Blue Health Initiatives 2016-2017 Impact Report

Initiatives
Blue Health
2016-2017 Impact Report

Table of Contents
2
A Message from Virginia Barnes
8
Trailblazers and Healthy Lifestyles Initiatives Map
3
Initiatives Overview
9
Trailblazers Initiatives Impact
4
Pathways Initiatives Map
11
Healthy Lifestyles Initiatives Impact
5
Pathways Initiatives Impact
12
Other Initiatives and Next Steps
1

A Message
from Virginia Barnes
Blue Health Initiatives is about Kansans. It’s about all of
us – coming together – to become a healthier place to
live. For too long, Kansas has ranked near the bottom
of the health charts. This report applauds the work of
the hundreds of Kansans partnering with Blue Cross
and Blue Shield of Kansas to improve the health of their
neighbors and families. Together, we’re investing in our
communities and in doing so, changing our state for
the better.
Since launching Blue Health Initiatives in 2016,
Blue Cross and Blue Shield of Kansas has charged me
with aligning much-needed resources toward sustainable
statewide progress. The effort is designed to support the
development of healthy initiatives that acknowledge the
long-term nature of this work. It will take all of us to see
this through. I hope you’ll join us!
As the Director of Blue Health Initiatives, I am honored
to support the Kansans involved in the initiatives outlined
in this report. I am a Kansan, born and raised, and I am
currently raising my own two children here in Topeka.
The health of our state is as important to me as a mother
and resident as it is to my professional work.
2

Kansans Serving Kansans
Blue Cross and Blue Shield of Kansas
As Kansas’ largest and local health insurer, Blue Cross
and Blue Shield of Kansas (BCBSKS) recognizes its
unique position to work with Kansas communities
to establish and sustain healthy environments and
lifestyles. BCBSKS is committed to helping all Kansans
lead healthier lives and make healthier choices each
day. In an effort to shape a healthier future for Kansas,
BCBSKS launched Blue Health Initiatives in 2016 to
support Kansas communities in developing enduring
solutions for Kansas’ health challenges.
While Blue Health Initiatives may be in the early
implementation stages, BCBSKS’ commitment to a
healthier Kansas is not new. Our focus on a healthier
Kansas has been ingrained since the beginning –
and we’re excited about this next phase of
community progress.
What is Blue Health Initiatives?
The mission of Blue Health Initiatives is to invest in
communities to create sustainable, healthy places where
Kansans live, work and play in ways that improve the
quality of their lives. The project provides the tools and
inspiration needed to holistically improve the health of
Kansas communities.
There are three key pillars that comprise Blue Health
Initiatives. The Pathways Initiatives create
community-wide change through cross-sector
engagement. The Trailblazers Initiatives catalyze change
by piloting innovative solutions to address the unique
needs of our rural state. The Healthy Lifestyles Initiatives
encourage Kansans to Be the Spark toward a healthier
Kansas through programs that promote healthy habits
throughout their lives. These three pillars will transform
Kansas communities in the years to come – and have
already begun to make an impact in the first two years of
funding. This report provides a summary of the activities
that occurred in 2016 and 2017.
For more information about Blue Health Initiatives,
please contact: Virginia Barnes, Director of Blue
Health Initiatives
Email: Virginia.Barnes@bcbsks.com
Phone: (785) 291-8004
Address: Blue Cross and Blue Shield of Kansas,
1133 SW Topeka Boulevard, Topeka, KS 66629
Our History
In Kansas, the Blue tradition of security
and dependability has thrived for over 75
years. In 1942, the company first opened
its doors with just three employees and
eight members.
Our Home
We are Kansans serving Kansans. Today
1,600 employees serve approximately
950,000 Kansans.
Our Initiatives
The Blue Health Initiatives grants are
divided into three pillars: Pathways,
Trailblazers and Healthy Lifestyles.
Our Health
Blue Health Initiatives take a holistic
approach to health by focusing on
improving the policies, systems and
environmental landscapes that shape
our quality of life.
In the future we’ll see
that people are riding
bikes, walking around,
eating healthier –
as their first thought,
not as an afterthought.
Rob Runquist, Lyon County
3

