Physician cost information: now online, see Page 14
Brown, White & Blue: theyâ€™re good for you
New leadership: President/Chief Executive Officer Mark White (left) and Chief Operating Officer Mike Brown
A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies
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.
Customer Service Numbers Individual Health Plans
Little Rock Number (501)
Arkansas Blue Cross and Blue Shield Health insurance plans for individuals and families 378-2010
Toll-free Number Winter 08/09
Arkansas Blue Cross Pharmacy Customer Service 1-800-863-5561 Specialty Rx Pharmacy Customer Service 1-866-295-2779
For information about obtaining coverage, call: Health insurance plans for individuals and families
Individual Health Plans (over 65) Medi-Pak (Medicare supplement) 378-3062
Medi-Pak Rx Membership
Medi-Pak Rx Claims
Medicare (for beneficiaries only):
For information about obtaining coverage, call: Medi-Pak (Medicare supplement) 378-2937
Federal Employee Program (FEP) 378-2531
Government Programs State/Public School Employees
Employer Group Health Plans Arkansas Blue Cross Group Services 378-3070
BlueAdvantage Administrators of Arkansas
Pharmacy Customer Service: Arkansas Blue Cross Health Advantage BlueAdvantage Specialty Rx
1-800-863-5561 1-800-863-5567 1-888-293-3748 1-866-295-2779
Regional Office locations are: Central, Little Rock; Northeast, Jonesboro; Northwest, Fayetteville; South Central, Hot Springs; Southeast, Pine Bluff; Southwest, Texarkana; and West Central, Fort Smith. Customers who live in these regions may contact the regional offices or call the appropriate toll-free telephone numbers above. Regional office locations and telephone numbers are listed on our Web sites. Web sites:
arkansasbluecross.com healthadvantage-hmo.com blueadvantagearkansas.com blueandyoufoundationarkansas.org blueannewe-ark.com
Vice President, Communications and Product Development: Karen Raley Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer: Gio Bruno Photographer: Chip Bayer Contributors: Chip Bayer, Damona Fisher, Kristy Fleming, Jennifer Gordon, Trey Hankins, Heather Iacobacci-Miller, Ryan Kravitz, Kathy Luzietti and Mark Morehead
4 Taking the lead 8 Delivering on the promise … in Arkansas and around the world 10 About to turn 65? 11 SilverSneakers eases pain in the back 12 Tools that are good for you
14 Review quality and cost with the Physician Connection 15 Latest news on diabetes 16 My food came from where? 18 Walking versus running Lose weight The Healthy Weigh! 19 Overweight teen? What parents should know 20 Health Roundup 22 Complications associated with menopause 23 Keep the germs away! 24 Are medical imaging tests safe? 26 What are exclusions on individual & family policies, and why are they necessary? 27 BlueAnn Ewe hits the road 28 Are you ready to get healthy? Good for you! 29 Case managers are on the front lines for you 30 The Doctor’s Corner 31 From the pharmacist: Oral cough and cold medicines for children 32 Dillard named vice president Blue & You Fitness Challenge group registration under way 33 Blue & You Foundation awards $1 million in grants Blue & You Foundation honored for support of respiratory health 34 Is Medi-Pak Advantage right for you? Our technology is good for you 35 Our wellness discounts are good for your pocketbook 36 Good for you Blue & You Winter 2008
Chief Operating Officer Mike Brown (left) and President/ Chief Executive Officer Mark White
taking the lead Blue & You Winter 2008
In these uncertain economic times, Americans are looking for financial stability and strong leadership within the health-care industry — attributes our customers strongly associate with Arkansas Blue Cross and Blue Shield. Strong, stable leadership and experience were two qualifications our board of directors considered in choosing those who would lead our company following the retirements of Chief Executive Officer Robert L. Shoptaw and Chief Operating Officer Sharon Allen. Fortunately, they did not have to look very far. Mark White, former chief financial officer of Arkansas Blue Cross, has taken the helm as president and CEO. Mike Brown, former executive vice president, was named COO. In Mark and Mike, Arkansas Blue Cross customers will find two leaders committed to providing our members with access to safe and affordable health care and to providing health information and support for customers as they make health-care decisions. Mark and Mike came to Arkansas Blue Cross from different backgrounds, yet there are many similarities. Both rose from entry-level positions in our family of companies to the executive level. Both left the company for a period of time to pursue other ventures, but returned when they realized that their passion was working to improve the access to and affordability of health-care services for the people of Arkansas. And both share a vision of what health care should be for Arkansans and a commitment to bring together all the resources at their disposal to move our state in that direction.
Mark White Surrounded by the lush farmland of the Delta, Mark White’s childhood in DeWitt, Ark., taught him to respect the land and the hard-working folks who live there. DeWitt, halfway between Stuttgart and the historic Arkansas Post, is a place where dragonflies dance above fields of rice in the summer and flocks of migrating ducks and geese fill the skies in the fall and winter. In the distance, the rice silos of Stuttgart rise out of the haze like the outline of a great city. It’s an area that has drawn Mark back time and time again, and when he thinks of our members, he thinks of his family and neighbors who have made a living supplying food for the rest of America. Mark joined Arkansas Blue Cross in 1970 as a staff accountant in the Provider Audit and Reimbursement Division. He was fresh out of Hendrix College with a degree in business and economics and quickly rose to division
manager. Still, he felt drawn to the land, and in 1975, he left the company to join a family farming business. During the next several years, Mark actively managed a farming operation raising rice, cotton and soybeans as principal crops. In late 1994, Mark returned to the company serving as a controller for USAble Life, an Arkansas Blue Cross subsidiary. Mark has been married to his wife, Sandy, since 1970. They have three grown children: Kati, Paul and Chris; and a grandchild, Claire. Settling into his new position as CEO, Mark emphasized that while the top two leadership positions at Arkansas Blue Cross have changed, other executive positions have remained the same or have been filled by people within the company who have proven their ability to serve at a higher level. “I have a lot of confidence in our leadership team, in their experience, their commitment and their industry expertise, and I know we can “We will continue to do fulfill or honor the things we do well the promises we have made to our — providing a broad members. “We have a network of physicians wonderful board and hospitals, paying that will continue its strong comclaims quickly and mitment to our accurately, and giving organization, our not-for-profit staexcellent service to our tus and our focus members.” — on the community. Bob Shoptaw Mark White will remain as chairman of the board and will continue to provide guidance and wisdom to the company gained from his long years as an industry leader.” Our members won’t see many, if any, immediate changes, Mark said. “We will continue to do the things we do well — providing a broad network of physicians and hospitals, paying claims quickly and accurately, and giving excellent service to our members. We will continue to work on enhancing our tools, technology and information to provide our members everything they need to make the best choices possible regarding their health care.” leaders, continued on Page 6
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leaders, continued from Page 5
