17.05.2022 Views

InsideBlue May 2022

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

InsideBlue

MAY 2022

A publication for the employees of the Arkansas Blue Cross and Blue Shield family of companies

Leading in

behavioral

health

Whole person,

whole health

page 4

A strong "Foundation"

for behavioral health

page 6

Normalizing our

conversation

page 8


Message from the CEO

You may have seen my vlog in April

about strides that Arkansas Blue Cross

and Blue Shield is taking to address

what I consider to be the biggest

healthcare crisis we are currently

facing: behavioral health.

I use the term behavioral health to

describe both mental health conditions,

such as depression, anxiety, and

trauma, and substance use disorders

caused by overuse of drugs or alcohol.

When we look at the challenges facing

healthcare – access, affordability,

quality, patient experience – behavioral

health is at the center of all these

issues. And its impact is growing.

COVID-19 exposed parts of our

population, our society, and our

healthcare system that were already

vulnerable and amplified them. Most

people who struggled during the

pandemic were struggling before,

and the pandemic has made it worse,

whether it was physical health

conditions, like obesity and chronic

health conditions; unmet social needs;

or health disparities due to geography,

race, or ethnicity.

Curtis Barnett

President and Chief

Executive Officer

2 InsideBlue May


When we look at the challenges facing

healthcare – access, affordability,

quality, patient experience – behavioral

health is at the center of all these

issues. And its impact is growing.

''

The pandemic has been a contributing But this is not just about bad

factor to people’s behavioral health: healthcare statistics getting worse.

• The average share of U.S.

adults reporting symptoms

of anxiety and depression

was 11% in January 2019. In

January 2021 it was 41%. The

highest rates, by far, were

experienced by young adults

between the ages of 18-24.

• More than half of parents

express concern over their

children’s mental well-being.

• One in three high school

students and half of all female

students report persistent

feelings of sadness or

hopelessness.

• Emergency room visits for

attempted suicide have risen

51% for girls.

If someone is depressed, anxious,

or fighting addiction, it’s difficult for

them to take care of other medical

conditions. Behavioral health plays

a significant role in an individual’s

ability to maintain good physical

health, especially with chronic health

conditions like diabetes, asthma,

heart disease, kidney disease and

lung disease. More than 80% of all

healthcare costs can be traced back to

a chronic health condition.

There’s a very personal side to this

issue. I suspect everyone has been

touched by a behavioral health

condition – either personally or through

a family member or close friend.

Individuals and families are suffering

and it’s impacting all aspects of their

lives.

If we’re going to help people live

healthier lives, the kind of lives they

deserve, and impact the rate in which

healthcare costs are growing, we

must make progress on the behavioral

health front.

That’s why we believe that improving

overall health means addressing

people’s physical, behavioral, and social

needs – a whole person approach.

To help accomplish this, Arkansas

Blue Cross is making significant

community and business investments,

and this issue of InsideBlue magazine

highlights our efforts.

I am proud of the direction we are

going, and I hope that after you read

this issue, you will be also.

More than

25%

of U.S. adults experience some

behavioral health disorder, yet

60%

don’t receive care for their

condition in a given year.

The rate is higher for

Millennials, who now make

up our largest generation.

Over

1/3

report having a behavioral

health condition, and

we’re seeing rapid

increases in major

depression and alcohol

and substance use.

The rate of diagnosis of a

behavioral health condition for

communities of color

is about

1/2

the rate in white

communities. This is

due to under-diagnosis

driven principally by

lack of access

and stigma. So,

behavioral health is a

significant health

equity issue

as well.

Suicide is the second

leading cause of death

among people aged

10-34

*Data from

National Allilance

for Mental Illness

May InsideBlue 3


national averages. Our state also has

some of the highest rates of chronic

disease in the nation.

Whole person, whole health

When we think about being well, we

often think about our physical health.

If we are physically sick, we seek a

doctor’s care for a diagnosis. But it’s

equally important to consider wellness

in terms of mental and emotional wellbeing

– our behavioral health.

Arkansas Blue Cross and Blue Shield is

working to provide opportunities for our

members and our communities to access

resources that support their whole health

– physical and behavioral.

Behavioral health and mental health

Behavioral health is an overarching term

to describe the connection between an

individual’s behaviors and the health of

their mind and body. Behavioral health

includes a person’s habits – emotionally,

biologically and behaviorally – that affect

their overall well-being.

Mental health is how people react to

their behaviors and environments that

impact their overall state of being.

Symptoms of mental health issues

include disruptive sleep, eating disorders,

maintaining healthy relationships

and even self-harm. Common mental

disorders include depression and anxiety.