Pathways Initiatives Map
Eight communities funded in Round One (Aug. 1, 2016 – July 31, 2019):
Atchison County, Bourbon County, Crawford County, Franklin County, Hoisington
and northern Barton County, Kearny County, Reno County, Wichita County
Eight communities funded in Round Two (Aug. 1, 2017 – July 31, 2020):
The city of Chanute (in Neosho County), Cowley County, Dickinson County, Geary
County, Harvey County, Lyon County, Northwest Collaborative (Atwood, Bird City,
Colby and St. Francis in Cheyenne, Rawlins and Thomas counties), Seward County
Pathways Initiatives
4

April 11, 2016
Pathways to a Healthy
Kansas RFP released
July 28, 2016
Pathways Round One
Kick-off Event | Grantee
awards ceremony
Pathways
Initiatives Impact
The Pathways Initiatives, also known as Pathways to a
Healthy Kansas, combine evidence-based solutions and
promising practices for improving healthy eating, active
living, and tobacco prevention to make a large impact
across multiple sectors in communities. The initiatives
represent the largest community grant program ever
funded by BCBSKS. The program provides community
coalitions with the tools and resources needed to remove
barriers and engage their communities.
The Big Picture
The World Health Organization defines health as
“a state of complete physical, mental and social
well-being and not merely the absence of disease or
infirmity.” Three risk factors of physical inactivity, poor
nutrition and tobacco-use lead to four of the leading
causes of chronic disease that cause 80 percent of the
deaths in the United States. The Centers for Disease
Control and Prevention data shows that increasing
physical activity, eating healthy and avoiding tobacco
are among the best ways to lower risk for developing
chronic diseases and to live healthier, longer.
Pathways to Success
Grantees are required to generate cross-sector
engagement through each of the following pathways:
• Core Pathway (coordination and planning activities)
• Seven Community Pathways: Community Policy,
Resident/Community Well-being, Food Retail, Health
Care, Restaurants, Schools and Worksites
PATHWAYS to a
HEALTHY
KANSAS
Eligibility & Awards
Each Kansas community has its own identity, with
valuable traditions that contribute to the overall character
of the state. The Pathways framework encourages
community coalitions to identify the strategies that
will work best for their residents while preserving and
enhancing the culture of each of the communities.
Eligible communities were required to:
• Be located in a semi-urban, rural or frontier county
• Have an active coalition or active Community Health
Assessment/Improvement Plan work group
• Illustrate commitment from community leaders
We chose ‘Pathways’ as the
name for this initiative in
recognition of the many paths
that must come together to
make real, sustainable change
in a community. We’re looking
at the big picture.
Virginia Barnes, Director of Blue Health Initiatives
How does Kansas fare in healthy eating, active living and tobacco use?*
41.7%
22.9%
17.2%
82.1%
Do not consume
fruit at least once
per day
Do not consume
vegetables at least
once per day
Currently smoke
cigarettes
Of adults do not participate
in the recommended
physical activity (aerobic
and/or strengthening)
*Source: http://www.kdheks.gov/brfss
5