Arkansas Blue Cross recognizes that when our members need care, quality is important, Mark said, which is why we have focused on providing more information on physician and hospital cost and quality through tools like Physician Connection. Our “By 2015, we want new Personal Health Arkansans, and all Record allows members to keep important Americans, to have personal health inforhealthier lives and to mation in one secure and easy to access have improved access location. And our medito effective and affordcal directors and nursing staff operating in able health care.” offices throughout the state continue to improve the valuable health information and support available to our members. Mark said he recognizes the concerns members have around the economy in general and on their ability to pay for the health care they need in particular. Arkansas Blue Cross shares a vision of the future with other Blue plans. “By 2015, we want Arkansans, and all Americans, to have healthier lives and to have improved access to effective and affordable health care. We want to encourage research on care that works, reward providers who deliver high-quality care, provide customers with the information they need to make good health-care decisions, promote healthy lifestyles and work with our government to ensure every American has health coverage.” Within Arkansas Blue Cross, Mark said you can expect to see a continued commitment to provide affordable health insurance products for our Medicare-eligible population. The company is focused on providing the best products possible for the greatest generation and for baby boomers as they age in to Medicare. As always, there will be strong support for our largest customers, like Walmart and the Arkansas State Employees/Public School Employees, he said, without forgetting for a moment that Arkan-
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sas has a number of small businesses and that the needs of these employers and those individuals and families who purchase insurance on their own must always be on our minds. Mark said the Blue & You Foundation for a Healthier Arkansas has been a tremendous asset to the state and will continue to improve the lives of Arkansans through its philanthropy. The Blue & You Foundation awards about $1 million in grants annually to non-profit or governmental organizations and programs that positively affect the health of Arkansans. Overall, the future is bright for Arkansas Blue Cross, and for its members, Mark said. He said the company has a good capital base and a strong investment portfolio and was not damaged by the financial meltdown that hurt so many other companies. “We will remain an independent Blue plan that is not-for-profit, locally governed and Arkansas-based.”
Mike Brown From California to Guam and then to Texas, Mississippi and Louisiana, Mike Brown’s childhood growing up as a Navy brat and later a construction industry family was a blur of new schools and homes. But after beginning high school in Little Rock, Mike spotted “the most beautiful girl in the world.” That was it. He made arrangements to finish high school in Little Rock, and Mike and Patsy now have been married for 41 years. They have two grown children, Greg and Michele, and two grandsons and two granddaughters. Mike attended Arkansas Tech University and earned his bachelor’s degree in business administration from the University of Arkansas at Little Rock. He worked on graduate studies at the University of Central Arkansas and Webster Univer“Our focus is on taking sity. He also completed the Executive Educacare of our members. tion program at the Everyone understands University Of Michigan that, and we’re all sup- Business School. In 1974, Mike was portive of each other.” looking for a job in
mortgage banking, but as he passed by the Arkansas Blue owner and customer is the same. Cross building on Gaines Street in Little Rock he thought Despite the tough economy, Mike said Arkansas Blue he’d stop in. He walked in, filled out an application and got Cross remains strong and has seen substantial growth, an interview immediately. He said he was up front about including the inclusion of some very large companies his qualifications and the pay he expected and received a doing business in Arkansas into our membership. He said call that evening offering a position in the Office Services the strengthening of Arkansas Blue Cross benefits all our Division. It wasn’t until the next day that he realized he members. Continuous growth means continuous improvewould be working in the mailroom. He also discovered ment and efficiency in our service, he added. later the pay he demanded and received was below the In the near future, Mike said, our members will see minimum for the job. an even greater presence of Arkansas Blue Cross around The position allowed him to meet people throughthe state. “We will be offering more for our members out the company and he progressed through our seven regional offices, quickly. Within a short time, he was providing a more customer-accessible “The first test of any assistant manager of the Claims Divicenter for them, and providing outsion, and oversaw the introduction of reach programs like SilverSneakers, program is to ask, ‘is it the first computerized claims system. and educational meetings on senior the right thing to do, Mike took a short break from Arkanliving, diabetes and other subjects to sas Blue Cross to work for Arkansas help our members live better, healthiand is it something we Power & Light, but came back for the er and more productive lives.” can do to improve the family atmosphere and the genuine Mike said that not all of our health focus on our customers. education and support programs are health of our mem“Something that one of the designed to reach large numbers of bers?’ It may only reach claims managers told me that really customers. Many are focused on distinguishes us from the rest is that those facing important decisions a small percentage, we look for reasons to pay claims, not about their health or who may be at the other way around. That really stuck risk. But “the first test of any probut if it gets to the with me. Our focus is on taking care gram is to ask, ‘is it the right thing to right people at the of our members. Everyone underdo, and is it something we can do to stands that, and we’re all supportive improve the health of our members?’ right time, then it is of each other.” It may only reach a small percentage, the right thing to do, Mike has been the executive but if it gets to the right people at the vice president of External Operations right time, then it is the right thing to not just for those since January 2006 and is now the do, not just for those involved, but for involved, but for all chief operating officer. “My job is difall our members.” And doing what’s ferent every day,” Mike said. “I have right for our customers is what Mike our members.” the good fortune to work with indiBrown is all about. vidual customers, providers, employer — Mike Brown groups, independent agents and brokers, and all of the Arkansas Blue Cross family associates.” Arkansas Blue Cross is different in many ways than other insurance companies, Mike said, but one of the biggest differences is that “we don’t have stockholders — our customers are our owners.” For-profit companies are focused on increasing shareholder value. He explained that as a not-for-profit mutual insurance company, we too are focused on increasing value, but in our case, the Blue & You Winter 2008
delivering on the promise …
8 Tom Wise, seated at a fly-tying table in his home study, visits with Rick Lolley, human resources manager for Rheem in Fort Smith (left) as well as David Needham (center) and Sandee Chaddock, both of the West Central Regional Office in Fort Smith. The flytying table, used to make lures for fly-fishing, was a retirement gift from Rheem to Tom.