Some mental disorders are more severe,

like bipolar disorder and schizophrenia.

When we have good behavioral health, we

may eat healthier, exercise, abstain or limit

alcohol and go to the doctor for checkups.

Conversely, poor behavioral health

conditions such as addiction, anxiety and

depression can limit healthy behavior and,

if ignored, can worsen our health.

Behavioral health in Arkansas

In Arkansas, rates of depression and

anxiety among adults exceed the

Individuals with chronic health conditions

like diabetes, asthma, heart disease and

lung disease are twice as likely to have

a behavioral health disorder. If someone

is depressed, anxious or dealing with

addiction, it is hard for them to effectively

care for their chronic health condition.

The COVID-19 pandemic has escalated

behavioral health issues in Arkansas.

Impacting these statistics and improving

the quality of life for Arkansans motivated

Arkansas Blue Cross to make a significant

investment in behavioral health.

How Arkansas Blue Cross is helping

Arkansas Blue Cross wants to become

the unquestioned leader for Arkansas

behavioral and whole person care. Our

vision? The best care model, member

experience, quality and cost.

David Jacobsen, vice president Medicaid

Business Development Strategy, is

leading Arkansas Blue Cross’ efforts to

help address behavioral health.

"Like physical health ailments, we have

all faced adverse behavioral health

situations either personally or with

family or friends," David said. “As a

health solutions company, we must

make an impact on behavioral health.

To that end, we are executing a strategy

that is designed to intentionally change

lives for the better by impacting every

touchpoint of the behavioral health

journey toward measurable outcomes.”

From January to June 2019, one in ten adults reported

anxiety or depressive disorder symptoms.

That number has increased to three in ten since May 2020.

4 InsideBlue May


Care managers: Arkansas Blue Cross

already has accredited care managers

to help our members navigate the

healthcare system. We also have

behavioral healthcare managers through

New Directions, our behavioral health

solutions partner. We are considering

dedicated Arkansas Blue Cross co-case

managers for behavioral health whole

person care.

Expanded access to telehealth:

Telehealth can help members access

the care they need when they need it

and reduce the stigma of getting help.

Telehealth can be scheduled quickly,

within one or two days, and sometimes

the same day. We added MDLive and

will be adding digital tools on our

website for anxiety, depression and

substance use.

Health education programs:

When faced with a new or ongoing

health condition like diabetes, chronic

asthma, or pregnancy, the information

can be overwhelming. Our education

programs give information to help our

members understand the link between

physical and behavioral health and find

the best care path for them.

Help Near Home, Powered by

Aunt Bertha: Arkansas Blue Cross

partners with a company called Aunt

Bertha. Aunt Bertha helps our social

workers find local resources that help our

members have healthier lifestyles.

Medical coverage: Arkansas Blue

Cross continues to develop robust

medical coverage to help with

behavioral health support. “I’m proud

of the steps our enterprise continues to

Before the pandemic,

the share of Arkansas adults

with any mental illness

was 20.3% in 2018-2019.

The national share was 19.9%.

From April 28 to May 10, 2021,

2018-2019 April-May 2021

Adults with mental illness

Adults with mental illness

19.9% National Average 30.7% National Average

20.3% Arkansas Average

take," said Bert Price, M.D., our medical

director with a background in psychiatry.

"Members can receive outpatient

psychotherapy, and their practitioners

don’t face complicated paperwork. Also,

covered treatments include medical

interventions for opiate addiction,

Transcranial Magnetic Stimulation

(TMS) treatment for depression, and

Brexanelone infusions to treat severe

symptoms of postpartum depression.

Coverage also includes residential and

inpatient care, and we added codes to

*Data from the Kaiser Family Foundation

35.5% of Arkansas adults reported

anxiety and/or depression disorder

symptoms. That’s higher than the

national average of 30.7% of adults.

35.5%

Arkansas Average

encourage collaborative care, like having

a social worker in primary care offices.”

Provider network: Building on our

existing Patient Centered Medical

Homes (PCMH) and Collaborative

Health Initiatives (CHI), we are

identifying behavioral health providers

to produce the best outcomes,

develop reimbursement models that

reward these providers for those good

outcomes and ensure our members and

physical health providers know about

these quality providers.

How physical, behavioral and environmental health factors intersect:

Depression or anxiety can

cause headaches, weight

gain, trouble sleeping,

muscle pain, and long-term

physical health conditions.

Living in an unsanitary

environment can cause

a risk of infections,

allergies or more

serious long-term

health issues.