March 31, 2017
First Implementation Grant
awarded (Bourbon County
walkability/bikeability
assessment)
July 19, 2017
Pathways Round Two
Kick-off Event | Grantee
awards ceremony
Preliminary Impact
The Pathways logic model outlines the short-term,
intermediate, and long-term outcomes anticipated as a
result of this initiative. Below you’ll find the early impact
highlights from communities awarded funding in the first
round of funding (2016-2019).
Atchison County
Established bike share program with stations at the
Visitors Center and YMCA.
Bourbon County
Formally adopted a Food and Farm Council and a
Non-Motorized Transportation plan based on the
completed and approved walkability/bikeability
assessment recommendations.
Crawford County
Key locations identified and funding secured for active
transportation signage to improve safety and awareness
of multi-modal active transportation.
Franklin County
Wellsville School District updated school wellness
policies, converted fountains into water bottle filling
stations, and provided clear water bottles to each student.
Hoisington and northern Barton County
Completed a sidewalk loop around Clara Barton Hospital
and introduced the “Providers Guide It, Walkers Stride It”
monthly walking club led by hospital staff.
Kearny County
Purchased and placing greenhouses in Lakin and Deerfield
Schools, Kearny County Hospital, and identifying locations
in partnership with the City of Deerfield.
Reno County
Secured “Pathways to a Healthy Restaurant Pledge” and
conducted assessment with Cara’s Cafe and Pizzeria.
Wichita County
Implemented Simply Produce in partnership with local
grocery store, Leoti Foods, allowing for bulk orders of
fresh produce and increased accessibility through pick-up
locations and delivery.
364,534
Across all 16 communities,
Pathways is improving access
to healthy lifestyles for 364,534
residents in Kansas (roughly the
same population as Wichita).
Implementation & Support
Grant funding for each community begins with a
coordination grant of $100,000. Additional implementation
and achievement funding becomes available as the
community demonstrates commitment and progress
toward initiative goals.
In addition to grant dollars, communities are provided
with technical assistance for planning, evaluation,
communications and measurement through
partnerships with:
• Community Engagement Institute at Wichita
State University
• jones huyett Partners
• Kansas Health Institute
• Public Health Law Center
• Thrive Allen County
• WorkWell Kansas
Community Feedback*
Respondents observed that grantee
communities are approaching culture change for
health improvement in new ways. Respondents
reported that Pathways catalyzed additional
action to existing efforts. Several recognized that
there has been good progress because it was
thoughtfully designed and the right communities
were selected from the start.
At least half of the community coordinators
stated that they had found success in certain
pathways. A few stated specific ways that
Pathways had helped in their community,
including strengthening the coalition, bringing
resources and momentum, and creating
concrete changes in the community. Others
noted that the technical assistance and
resources have been helpful, that the project is
going better than they expected, and that they
feel accountable for their success.
Respondents indicated that the advisory council has
been a large contributor to the recognition of the
Pathways efforts across Kansas, and that council
members have included BCBSKS as an organization
with a key role in improving community health.
*as submitted in Year One Evaluations
conducted by the Kansas Health Institute
6

Trailblazers and Healthy Lifestyles Initiatives Map
Trailblazers Initiatives
Healthy Lifestyles Initiatives
(statewide)
8

Nov.14, 2016
Initial training for Healthify
with partner organizations in
Shawnee and Douglas Counties
Feb. 23, 2017
One-year Trailblazers
Innovation Grant awarded
to Thrive Allen County
Trailblazers Initiatives Impact
What is Trailblazers?
The Trailblazers Initiatives are designed to drive health care
innovation that addresses the unique needs of Kansas.
In a rural state like Kansas, there are often unique
barriers to health and access to health care that are
not seen in more urban states. Where existing national
solutions may not fit Kansas communities, customized,
research-based solutions are necessary.
Grantees are selected in promising areas where proven
strategies for success do not yet exist. Our partners are
blazing a trail into a healthier future by exploring how to
improve the social determinants of health, increase access
to care, and streamline the coordination of services.
Education
Health and
Health Care
Social
Determinants
of Health
Trailblazers in Allen County
Neighborhood
and Built
Environment
Economic Stability
Social and
Community
Context
Writing the next chapter for a rural turnaround in health
care requires policies and systems to encourage healthy
choices. In Allen County, efforts are focused around
reaching low-income residents and ensuring that healthy
policies are diffused throughout the community.
By reorienting existing work and testing new strategies
to address the ongoing barriers facing the low-income
community, these trailblazers are helping residents to
believe that a healthy lifestyle is possible. Below is a list of
innovative practices being implemented in Allen County:
• Facilitating peer-led support for smoking cessation
among the residents of Iola Housing Authority’s three
complexes. Additionally, new non-smoking policies
were developed to encourage residents to access
cessation resources.
• Analyzing the nutritional value of weekly “Sunday
Soups” hosted by the local Presbyterian church to
identify and propogate healthier practices.
• Increasing housing stability by providing resources
and education to both tenants and landlords by
partnering with the Iola Public Library to offer
community-wide trainings.
Healthify Northeast Kansas Network
The mission of Healthify is to build a world where no
one’s health is hindered by their need.
By sponsoring the Healthify software and sharing
it with partners, BCBSKS is increasing community
organizations’ access to valuable service data. The
project positions BCBSKS as a leader in improving the
social determinants of health and helps communities
paint a clearer picture of their health needs.
The initial focus region for the initiative is Shawnee County
and the surrounding areas. In addition to the cloud-based
data tools referenced above, the partnership also provides
communities with specialized consultants to assist in
understanding the data. From provider behavior to care
coordination trends, the initiative is currently informing
strategies within 34 organizations – many of the essential
providers in Shawnee and Douglas County.
The graph below is a one-year snapshot of the top
service needs of the region, captured by analyzing user
resource searches:
23%
Health
28%
Housing
23%
Food
13%
Transportation
13%
Financial
Support
9