Sometimes going the extra mile actually means going an extra thousand miles. That’s exactly what Sandee Chaddock, R.N., medical affairs manager for the West Central Regional Office, did one Saturday in June 2008. On Friday, June 20, Tom Wise and seven of his friends headed north in three cars from Fort Smith for a fly-fishing trip in Canada. Though a retired plant manager for Rheem Manufacturing, Tom still works as a consultant for the company. He was ready for a break and a chance to try out some of the flies he ties at home. As a retiree, Tom’s health insurance had switched to Blue Cross Blue Shield of Alabama. Rheem’s active Blue & You Winter 2008
employees are covered by Arkansas Blue Cross and Blue Shield. By early Saturday morning, Tom already had taken his turn at the wheel and was snoozing comfortably in the back seat. They were about 30 miles from their destination when a deer darted into the road, startling the sleepy driver. The car missed the deer but went careening into a boulder. “At first I got out and walked around, but the pain in my back was tremendous. I finally sat in the backseat and pulled on the handle in the roof to take some of the pressure off,” Tom remembered. A friend in one of the other cars left to find help, and other friends tried to make Tom as comfortable as possible. Luckily, the
other passengers in the damaged car only received minor injuries. An hour and a half after the crash, a helicopter came to take Tom to the nearest hospital, but his ordeal was far from over. A few minutes into the flight, the pilot informed Tom that he was out of fuel, and he landed in a field. An ambulance took him the rest of the way to the nearest hospital, where he was stabilized. However, the hospital was too small to treat his injuries. The hospital’s plan was to get Tom to the nearest hospital in the United States, but Tom was insistent; “I’m going home,” he told them. That’s when he called his boss at Rheem who, in turn, contacted their
in Arkansas and around the world human resources manager, Rick Lolley. Rick tried contacting Blue Cross Blue Shield of Alabama but wasn’t able to reach anyone. David Needham was mowing his lawn in Van Buren when he got a call from Rick, who explained the situation and asked if the regional Blue Cross office could help. David quickly called Sandee, who was in the swimming pool at the time. She changed and headed for the office, calling the hospital in Canada when she got there. For Sandee, that was the beginning of what became a mission — to get Tom Wise home. The charge nurse at the Canadian hospital told Sandee that Tom had multiple spinal injuries, several broken ribs and a head contusion. He needed a bigger hospital, and the only air transportation that they could locate would be very expensive. Sandee started calling various air transport companies and found one in Fort Smith that would fly Tom and one of his companions to Sparks Regional Medical Center for much less. Still unable to reach the Alabama Plan, Sandee called and talked to Tom, and they determined that they couldn’t wait any longer. Around 10 p.m., Tom and his friend started their trip back home, arriving at Sparks around 3 a.m. the next day. In the days following that hectic Saturday afternoon, David talked with Sandee and commended her for going the extra mile for Tom. “He’s Blue so he is ours,” she acknowledged, “he lives here and he’s mine and I was going to get him home.” After a few telephone calls, Tom’s trip home from Canada was covered 100 per-
cent by Blue Cross of Alabama. “Sandee is a difference maker, and I saw it in action,” David said of the way she followed Tom’s case, from the initial telephone call to his medical care at Sparks. Amazingly, Tom didn’t need surgery for his injuries but suffered a bout of pneumonia while in the hospital, which set back his recovery a bit. He spent a few days in occupational therapy and then, on Independence Day, was released to finally go home. Tom said Sandee visited him in the hospital and at his home afterward. “Sandee did a fantastic job of taking charge of a complex situation. I’m very impressed with Arkansas Blue Cross,” Tom said. Tom said he is still in pain and has to wear a brace for a while longer, but the worst part of the ordeal is that he didn’t get to go fishing. “I never knew fishing was a contact sport,” he joked.
Editor’s Note: It’s employees like Sandee Chaddock and David Needham who build the Blue brand one customer at a time. Their commitment to Blue members — even when they aren’t covered under our plan — is a moment of truth that will not be forgotten by Tom or Rheem or the others with whom they come in contact ... actually likely will be shared with many others for many years. Sandee was recognized for her extraordinary “putting members first” dedication with the 2008 Sharon Allen Member Satisfaction Award presented to an employee by Arkansas Blue Cross.
(Left to right) David Needham, Tom Wise, Sandee Chaddock and Rick Lolley stand beneath the sign outside of the Rheem factory in Fort Smith.
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about to turn 65?
Every month about 2,335 Arkansans turn 65. If you or a loved one are about to turn 65, then you already are being bombarded with information about Medicare. It used to be that Medicare was pretty straightforward. When you turned 65, you went onto original Medicare, and if you could afford it, you purchased an additional supplement. About six months before your 65th birthday, it’s a good time to start considering your health insurance options. These days, folks who “age in” have several options, which is a good thing. But it can be confusing to choose the best plan for you. If you
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are confused, turn to Arkansas Blue Cross and Blue Shield for help. You’ve trusted us throughout the years, so it only makes sense to trust us now. About six months before your 65th birthday, it’s a good time to start considering your health insurance options. Call
1-800-392-2583 for help. Through our Medi-Pak Plan Finder tool on the Web, you can answer a few simple questions to determine if you need our Medi-Pak supplement, our Medi-Pak Rx Part D prescription
drug plan or Medi-Pak Advantage, our Medicare Advantage Private FeeFor-Service plans. You also can call our internal licensed representatives at 1-800-392-2583 to help you. Or, you can contact a Farm Bureau or independent insurance agent who is licensed to sell Arkansas Blue Cross policies for Medicare-eligible people. If you need help finding an agent, call 1-800-634-6314.
Thelma Wyatt of Batesville thanks the SilverSneakers® Fitness Program every morning. “Before joining SilverSneakers, just getting up out of bed in the morning was a chore,” she said. “My husband would have to help me get up and around,” Thelma remembered. “We would heat damp towels in the microwave and place them on my lower back, then do a stretch exercise that I was taught at rehab. I would even need help with the stretch. As the day progressed, I slowly loosened up and became more mobile.” Then, Thelma joined the SilverSneakers Fitness Program through the White River Medical Center’s
SilverSneakers eases pain in the back Physical Rehab Outpatient Services. “Now, I am up and about with little thought of needing help for my weak back,” she said. “My back is so much stronger. I am not as stiff and have almost no pain.” But that isn’t the only benefit Thelma gets from going to SilverSneakers; she also has diabetes and is insulin dependent. “Going to the SilverSneakers class and watching my diet has helped me lower my blood sugar numbers,” Thelma said. “This all means less pain and suffering for me and fewer trips to the doctor.” Thelma said she is thrilled at the success she has had through SilverSneakers and the new friends she
has through the program. “I appreciate the SilverSneakers program and Arkansas Blue Cross and Blue Shield,” she said. “This program has been such a great help for me!” To enroll in SilverSneakers, MediPak and Medi-Pak Advantage 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.