A lack of nutritious food

(food insecurity) can

impact childhood physical

and mental health

development, and cause

health issues in adults.

May InsideBlue 5


A strong ‘Foundation’

for behavioral health

In May 2021, the Blue & You Foundation for a Healthier

Arkansas committed $5.29 million to expand behavioral health

resources across our state – the largest one-time investment

the foundation has ever made. The grants went to six Arkansasbased

organizations that are working to improve access to and

awareness of behavioral health programs. The seven grants

work to address behavioral health needs in children and adults

and train future behavioral health professionals.

“Starting the conversation is the first step to ending the

stigma,” said Rebecca Pittillo, executive director of the Blue

& You Foundation, “and finding a behavioral health provider

when and where you need them isn’t always possible. We’re

supporting these services to improve access to behavioral

healthcare services and with the work we are funding to

destigmatize mental health, it should make it easier for people

to speak up and seek the behavioral healthcare they need.”

Supporting children and their families

In Arkansas, the need for childhood behavioral healthcare

ranks higher than anywhere in the country. Behavioral health

conditions in children, like anxiety, depression, or issues

conditions related to childhood trauma, can lead to significant

health problems if not detected and treated early. Two Blue

& You grants specifically focus on early childhood intervention:

The HealthySteps program through Arkansas

Children’s Hospital places behavioral health specialists

in pediatric clinics in Arkansas to help families better

understand and recognize symptoms of behavioral

health conditions in children and connect them to care.

Spring 2022 Update: Arkansas Children’s has hired

clinical social workers to place in selected clinics

and will begin implementing the program in May 2022.

The Arkansas Trauma Resource Initiative for Schools

(TRIS) through UAMS provides resources and

training to school faculty and staff to recognize signs

of childhood trauma and support children and their

families by connecting them with local behavioral

healthcare resources. The program also offers

behavioral health resources and trauma response

consultations to schools during times of crisis.

Spring 2022 Update: The TRIS program has trained

more than 2,000 school personnel and held 44

training sessions in 23 cities. Since August 2021,

15 post-trauma consultations have been held in

schools across the state.

Integrating social workers into primary care settings

In an effort to address the shortage of behavioral health providers

in the state of Arkansas, the Blue & You Foundation created

endowment funds for Arkansas State University, the University

of Arkansas – Fayetteville and the University of Arkansas

– Little Rock to expand their Master of Social Work programs,

specifically to support students in the Master of Social Work

Program who are pursuing internships in a primary care setting.

Arkansas State University Spring 2022 Update:

Two students met the criteria and worked received

scholarships to be placed in medical clinics in

Northeast Arkansas through the spring semester. They

will graduate in May and have opportunities at the

clinics where they worked. They The university hopes

to identify 15 more clinics by the end of May to create

more spaces for student to complete internships in

medical clinics. allow more students to intern.

University of Arkansas - Fayetteville Spring 2022

Update: The university has worked over the last

six months to develop the program with the help

of the Arkansas Behavioral Health Integration

Network. The program has identified the need for

more Marshallese and Spanish-speaking clinicians,

and the endowment will focus on supporting

students with this background who express interest

in working in primary care clinics. Although the

scholarships through the endowment are not

exclusive to this demographic, the university hopes

to see workers in this field expand through the

support of this scholarship.

University of Arkansas – Little Rock Spring 2022

Update: Two students completed internships in

primary care clinics and will graduate in May. The

university is screening additional students for the

scholarship for the fall semester and working with

the Arkansas Blue Cross provider network team to

find clinics that will partner with the program.

6 InsideBlue May


Even when people feel that they may be experiencing

symptoms of a behavioral health condition, they often

don't know where to go to get help. By making these

services available, we're making it easier for people

to access the care they need right from their primary

care provider's office.

– Rebecca Pittillo

Executive Director, Blue & You Foundation For A Healthier Arkansas

Normalizing the Conversation

Removing the stigma attached to seeking behavioral

healthcare and improving accessibility is the third goal of the

Blue & You Foundation behavioral health grants. Arkansas

Blue Cross has developed an awareness campaign around

two organizations focused on improving access to behavioral

healthcare. The campaign helps that are working to remove the

stigma associated with behavioral health conditions that may

prevent people from seeking care.

NAMI Arkansas

The National Alliance on Mental Illness (NAMI) Arkansas

chapter is helping to increase awareness and promote

acceptance of behavioral health conditions and promote

seeking care. With Blue & You support, NAMI Arkansas

is helping high school and college students to establish

campus chapters.

Spring 2022 Update: NAMI Arkansas is working to

reach more schools and providing an outreach toolkit

to students that want to set up NAMI on Campus and

NAMI High School Clubs.

