InsideBlue May 2022

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