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tools that are 12 If you are building a house, you need to have a toolbox. To build a better you, you need to have some tools as well. Arkansas Blue Cross and Blue Shield wants you to have the health tools you need, at your fingertips, day and night. That’s why we created My Blueprint, our online selfservice member portal. It’s a toolbox on the Internet!
Personal Health Record Every building project needs a firm foundation and ours starts with the online Personal Health Record (PHR). By combining information provided by you and information available from claims data, we can give doctors a solid base to understand your overall health and consider your potential risks. A PHR can be useful when you: • Have an emergency • Go to a new doctor • Travel out of state Blue & You Winter 2008
• Have a drug interaction • Want to keep up with your children’s immunizations Information in the PHR is available to you and to Arkansas physicians who have been authorized to access the information. In addition, you can grant access to out-of-state physicians. Just as safety comes first in construction, our Care Alerts within the PHR give you a heads up when it’s time to schedule specific preventive health-care services, like mammograms or eye tests for diabetes. Care alerts show up in your PHR when you log in. You can build your PHR by using the PHR Manager to include past medical history. This includes information that may have been under different coverage, family medical history, a social history (educational background, if you smoke, drink),
additional insurance information, advanced directives and emergency contacts. You can opt in or out of the PHR at any time. All doctors have the ability to view the information, unless you choose to opt out of participating in the PHR. You can block individual tests and diagnoses making the information available only to you. All information regarding mental health and sexually transmitted diseases, as well as, other sensitive issues are automatically blocked.
HealthConnect Blue This multi-faceted resource provides a wide variety of tools for you: • Health Tools – The interactive health tools include several calculators to help you figure out your stress level, pregnancy due date, if you have a smoking or drinking problem and keep track of children’s immunizations. The Personal
13 Health Assessment allows you to answer a series of questions about your health and your habits and receive a custom health report that includes a plan of action for
tion of HealthConnect Blue, you can exchange e-mail messages with a Health Coach and receive an answer within 24 hours, usually much sooner. The Health Coach also can provide resources for more information in the That’s why we created Bookmarks section. The health information , section includes access to the Health Crossroads® health deour online self-service cision-support Web site, which features 15 modules on major member portal. It’s a medical conditions, along with bookmarks to allow you to toolbox on the Internet! retrieve information quickly. Health education and commuimproving health (see related arnity resources to help you with a ticle on Page 28). Health tools also chronic illness also are listed. include a symptom diary to help • Healthy Living Support – The you track symptoms and a medicaLifestyle Management Programs tion list that you can print and take are online courses designed to help to your doctor. you learn how to achieve a healthy • Dialog Center – Through this secweight, maintain a healthy diet,
manage stress, prevent and manage back pain, and stop smoking. • Online Health Encyclopedia – Healthwise® Knowledgebase is an easy-to-understand health information encyclopedia containing current, evidence-based and unbiased information on medical conditions, illnesses, treatments and procedures, etc. You can search information by health category and symptoms. You can review the medical tests that may be given for specific conditions. The encyclopedia also includes information on medications and a tool to help you find a support group. Be a better you with tools that are good for you. To access your toolbox, go to arkansasbluecross.com or healthadvantage-hmo.com and log in to My Blueprint.
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review quality and cost with the online Physician Connection Choosing a doctor or hospital that charges high prices doesn’t ensure you will get the best care. And because we care about your health and your pocketbook, we’ve just made choosing a doctor a bit easier. Now members who need help selecting a doctor can check out the “Cost of Care” information available through Physician Connection in the secure member self-service center of the Arkansas Blue Cross and Blue Shield Web site.* A physician’s cost of care information is available in the following specialties: allergy/immunology, cardiology, dermatology, endocrinology, family medicine, gastroenterology, general surgery, internal medicine, neurology, neurosurgery, obstetrics/ gynecology, ophthalmology, otolaryngology, pediatric medicine, pulmonary diseases, and urology. Cost information is rated on a Blue & You Winter 2008
graph from “Lower Cost” to “Higher Cost.” To determine a physician’s costof-care rating, Arkansas Blue Cross and Blue Shield and its family of companies used only the claims filed with us for services performed, ordered or prescribed by the physician and used only those services that are relevant to the physician’s specialty. Some in-network physicians may have declined to allow us to report their cost information and, in those cases, it is noted in Physician Connection. Additionally, if there is not enough claims data to review a physician or their services are so highly specialized that there are no comparable specialists, it also is noted on the Web site. Also, if you want to know more about the quality of care available from one provider specialty group compared to another provider specialty group (for example: internal medicine vs. cardiology), this information
is available for you to review. How do we determine “quality”? There are certain standards of care that medical experts have determined physicians should follow in many — but not all — situations. For example, if you have had a heart attack, in most cases, your cardiologist will be prescribing a “beta blocker” to prevent complications from the heart attack. That’s considered a measure of quality for that physician’s specialty (in this case, cardiology). So, the quality information shows the percentage of time that physicians in that specialty followed recommended care guidelines. Within Physician Connection on our Web sites, members can search for physician cost-of-care information by physician name or specialty. Members may then review “Details” that include cost information, if available, as well as other information such as physician, continued on Page 27
latest news on diabetes Vision loss? Loss of vision is almost twice as common among U.S. adults with diabetes compared to those without diabetes, according to a study published by the Centers for Disease Control and Prevention (CDC). Diabetes can cause vision loss through a complication known as diabetic retinopathy (an eye disease caused by damage to the tiny blood vessels supplying the retina). People with diabetes also have increased rates of glaucoma and cataracts, both of which can lead to vision loss. Experts recommend that people with diabetes have a yearly eye exam to detect eye disorders early when they are most treatable. Controlling
your blood sugar and blood pressure also helps prevent eye complications.
Diabetes becoming more expensive Adults with Type 2 diabetes are receiving increasingly more complex and expensive treatments, according to the Archives of Internal Medicine. These treatments include newer, more costly drugs despite a lack of evidence for the new drugs’ benefits and safety. The new study follows updated treatment advice for Type 2 diabetes. In those recommendations, an expert panel told doctors to use drugs that are known to be effective, and less expensive, first.
Another study adds to the evidence that metformin — an inexpensive generic used reliably for decades — may prevent deaths from heart disease, while the newer, more expensive Avandia didn’t show that benefit.
Blood sugar testing is important — so we want to help you with the cost Arkansas Blue Cross and Blue Shield recognizes the benefits of routine blood sugar testing for people with diabetes, and we encourage our members with diabetes to continue this important activity. For Arkansas Blue Cross members only, we are diabetes, continued on Page 23
If you are a member and have questions about our Diabetes Education Program, call 1-800-686-2609.