Tonic for Health Partnership
with KU Asthma Team
BCBSKS is partnering with the University of Kansas
Asthma Center to design a pilot to help providers connect
with their asthma patients more effectively between
visits to improve asthma management outcomes. The
KU Asthma team is working with a network of providers
through the KU ECHO program. ECHO creates a virtual
community of learners engaged in collaborative learning
via secure, easy-to-use videoconferencing technology.
Case-based, interactive training sessions help disseminate
best practice guidelines while supporting implementation
of standardized practice protocols for asthma in the
primary care setting. These protocols help reduce variation
in care and improve outcomes for patients experiencing
asthma across the lifespan.
BCSBKS is providing access to the Tonic for Health survey
platform. Tonic allows users to create and edit surveys,
questionnaires, and forms in real time to offer simple
online surveys that can be deployed on an iPad in a clinic
or via email or text to any smartphone or computer. The
system makes patient data available in a variety of reports
and allows for real time alerts when providers receive
actionable information from a patient’s survey results.
In 2018, Kansas providers participating in the KU ECHO
learning network will have the opportunity to participate in
a pilot program that allows them to extend the
best- practice care learning from their ECHO sessions
through the Tonic tool. The KU Asthma Center team,
led by David Burnett, PhD, RRT, AE-C, and Dr. Matthew
Sharpe, has designed asthma control test (ACT) and
asthma quality of life surveys using the Tonic platform
that will allow providers to connect with patients between
visits for more frequent and consistent monitoring of their
asthma. Depending on the results of a series of quick
surveys that will be sent to patients, the providers will be
able to make adjustments to the patient’s asthma action
plan, or make sure the patient is seen at the clinic again if
their asthma is not under control.
This program looks to provide primary care providers,
especially in rural settings, with access to continuing
education and tools that make it easier for them to help
patients manage their health outside the walls of the
provider’s clinic so that Kansans have improved health
outcomes and better quality of life.
10

July 1, 2016
GoNoodle partnership launched
to provide physical activity
resources to Kansas teachers
July 28, 2017
Partnership launched with
Kansas Association for Youth to
engage high school students in
Be the Spark Initiative
Healthy Lifestyles Initiatives Impact
What is Healthy Lifestyles?
Healthy habits are developed early in life and once
established are difficult to change. However, research
shows there is a sharp decline in physical activity starting
in elementary school and continuing through middle and
high school. 28 percent of Kansas youth are getting the
recommended 60 minutes of daily physical activity. This
suggests our social structure may not be supporting
physical activity for youth.
The Healthy Lifestyles Initiatives are working to address
these challenges by providing grants and resources to
inspire healthy behaviors that will endure for a lifetime.
19
year
old
BikeShareICT
60
year
old
New data shows
that the average
American at age
19 is as sedentary
as a 60-year old.
As a program of HealthICT, BikeShareICT is a collaborative
funding partnership between the City of Wichita, BCBSKS
and the Wichita Community Foundation that makes active
transportation available in Wichita.
An initial contribution of $194,000 was provided to
assist with the purchase of bikes and the corresponding
marketing support needed to promote the new bike-share
initiative. The program launched in May 2017 and here are
the preliminary results:
• As of Jan. 25, 2018: 8,155 trips, 4,126 active members
• 21 stations – 20 in downtown Wichita and one at
Sedgwick County Park
• 2nd highest ridership nationwide for Zagster systems
• Avg. age 20-23 years old
• Over 11 million calories burned since May 3, 2017
Be the Spark
In an effort to increase Kansas teens’ awareness of
the importance of leading an active lifestyle, the Be the
Spark Initiative challenges teens to engage their peers
in a healthier lifestyle. A two-year, $150,000 grant was
provided to the Kansas Association of Youth Alumni
Network in 2017 to support the following activities.
• Local Kansas Association for Youth (KAY) clubs
were given tools and resources to promote a
healthy lifestyle. Students were given a “challenge
booklet” and encouraged to share their experiences
with photos and videos online, using the
#BeTheSpark hashtag.
• Clubs have the opportunity to apply for mini-grants
in 2018 to create a project where their peers and
future generations have access to a fun way to
stay physically active. Clubs who completed the
#BeTheSpark challenges will be given preference in
the grant review process.
As of February 2018, 33 KAY clubs submitted a letter
of intent to apply for funding. Grant applications are
due March 15, 2018, and awards will be announced
May 1, 2018.
GoNoodle
GoNoodle’s online movement and mindfulness videos
activate children’s bodies and brains for use at school
and at home. The GoNoodle partnership was launched
in 2016 in 14 Kansas counties. After engaging more
than 55,000 students and 2,700 teachers in the first
year, BCBSKS was proud to expand the program
in 2017 to serve all 103 Kansas counties served by
BCBSKS. As a result, all elementary school teachers
throughout the BCBSKS service area now have free
access to the premium version of GoNoodle, helping
them get students moving while deepening learning
throughout the day. 2016 survey data shows that 97%
of participating teachers observed improvement in
students’ attitude toward physical activity and 96% of
teachers observed improvements in students’ social and
emotional health.
11

