, Searcy ($50,447)

• Harmony Health Clinic, Little Rock

($50,000)

• Helen R. Walton Children’s Enrichment

Center, Bentonville ($58,255)

• Hospice of Texarkana, Texarkana

($11,505)

• Kimmons Junior High and Sutton

Elementary, Fort Smith ($104,860)

• Lawrence Memorial Health Foundation,

Walnut Ridge ($42,270)

• Madison County Health Coalition,

Huntsville ($66,360)

• NEA Clinic Charitable Foundation,

Jonesboro ($30,400)

• North Arkansas Partnership

for Health Education, Harrison

($117,371)

• Northwest Arkansas Free Health

Center, Fayetteville ($50,000)

• Northwest Arkansas Women’s

Resources, Rogers ($49,756)

• Paragould Light, Water and Cable

Employees, Paragould ($17,000)

• Parenting and Childbirth Education

Services, Jonesboro ($33,617)

• Pulaski County Youth Services,

Little Rock ($16,050)

• River City Ministry of Pulaski

County, North Little Rock ($24,000)

• Shepherd’s Hope Neighborhood

Health Clinic, Little Rock ($25,000)

• University of Arkansas at Little

Rock (UALR), Little Rock ($50,100)

• University of Arkansas for Medical

Sciences (UAMS), Little Rock

($34,397)

• University of Arkansas for Medical

Sciences (UAMS), Little Rock

($80,961)

• Van Buren County Schools, Clinton

($55,200)

The Blue & You Foundation

received 94 grant applications requesting

$5.7 million in support.

The Blue & You Foundation will

accept proposals for its next funding

cycle any time between Jan. 1 and

July 15, 2010. For more information,

visit the foundation Web site at

blueandyoufoundationarkansas.org.

The foundation is an independent

licensee of the Blue Cross and Blue

Shield Association and serves the

state of Arkansas. The foundation is

a 501(c)(3) organization.

Blue & You Winter 2009


30

Baldor — Building a lean machine

At Baldor Electric Company, employees are encouraged

to look for innovation — whether it is creating

new products and work processes, finding ways to trim

excess costs, developing and implementing leading

edge information technology or developing and promoting

wellness initiatives. Baldor’s leadership knows

that when everyone contributes, everyone wins. And,

when you want to both lower costs and improve health,

visionary companies like Baldor look to themselves and

their employees to lead the way.

In 2008, Baldor chose to switch all employees nationwide

to one source for the administration of its group

health insurance, and BlueAdvantage Administrators of

Arkansas — a subsidiary of Arkansas Blue Cross and

Blue Shield — was a perfect fit. Baldor, whose world

headquarters is located in Fort Smith, Ark., wanted a

health plan administrator that understood their longterm

objectives around creating a healthy workplace

and had the resources to assist them in creating a

culture of health.

So in early 2009, the Baldor Wellness Council, comprised

of employees from each of

its 22 U.S. locations, was formed

to promote the new “Fit4Life”

wellness program nationwide and

engage all 6,500 employees in

healthier lifestyles. The Fit4Life

program encourages employees to

get involved in workplace wellness

educational activities and initiatives,

while focusing on improving

their overall health and well being.

Martha Carlson, regional executive for the Arkansas

Blue Cross West Central Regional Office in Fort Smith,

started discussing the concept of wellness with Jason

Green, the vice-president of human resources at Baldor,

and Tona Schmidt, the staffing manager and coordinator

A Baldor

employee

gets his

blood pressure

checked during a

health screening.

I think Arkansas Blue

Cross has as much

of a vested interest in

not only the success

of the program but

in the health of our

employees as we do.

of the Baldor Wellness Council.

“Martha helped us understand the resources that

were available to us through our relationship with Arkansas

Blue Cross,” Green said, referring to HealthConnect

Blue, Arkansas Blue Cross’ multi-faceted integrated

health resource that provides a wide variety of tools

for healthy living.

Get Your Motor Running

As a start to their Fit4Life companywide wellness

efforts, Baldor encouraged all employees, not just those

on the company’s insurance plan, to

complete the online Personal Health

Assessment available through

HealthConnect Blue. This was not

an easy accomplishment in an environment

where most employees

work on a production line.

Baldor began the process by

providing onsite biometric screenings

(blood pressure, blood sugar,

cholesterol and weight) for employees

to assess their health. Arkansas Blue Cross

representatives then walked Baldor employees through

the registration process for My Blueprint using onsite

computers and instructed them on how to complete

the Personal Health Assessment. By participating in the

Blue & You Winter 2009


Personal Health Assessments, Baldor will establish a

benchmark on their employee’s current health status.