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my food came from where? Who knew that going to the nearest grocery store was like going to an international bazaar? Since the U.S. Department of Agriculture (USDA) enacted the new Country of Origin Labeling (COOL) regulations in September, we can tell if our lamb is from New Zealand or if our bananas are from Brazil. This can help if there is an outbreak of food-borne disease. But don’t expect to get a genealogy lesson for everything you put in your mouth. There are some exceptions to the new rules. The COOL rules cover muscle cuts and ground beef, veal, lamb, chicken, goat and pork. Also included are fresh and frozen fruits and vegetables, macadamia nuts, pecans, ginseng and peanuts. The USDA implemented COOL for fish and shellfish in 2004. The COOL rules apply mostly to foods that are not processed. USDA has revised the definition of a processed food to include items that have undergone a physical or chemical change (e.g., cooking, curing, smoking) or have been combined with other foods (mixed vegetables) or food components (e.g., chocolate, breading, tomato sauce). These are excluded from COOL labeling. The COOL rules don’t just affect foods coming into
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the United States; there are specific criteria that must be met before certain foods can proudly bear a “United States Country of Origin” declaration.
Why all the fuss? Since the Tariff Act of 1930, all imported items have been required to state the country of origin, in English. That is why your shirt label may say “Malaysia,” or your pen may have “India” stamped on it. But many food items are shipped by crate, and it was determined at the time that it would be cost prohibitive, and very challenging, to actually label the foods themselves. With today’s technology, however, it isn’t too difficult to put a nontoxic label on each peach in a grocery store or to include the origin on every package of pork. Another reason for COOL is to provide consumers with better transparency about the foods they buy. While many food-borne illnesses have originated right here in the United States (E. coli in spinach from California), others have come from imported foods (salmonella in peppers from Mexico). By labeling foods with a country of origin, it can be easier to trace where suspect food items
were grown. That allows officials with the Centers for Disease Control and Prevention to give clearer instructions to the public when an outbreak of a food-borne illness occurs.
Digesting the facts Here is an outline of how the new rules apply to some everyday food items. Vegetables If you buy a head of lettuce, it should be clearly labeled. If you buy a bag of salad mix, it may state where it was assembled, but it may not clearly state where all the vegetables originated. Peanuts Most Americans buy their nuts roasted or as peanut butter, which excludes them. Whole imported peanuts, however, must be labeled.
By labeling foods with a country of origin, it can be easier to trace where suspect food items were grown. Restaurant food Food service is specifically exempted from the requirements. Frozen produce A bag of peas or a bag of carrots should tell you where they were grown. A bag of peas and carrots is considered processed and will not need to be labeled. Source: U.S. Department of Agriculture
Fruit Retailers will have to disclose where most fresh and frozen fruit was grown. However, mixing a variety of fruit could qualify it as being processed. Pre-sliced produce also must be labeled but dried fruit does not. Fruit juice does not need country of origin labeling.
Pork Retailers have to disclose where muscle cuts of pork and ground pork come from, but the rules exclude pork products such as bacon, lunch meat and sausage. Seafood In general, raw seafood must be labeled, but seafood that has been breaded, cooked, marinated or otherwise processed isnâ€™t included.
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walking versus running 18
So you’re ready to start a fitness routine. You’ve dedicated yourself to fitting 30 to 60 minutes of exercise most days of the week into your hectic schedule. Now what? Should you walk or run? There has been much debate on which one is more beneficial and whether or not running really does burn more calories. Sometimes it’s really about what is right for you and what will keep you the most motivated in your exercise journey. When to walk rather than run: 1. New to exercise? If you’re just starting out, walking is probably the safest choice. Start slowly and increase your speed, adding intensity, as you become more fit. The higher your intensity level, the higher the calorie expenditure. 2. Do you have a history of joint problems or injuries? Take it slower and stick to walking. Walkers, in general, experience fewer injuries than runners. 3. Are you in a time crunch? If you only have 10 minutes here and there, walking can be ideal for you. You can just slip on your walking shoes and take a quick trip around the block two or three times a day without working up a showerBlue & You Winter 2008
causing sweat. The bottom line is this, both walking and running have rewarding health benefits. But, not everyone can run. It’s important to choose the type of exercise most suited to you. Also, remember to consult your physician
if you have any questions or concerns before getting started. Sources: health.ninemsn.com, healthlibrary.com and healthmed. com.
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 selfaddressed, postagepaid envelope.
It is estimated that 14 to 16 percent of adolescents age 12-19 are overweight.
what parents should know. We’ve all heard that there is an obesity epidemic for children and adults in the United States. But what about teenagers? What are the implications of an overweight teen? Being overweight in adolescence can pose serious health risks and should not be overlooked as something a child will grow out of as he/ she hits a growth spurt. Research is beginning to show that being overweight in the teen years carries over into adulthood. In fact, one study has shown that heart disease risks associated with obesity in adolescence increases the likelihood of heart attack in young adults. It is estimated that 14 to 16 percent of adolescents age 12-19 are overweight (National Center for Health Statistics, 2001; National Health and Nutrition Examination
Survey (NHANES), 1999-2002). Some consequences of overweight adolescence include: • Hyperlipidemia, which is a group of disorders characterized by elevated levels of cholesterol, triglycerides and/or low density lipoproteins (LDL) and low levels of high density lipoproteins (HDL). • Glucose intolerance, which is a precursor of diabetes. • High blood pressure. • Sleep apnea, which can lead to health, performance and safety problems. • Type 2 diabetes. • Early onset of sexual maturation in girls and delayed sexual maturation in boys. What can you do to help an adolescent who is overweight? • Make sure that it is not the result
of a medical condition or side effect from medication like corticosteroids. • Encourage physical activity. • Prepare or offer a balanced diet. • Do not purchase sodas. • Teach your teens about portion control. Typically, extra weight on teens is a result of poor eating habits and a sedentary lifestyle. These bad habits can carry over into adulthood, so it’s important to change them early and reduce the risks of serious health problems, both for today and the future. Sources: Centers for Disease Control and Prevention, Medical News Today, webmd.com, Texas Heart Institute Heart Information Center and the Sleep Foundation
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HEALTH ROUNDUP • HEALTH ROUNDUP • HEALTH ROUNDUP • HEALTH ROUNDUP • HEALTH ROUNDUP • HEALTH R