Other Initiatives
Maternal Infant Health Coalition
One of the basic indicators of the health of a community
or state is infant mortality (the death of an infant before
one year of age). For this reason, BCBSKS partnered
with Dr. Nikki Keene-Woods and the Maternal Infant
Health Coalition (MIHC) in Sedgwick County in support
of their community-wide work to improve maternal and
infant health outcomes.
MIHC is dedicated to making Sedgwick County the best
place for children to be born and grow. Their mission
is to improve maternal and infant health outcomes in
Sedgwick County by assuring quality preconception and
perinatal care and using data driven, evidence-based
practice and quality improvement processes. A one-year
grant was awarded for $25,000 in 2017 in partnership
with the Wichita State University Foundation, who
served as the fiduciary agent.
Healthy Happy Holidays Flu Shot Campaign
Every year, millions of people get the flu. The good
news is that Kansans can lower their risk by getting the
influenza vaccination. In Fall 2016, BCBSKS partnered
with Dillon’s Pharmacy to offer seasonal influenza
vaccinations to Kansans ages six and over, regardless
of insurance coverage. Flu shots were administered at
57 Dillon’s Pharmacy locations statewide. Additionally,
four one-day winter preparedness clinics were hosted
in Topeka, Junction City, Emporia and Manhattan, in
partnership with WIBW’s Jeremy Goodwin.
Over 10,000 more vaccinations were provided during
this campaign period compared to the same period in
2014, and over 4,000 more than in 2015. Though this
has been a positive partnership, there has also been an
increased awareness of the availability of the vaccination
at pharmacies in the past two years, and numerous other
organizations are now doing similar promotions. For
this reason, BCBSKS directed resources to other health
initiatives in 2017.
Next Steps
When reviewing the 2016-2017 Impact Report, it is clear
that these years were comprised of identifying needs,
establishing new partnerships, and launching new
initiatives. As we look at 2018 and beyond, it is critical
we continue to collect and evaluate the data submitted
through our partners’ reporting – and equally important
that we resist making significant changes to initiatives
that are just beginning to demonstrate success. The
consistent, enduring support of BCBSKS is an important
factor contributing to our community partners’ ability
to develop the long-term solutions needed to improve
health outcomes in Kansas communities.
Even so, there are early lessons that will impact our
strategies moving forward. The alignment of the
initiatives under three pillars – Pathways, Trailblazers,
and Healthy Lifestyles – is an intentional effort to
clarify the mission and tactics of Blue Health Initiatives.
Streamlining will enhance our ability to reach new
audiences and clarify the message.
2018 priorities include increasing visibility of these
initiatives, cross-sharing promising practices across
various sectors and communities, and continuing
to strengthen BCBSKS’ role as a thought leader in
improving the social determinants of health.
The success of Blue Health Initiatives depends on
all of our involvement to improve the places where
Kansans live, work and play. We hope you’ll join us in
improving the quality of life of all Kansans – today and
for future generations!
12

An independent licensee of the Blue Cross Blue Shield Association.