AR ConnectNow

AR ConnectNow immediately connects people with UAMS

Psychiatric Institute clinicians through a 24/7 call center at

800-482-9921. Health insurance isn’t required to use UAMS AR

ConnectNow, and you do not need a referral from a physician.

Spring 2022 Update: Seeking a rebrand that better

demonstrates the accessibility and immediacy of

the service, the organization changed its name from

AR-Connect to AR ConnectNow, and is focusing on

an awareness campaign, funded by the Blue & You

Foundation, which will primarily target students,

faculty, and parents throughout the state.

You can find out more about these programs and more at

normalizetheconversation.com.

The foundation investments

focus on programs that:

• Build life-long health, resiliency and wellbeing

for children and families by activating

early intervention practices and addressing

the drivers of behavioral health conditions.

• Expand the behavioral healthcare workforce

and better integrate behavioral health into

primary care, which will improve access.

• Remove barriers to care, like the longstanding

stigma around receiving

behavioral health treatment.

May InsideBlue 7


Normalizing our conversation

Stress, anxiety, burnout, depression and substance use can be difficult to talk about, but they are more

common than many realize. It’s time to talk about it. It’s time to normalize asking for help and end

emotional health stigma. Several employees offered to share their stories to normalize the conversation.

There's no lion! by Jake Debord // supervisor of Systems Programming for IT Support

In spring 2020, it seemed like I had stress

in all areas of my life, and I felt like I

was becoming unglued. The pandemic

hit, and uncertainty affected everything.

I felt isolated because I’m a social

person and I couldn’t go out or see my

friends as often. My partner Ryan worked

insane hours (including nights) as a

resident physician at Arkansas Children’s

Hospital. Also, I started a massive new

work project called HITRUST. I missed

seeing my colleagues in person – we’re

a bunch of weirdos, and we love each

other for exactly that.

Even good things bring stress. I was

promoted to supervisor in May, so I also

was learning how to be a manager and

how to lead remotely.

Now, I’ve been through things in my life,

and I feel like I’m a strong, intelligent

person who can figure out a lot on my

own. But I knew I needed help.

I decided to contact the Employee

Assistance Program (EAP) because I’d

heard that New Directions offered things

like life coaching. And that I also knew it

was confidential, so I figured why not?

I’m a tech person and trained to be

a troubleshooter. If I can understand

what’s wrong with a system, I can seek

solutions. My therapist was tech support

for my brain. She gave me articles to read

and exercises for my brain, the system I

needed help with.

My therapist said, “Unless a lion is

coming at me from the garage, you

are safe!” My brain and body were

interpreting anxiety as life-or-death. I was

in overdrive and really didn’t need to be.

I’m not exaggerating when I say that I

learned a technique called mindfulness

and changed my life. I learned when my

mind was racing I can remind myself

that there’s no lion! I can relax my

jaw, breathe in and out deeply, and

ask myself, “What do you see right

now? What do you hear? What can you

taste?” Focusing on my senses brought

me out of that state of panic, and I could

return with a clearer mind (and lowered

heart rate).

Through therapy, I realized that I was

using alcohol to relax and unplug but

it wasn't getting at the root problem

for me. I decided to stop drinking

alcohol in February 2021, and my mind

has been clearer.

What’s even better is that I’ve applied

what I’ve learned to help work situations,

and I’ve shared the tools with other

employees.

By sharing my story, I hope that people

will know that deciding to get a little

help is actually a sign of strength. I

want to help reduce the stigma. Oh,

and a “data point:” New Directions

doesn’t give reports to Arkansas Blue

Cross with employees’ names! So if

you’re worried about that – if that’s

what’s standing between you and

calling – please don’t let it.

Surviving life's tidal waves

by Jen Bridgeman // manager of Content

and Communications for Corporate Marketing

In the summer of 2014, I had a convergence of life-altering

events that made my mental health spiral. My parents both

exhibited rapid cognitive decline, and it was clear that my

already rocky marriage was failing. I felt like a tidal wave was

looming over me, just waiting to crash down. I found myself

going to my car to cry for several minutes at a time during the

day while trying to put on a brave face to my coworkers.

I had talked with a counselor years before and remembered

how much it helped. I called the employee assistance program

(EAP) and found a counselor just blocks away from my office.

I immediately had a great connection with Melanie, the

counselor. Through EAP, I was able to get six free visits. It was

clear I would need more, but the copay was manageable.