National Children’s Study enters new phase The Arkansas Children’s Hospital Research Unit in Benton County is one of 105 centers throughout the United States that will participate in a long-term study examining the effects of genetics and the home environment (among other factors) on children. The study, funded by the National Institutes of Health, is trying to determine why obesity, cancer and autism are on the rise in children. Study centers will begin recruiting pregnant women
in January with the goal of following more than 100,000 children from before birth until age 21. Throughout the study, mothers and children will complete interviews and questionnaires and provide blood, urine and hair samples. Additional information about the National Children’s Study is available from nationalchildrensstudy.gov. Source: National Institutes of Health
excess weight m increase breast Obesity is not good for anyone, but for women, it poses an additional danger — obesity has been linked to breast cancer. Doctors aren’t sure why this link exists but they are convinced it is there. They are urging women to watch their weight and increase their exercise to
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ROUNDUP • HEALTH ROUNDUP • HEALTH ROUNDUP • HEALTH ROUNDUP • HEALTH ROUNDUP • HEALTH ROUNDUP
tips for controlling high blood pressure Has your doctor told you that your blood pressure is too high? By taking these steps towards a healthier lifestyle, you may be able to control it without medication. 1. Watch your waistline and weight – Men with waists greater than 40 inches and women with waists greater than 35 inches are considered to be at risk of high blood pressure. 2. Get moving – 30 to 60 minutes of exercise most days is recommended. 3. Watch what you eat – Load up on whole grains, fruits, vegetables and low-fat dairy products. 4. Put down the salt shaker – Cut down to 2,400 mg a day or less. 5. Cut happy hour short – Have no more than one drink for women and two drinks for men per day. 6. Avoid nicotine – Take advantage of a smoking cessation program,
and avoid secondhand smoke. 7. Cut the caffeine – Drink no more than two cups of coffee a day. 8. Take a deep breath – Learn to relax and learn breathing exercises. 9. Get to know your doctor – Get regular wellness exams. Sources: mayoclinic.com, webmd.com and prevention.com
may t cancer risk help stave off what is the most common cancer among women, nonmelanoma skin cancer aside. Studies have found that, in general, obesity is linked to cancer. Still other studies have found that women with breast cancer are more likely to live shorter lives and suffer a recurrence of their cancer if they are overweight.
There is good news. Studies have shown that exercise — 30 minutes to 60 minutes a day of moderateto-high intensity physical activity — decreases breast cancer risk. Source: National Institutes of Health
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complications associated with
So you’ve made it through the hot flashes, night sweats and mood swings. You’ve officially reached postmenopausal status. Time to sit back and relax. Not so fast. Post-menopause may come with its own set of issues. The Mayo Clinic lists four complications that may be associated with menopause. While you may not be able to avoid them entirely, adopting and maintaining a healthy lifestyle may greatly reduce your risks for many of these complications. 1. Heart disease. While the risk of heart disease for women goes up even more after menopause, there are ways to reduce your risks: • Don’t smoke; avoid secondhand smoke. • Get regular exercise. • Adopt healthy eating habits Blue & You Winter 2008
by eating more fruits and vegetables, whole grains and low-fat dairy products. 2. Osteoporosis. Osteoporosis is a disease causing bones to weaken and become brittle resulting in loss of bone mass and strength. While there are medications and treatments, you also can: • Get plenty of calcium and vitamin D. The daily recommendations are 1,200-1,500 mg of calcium and 400-800 IU of vitamin D. • Get regular exercise. • Don’t smoke. • Reduce your alcohol intake to no more than one or two drinks per day. 3. Urinary incontinence. A lack of estrogen may lead to weakened bladder control. To reduce your risk:
• Lower your caffeine intake. • Strengthen your pelvic muscles with Kegel exercises. • Maintain a healthy weight, or make a commitment to lose weight if needed. 4. Weight gain. The weight gain may be more of a result of lifestyle and aging factors rather than hormonal changes. Preventing or reversing weight gain does become harder as we age. But the importance of maintaining a healthy weight remains the same as it reduces the risks of heart disease, stroke, type 2 diabetes and even breast cancer. • Increase your activity level. • Lower your calorie intake. Sources: mayoclinic.com and webmd.com
diabetes, continued from Page 15
offering to waive the deductible for blood glucose testing supplies (lancets and testing strips) for members who are currently, or were previously, enrolled in our diabetes education programs. The eligible programs include the Diabetes Education Program (for adults 18 years or older) and the On The Level Youth Diabetes Education Program (for children and adolescents ages 17 and younger). These yearlong education programs provide monthly information through the mail regarding all aspects of diabetes care. If you have not enrolled, you can go online to My Blueprint, access HealthConnect Blue, select the Health Education Programs link and then choose the Diabetes link. Then you can easily download and print the enrollment form, complete it and return it to Arkansas Blue Cross. The deductible for diabetic testing supplies automatically will be waived the month after the form is received. If you have questions, call 1-800-686-2609. Please note: The Diabetes Education Programs of Arkansas Blue Cross are for health education purposes only. We do not offer medical advice or medical services. Always consult your treating physician(s) for any medical advice or services you may need. As a member, you may select providers, services or products. Please check your member benefits for coverage of services. All information furnished by you is kept strictly confidential and only used to provide us with information necessary for participation in these programs.
Always remember to wash your hands because keeping your hands clean is one of the most important ways to avoid getting sick and spreading germs to others. It is best to wash your hands with soap and clean running water for 20 seconds. However, if soap and clean water are not available, use an alcohol-based product.
When should you wash your hands? • • • • • • • •
Before preparing or eating food After going to the bathroom After changing diapers or helping a child in the bathroom Before and after taking care of someone who is sick After blowing your nose, coughing or sneezing After handling an animal or animal waste After handling garbage Before and after treating a cut or wound
Source: National Institutes of Health
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Advancements in medical imaging now allow us to see inside the body in ways we once never dreamed possible. But while these tests provide detailed information, they often expose patients to large amounts of ionizing radiation. Often, these tests are ordered when they may not even be reliable in diagnosing a medical condition or appropriately administered radiation doses. At Arkansas Blue Cross and Blue Shield and its family of companies, your health and safety are our primary concern. Due to the amount of radiation exposure from the overuse of imaging tests, and the unreliability of some testing equipment, Arkansas Blue Cross is taking steps to help ensure our membersâ€™ safety in Blue & You Winter 2008
two ways. First, through educating members about long-term effects of radiation exposure and through prior authorization of certain high-tech imaging procedures to eliminate unnecessary tests, and second, through proper credentialing (verifying standardization) for all freestanding advanced imaging centers in Arkansas before they can be included in our network.