While individual results are strictly confidential, aggregate

data (overall results combined) can be used to help

the Wellness Council define activities and support the

needs of Baldor employees in the future. Additionally,

after completing the Personal Health Assessment,

each employee received a copy of personalized information

on how they can improve their health and, if

needed, were guided to health education programs provided

by BlueAdvantage to help them care for chronic

conditions.

“Baldor is a great company,” Carlson said. “They

are very focused on treating their team members with

respect and dignity. That certainly shows through the

investment they’ve made in their employee’s health

and wellness. This is a top down initiative with a solid

company wellness team focused on a multi-year wellness

plan. We enjoyed working side by side with Baldor

during these onsite events, and it’s just the beginning.”

“We are working together to make the program successful

and ultimately improve the health of our employees,”

Green said. “I think Arkansas Blue Cross has

as much of a vested interest in not only the success of

the program but in the health of our employees as we

do. So I think that makes a big difference. It isn’t just

another wellness program, it’s our vision for the future.”

We love to hear from you!

May we help? For customer service, please call:

Little Rock Toll-free

Number (501) Number

Medi-Pak members 378-3062 1-800-338-2312

Medi-Pak Advantage members 1-877-233-7022

Medi-Pak Rx members 1-866-390-3369

Arkansas Blue Cross members 378-2010 1-800-238-8379

Pharmacy questions 1-800-863-5561

Specialty Rx Pharmacy questions 1-866-295-2779

Health Advantage members 378-2363 1-800-843-1329

Pharmacy questions 1-800-863-5567

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

Pharmacy questions 1-888-293-3748

State and Public School members 378-2364 1-800-482-8416

Federal Employee members 378-2531 1-800-482-6655

Looking for health or dental insurance? We can help!

For individuals, families

and those age 65 or older 378-2937 1-800-392-2583

For employer groups 378-3070 1-800-421-1112

(Arkansas Blue Cross Group Services, which includes

Health Advantage and BlueAdvantage Administrators

of Arkansas)

Prefer to speak with someone close to home? Regional Office

telephone numbers:

Pine Bluff/Southeast Region 1-800-236-0369

1800 West 73rd St.

Jonesboro/Northeast Region 1-800-299-4124

707 East Matthews Ave.

Hot Springs/South Central Region 1-800-588-5733

100 Greenwood Ave., Suite C

Texarkana/Southwest Region 1-800-470-9621

1710 Arkansas Boulevard

Fayetteville/Northwest Region 1-800-817-7726

516 East Milsap Rd., Suite 103

Fort Smith/West Central Region 1-866-254-9117

3501 Old Greenwood Rd., Suite 5

Little Rock/Central Region 1-800-421-1112

320 West Capitol Ave., Suite 900

31

Go to Blue & You Online on our Arkansas

Blue Cross and Health Advantage Web sites

for more on Baldor’s Fit 4 Life Program.

Web sites:

arkansasbluecross.com

healthadvantage-hmo.com

blueadvantagearkansas.com

blueandyoufoundationarkansas.org

blueannewe-ark.com

Blue & You Winter 2009


32

At Arkansas Blue Cross

and Blue Shield, we are

always looking for new

ways to be "Good for You."

Here are some of our

latest accomplishments.

Information is good for you! Especially information from

your member magazine, Blue & You! That’s why we’ve

created Blue & You Online. It’s an online version of our

magazine with more information about our featured

stories, more photos and links to more information on

plans, products and information to help you better manage

your health and your health plan. Go to our Arkansas

Blue Cross and Blue Shield and Health Advantage

Web sites and enjoy even more information that’s good

for you!

Want to get fit and need a good deal?

We offer both! If you are a member, visit our Web sites

and receive a discount to a fitness center near you! Go

to arkansasbluecross.com or healthadvantage-hmo.com,

select the “Discount Wellness Program” in the Blue &

You Online section or visit the “Members” section and

select the “Member Discount Programs” under the

Popular Links heading. Either way, find a gym, start saving

money and get fit!

Prepare for a Pandemic

Arkansas Blue Cross and Blue Shield wants you to be

prepared during a pandemic or other emergency, so we

have updated a special publication to help you and your

family. “Preparing for a Pandemic,” is available in the

“Members” section of all of our Web sites, or you can

find a link to the publication in the Blue & You Online

section on the home page of the Arkansas Blue Cross

and Health Advantage Web sites.

In Preparing for a Pandemic, you will find:

• Tips on how to avoid spreading germs and how communities

may respond during an emergency.

• Instructions on caring for sick family members and

when to seek medical help.

• Key local and national pandemic resources, how to

access your personal health information, and a place

to assemble critical information about your family.

• Information on how your benefits may change during

a declared pandemic and how to reach us during an

emergency.

Blue & You Winter 2009

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