During my conversations with Melanie, we were able to

identify all the stressors wrapped up in that tidal wave and

talk through how each would impact my life. The amazing

thing was that by identifying my biggest fears, they became

less frightening, and I could plan my next steps and move

forward. By the end of that year, I was divorced, broke and

had full guardianship of my parents. But I was happy.

I learned something so valuable in that process. When you

get hit by life’s tidal waves, sometimes all you can do is

hang on. But when the pain and frustration recedes, you

come to a very special moment; you get to decide what you

pick back up. By choosing what I wanted for myself, I was

able to get my parents into assisted living, pay off my debt,

and find a loving, healthy relationship.

If you are struggling with whether to call EAP, the answer is

yes. If you need a friend to talk about it, I’m here. You don’t

have to feel alone.

8 InsideBlue May


When stress "breaks" your heart

by Jessica Myers // claims specialist III for Blue Advantage National Accounts Adjustments

Last year, I was diagnosed with takotsubo

cardiomyopathy, better known as “broken

heart syndrome.”

The months leading up to a trip to Texas

for my daughter’s regional gymnastics

competition were stressful. In addition to

working full-time, I’d taken on new duties

at church, my daughter’s team practices

three evenings a week, but I had been too

exhausted to be there the last six months.

The day before our trip, my mom fell

at my home and I had to call 911.

Thank goodness she was okay. That

evening, while shopping, I had what

felt like extraordinarily strong muscle

spasms between my shoulder blades.

I pushed myself through the pain and

exhaustion. I got to bed about 1 a.m.

and got up at 5 a.m.

The next day, my husband, daughter and

I headed to Texas and I began to relax.

We went to sleep around 10:30, but at

12:03 a.m., I sat upright in bed flooded

with panic with the urge to jump from

our balcony window.

I called 911 and woke my husband.

When the paramedics took my vitals,

they were normal, but I knew something

wasn’t right. I asked my husband to take

me to the ER. There was some shame

and a feeling of guilt because my

husband didn’t know what to make of

this. I’d never called 911 for a panic

attack and having my daughter see me

like this was unbearable.

Because of COVID restrictions, my

husband and daughter had to leave me

at the ER – and I felt like I was a million

miles away from my home in Benton.

After two EKGs, a heart cath and heart

ultrasound, the doctors determined that

I had takotsubo cardiomyopathy, also

known as “broken heart syndrome.” It’s

pretty rare, but it happens when the heart

muscle becomes suddenly stunned

or weakened. My “ejection fraction” was

a staggering 10-15% of function – heart

transplant status.

I was so scared and alone in that hospital

bed by myself. I was beyond thankful

for the lone ER physician who ran tests

and realized I wasn’t going “crazy.”

Many people who have takotsubo

cardiomyopathy say it began with a panic

attack. Why this is and why I felt like

jumping off that balcony I’ll never know.

I’m not going to sugar coat it – it was

a very tough day. I was able to pull

through because I made my husband and

friends aware I was having a very hard

time. Also, I didn’t want any regrets and

wanted my daughter to have her mother.

I can understand and am sympathetic to

those who couldn’t pull through. I know

how it feels.

After getting help, I was put on

medication and ordered to bed rest.

In two months I improved and was

even able to run half a mile.

No transplant needed.

To this day I still struggle on occasion

with functioning depression and

I just take it a day at a time. I do try and

tell myself that was the lowest I’ve felt,

so I can pull through again and again.

Ready to take the next step?

All of these resources are free and confidential.

New Directions Behavioral Health provides articles, videos, counselors,

career coaches, case managers and more, and also can help with diagnoses such as autism

and substance abuse. Call 877-801-1159 or visit eap.ndbh.com and use code arkbluecross .

UAMS Health AR ConnectNow

psychiatry.uams.edu/clinical-care/arconnectnow

The Arkansas Behavioral Health Call Center

800-482-9921

National Suicide Prevention Lifeline

800 -799-SAFE (7233) or 800-787-3224 (TTY)

National Veterans Crisis Line

800-273-8255, press 1

JustFive self-guided help for learning about

substance abuse justfive.org/newdirections

Substance Abuse Hotline

877-326-2458

May InsideBlue 9


InsideBlue

A publication for the employees of the Arkansas Blue Cross and Blue Shield family of companies

EDITOR: Katie Eisenhower DESIGNER: Ryan Kravitz PHOTOGRAPHERS: Chip Bayer and Cindy Momchilov

CONTRIBUTORS: Curtis Barnett, Jennifer Bridgeman and Rebecca Pittillo

VICE PRESIDENT of CORPORATE MARKETING: Alison Melson

00003.04.01.0222

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!