What is your risk? If your doctor suggested an X-ray to determine the cause of pain in your abdomen, you might not think twice about it. But what if he or she suggested 500 X-rays? The fact is, medical imaging uses
different levels of radiation, and some doctors are not even aware of the levels of exposure for each test. The scientific unit of measurement for radiation dose, commonly referred to as effective dose, is the milliSievert (mSv). The International Commission on Radiological Protection recommends limiting the annual radiation dose for the general public to 1 mSv. Yet some medical tests, like a CT scan of the abdomen, have a typical effective dose of 10 mSv. This is the equivalent of 500 chest X-rays. It would take 3.3 years to get the same level of radiation from nature. See the table on the next page for more examples. Obviously, if you are sick, you may need these tests to help diag-
nose the problem. But you should be aware of the amount of radiation you will receive and talk with your doctor about the overall risks. If you have a confusing health problem, you may have various specialists order any number of imaging tests, increasing your radiation exposure each time. The potential long-term effects of repeated high levels of radiation exposure include the increased risk of cancer, genetic defects and birth defects. Radiation experts estimate that an accumulated ionizing radiation dose of 10 mSv will increase the risk of developing cancer or leukemia to 1 in 1000 for adult men. A dose of 100mSv will increase that risk to 1 in 100. Women and children have an even higher risk of developing cancer from ionizing radiation.
Why are we credentialing imaging centers?
societal Commission for the Accreditation (ICA) of Magnetic Resonance Laboratories, the ICA of Nuclear Medicine Laboratories or the ICA of Computed Tomography Laboratories.
What you should do As a patient, you should be aware that: • X-ray, CT, nuclear cardiology studies and PET scans do involve some potential risk of radiation exposure • Multiple examinations increase the risk • You can and should discuss the risk with your physician • Examinations “just to see how things are going” are rarely necessary If your doctor suggests you have an X-ray, PET scan, CT scan, nuclear cardiology study or MRI, you should discuss the risks with him/her. If your doctor directs you to a freestanding imaging center, check with Arkansas Blue Cross to verify that it is within network. Even if the imaging center was in network recently, you still should check its status; freestanding imaging centers had until the end of 2008 to provide proof of credentialing
before they were dropped from the network. Only freestanding imaging centers that have been credentialed by National Imaging Associates, the company Arkansas Blue Cross uses for this safety measure, will be part of an Arkansas Blue Cross provider network. If you go to an imaging center that is not credentialed, the claim may be paid at the out-of-network rate and the check may be sent to you, not the provider. It will be your responsibility to pay the provider, who may bill you for more than the out-ofnetwork amount. To determine if an imaging center is in network, call an Arkansas Blue Cross, Health Advantage or BlueAdvantage Administrators of Arkansas Customer Service representative (numbers are available on Page 3). You also can search the provider directories on our Web sites.
Imaging centers in hospitals Sources: europa.eu.int/comm/enare calibrated and credentialed on a vironment/radprot/118/rp-118-en. regular basis through the Joint Compdf; U.S. Food and Drug Administramission Accreditation of Healthcare tion, AHIP Coverage, National ImagOrganizations (JCAHO). This verifies ing Associates, U.S. Environmental that the equipment has been tested Protection Agency, National Academy and is in compliance with national of Sciences safety standards. However, there has been no national regulation of freestanding imaging centers. Diagnostic Procedure Typical Effective Dose (mSv) Number of Chest X-rays for Equivalent Effective Dose While the risk of overexposure from noncompliant equipChest X-ray (PA film) 0.02 1 ment is small, Arkansas Blue Skull X-ray 0.07 4 Cross determined that credentialLumbar spine 1.3 65 ing was in the best interest of our members to verify that these I.V. urogram 2.5 125 centers have been tested and Upper G.I. exam 3.0 150 are within recommended safety Barium enema 7.0 350 levels (see related information on Page 36). Imaging centers must CT head 2.0 100 be credentialed by the American CT abdomen 10.0 500 College of Radiology, the Inter-
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what are exclusions on individual & family policies, and why are they necessary?
If you’ve ever had health coverage through an employer and then applied for Arkansas Blue Cross and Blue Shield’s individual coverage, you may have been told we were excluding coverage for a particular condition or body part (e.g., the knee you have had surgery on). OK, but the main reason you needed insurance was to cover the condition or body part being excluded! So how does this work? Arkansas Blue Cross wants to provide affordable health insurance to as many Arkansans as possible. Group insurance can cover medical conditions like your knee because you and your employer share the cost of premiums and the risk is spread among all members of the group. Most Arkansans can’t afford that kind of coverage on their own, so we developed less expensive products for individuals. One way we reduce the cost of individual insurance is to underwrite applicants. Underwriting allows us to assess the potential financial risk associated with each applicant. If an applicant is a high risk, we have three options: • Charge a higher premium. • Exclude the condition that has increased the risk. • Decline to offer coverage. We use the first two options when necessary, Blue & You Winter 2008
and decline coverage only as a last resort. Often, the only way we can offer coverage, and still keep the price reasonable, is to exclude a condition. This provides coverage for your other health-care needs, including unexpected accidents or illnesses. The good news is that not all exclusions are permanent. If your child has recurrent ear infections, your child’s ear and mastoids may be excluded. But after two years, if your child has been free of ear infections, you can apply to have that exclusion removed from your insurance policy. For more information about individual and family insurance plans (for those under age 65 and not covered by Medicare), visit arkansasbluecross. com, or call 1-800-3922583 (if you don’t have Arkansas Blue Cross) or 1-800-238-8379 (if you are an Arkansas Blue Cross member).
BlueAnn Ewe hits the road Northeast Regional Office attends FutureFuel picnic with BlueAnn Ewe Arkansas Blue Cross and Blue Shield’s Northeast Regional Office in Jonesboro, accompanied BlueAnn Ewe to the annual FutureFuel company picnic held in Batesville. BlueAnn, the Arkansas Blue Cross health ambassador, greeted the children. There was a band, all sorts of games and activities, a petting zoo and a fish fry.
BlueAnn Ewe visits with the families of employees of FutureFuel Chemical Company of Batesville at their annual company picnic.
BlueAnn attends Red Ribbon Rally and “stomps” against drugs Arkansas Blue Cross and Blue Shield’s Central Region celebrated Red Ribbon Week at the Red Ribbon Rally held in the Little Rock River Market. Red Ribbon Week is the oldest and largest drug prevention campaign in the country. Red Ribbon Week is a campaign for communities and individuals to make a commitment to drug prevention, education and to live drug-free lives. During the Red Ribbon Rally, BlueAnn joined the Parkview Magnet High School Heroes on stage to teach local elementary school children “The BlueAnn Stomp,” a dance and chant about staying drug and smoke free. BlueAnn Ewe greets students as they arrive at the Red Ribbon Rally held in the Little Rock River Market on October 21.
physician, continued from Page 14
physician address, education, etc. For additional information on the cost of health care, you also may want to refer to the Physician Connection Medical Cost Estimator and Price List for Common Medical Procedures. Physician Connection is available exclusively to members and can help members make informed
medical decisions. * If you haven’t already registered for a member selfservice center, visit the home pages of our Web sites — a complete list is on Page 3 — to register for My Blueprint or My Tracker.
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good for you! If you are ready to make a change, take our online
Personal Health Assessment. Are you ready to improve your health but don’t know where to start? Eligible members may take the online Personal Health Assessment (PHA) on the Arkansas Blue Cross and Blue Shield, Health Advantage, and BlueAdvantage Administrators of Arkansas* Web sites. Take the PHA today and get a Personal Action Plan that will tell you the changes you can make that will have the biggest impact on your health. Getting started is easy. The PHA includes: • A simple set of questions to help create a plan of action you can live with in order to improve your health. • A customized Action Plan, based on your answers, that includes an interactive lever that shows you Blue & You Winter 2008
how your health will improve with the actions you take. • A virtual guide to help you through the assessment sections and motivate you to a healthier you! There are health risks you can’t change, such as your family health history. Your PHA Personal Action Plan includes a Wellness Score based on health risks that you can change, your Personal Action Plan also provides you with the three areas of your health where you can make the biggest difference, if you take action. These goals are broken down into three simple steps: Read — Links to specific information in the online Healthwise Knowledgebase® and other nationally recognized health information on the Web that are important to your action plan.
Talk — Resources available for support including Health Coaches and case managers. Do — Specific actions you can take to start making healthy changes today. Remember, your goals are based on your answers to the assessment questions and the changes you indicate that you are ready to make. If you are ready to make a change, we have the resources to help! To create your own PHA, go to one of our Web sites (see Page 3 for list), log in to My Blueprint, our member online self-service center, select HealthConnect Blue, and then select Health Tools. It’s easy, free and it could change your life! * The BlueAdvantage PHA is available to eligible BlueAdvantage groups only.
are on the front lines for you
Whether it’s on the telephone or by your bedside, Arkansas Blue Cross and Blue Shield’s case managers are there for you and your family when you need them the most to help you best manage your health plan benefits and ensure you get the resources you need to recover from a serious illness or injury. “When you are sick or injured, you may see dozens of doctors and specialists. If I’m assigned to you as a case manager, I work with you and your family until everything is resolved,” said Sheila Bulloch, a case manager for the Arkansas Blue Cross Central Regional Office. “Case managers don’t offer medical advice, but we do act as an advocate for you to provide information on the resources available to help you recover. We’re someone who knows about you and we can look at the big picture and see not only what your medical needs are, but how your health plan benefits can cover those needs.” In order to have the expertise required, case managers for Arkansas Blue Cross must be registered nurses and certified case managers, which requires completing 80 hours of continuing education every five years. Sheila said the training is important, because it “keeps us fresh and gives us new ideas on how to help our members.” To assist with the continuing education case managers need, Arkansas Blue Cross sponsors a conference for them each year. Since case managers are on the “front lines” when it comes to our members, it was fitting
Kathleen Moreo uses the M*A*S*H theme as an opportunity to honor members of the Arkansas Army and Air National Guard. Moreo spoke at the conference about assuming the role of a “wellness case manager.”
that this year that the Arkansas Blue Cross 10th Annual Case Manager’s Conference had a M*A*S*H theme. The acronym for case managers, however, stood for “Mindset, Assuming the role, Shaping up and Healthy eating & Humor.” More than 330 people registered for this year’s conference, the highest total ever. Arkansas Blue Cross case managers were encouraged to invite case managers in the community from hospitals, home-care agencies and doctors’ offices they work with on a daily basis to attend. Case managers received six continuing education units for attending the conference. This year’s conference featured an impressive lineup of speakers, starting with David A. Lipschitz, M.D., Ph.D. “Dr. David,” as he is called, is among the world’s most renowned geriatricians, and his message to conference-goers emphasized their role in the future. “The single most important
individual, as we prepare for the future, is the case manager,” he said. “Half of 85 year olds are dependent either because of a physical disability or memory loss. In 20 years, I’ll turn 85. And when I reach 85 there is a 50 percent chance that I won’t be able to live by myself. Everything you talk about today should be focused on reducing dependency.” Other speakers included: • Kathleen Moreo, RN. With more than 25 years of experience in the health-care industry, Kathleen urged case managers to assume the role of “health educator.” • Zonya Foco, RD. A best-selling author, television host and nutrition speaker, Zonya demonstrated the benefits of establishing just “one good habit.” • Bobbie Staten, RN. A nationally known motivational speaker, Bobby used her warm-hearted humor to look at the situations facing case managers.
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Wanna lose weight? Write it down!
If you write down everything you eat and use a calorie counter to calculate your calorie intake, new research shows that you will consume fewer calories. Studies show that people underestimate the number of calories they eat each day, so writing it down keeps you honest. Here’s a quiz: From the Starbucks menu, which of the following has the fewest calories and least amount of fat? A) Blueberry muffin B) Zucchini walnut muffin C) Baked apple fritter D) Cheese Danish If you guessed the zucchini muffin or the baked fritter, you might want to buy a calorie counter. Actually, the cheese Danish is the “healthiest” choice and has half the calories and fat of the other items.
Do you really want to retire early? Early retirement might not be so good for your health, according to a
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new study. It found that early retirees live shorter life spans than later retirees. People who retire before age 55 died at the youngest average age followed by people retiring between ages 55 and 64. Retirement at age 65 or older resulted in the longest life span. However, younger retirees might be in worse health than later retirees. For people who retire early, remember it’s important to remain active and to live a healthy lifestyle.
Vitamin D is good for you! Vitamin D has long been touted as good for strong bones, but more recently, research has shown that it’s important to your overall health. So, how do you get vitamin D? Sunlight is the most important source of this vitamin. Light waves from the sun convert a type of cholesterol in the skin to vitamin D. Unfortunately, most Americans do not get enough vitamin D from sun exposure, and low levels of vitamin D increase the risk for several diseases including: heart disease, stroke, diabetes, high blood pressure, migraine headaches and several types of cancer (including breast and prostate). The recommended daily allowance (RDA) for vitamin D is 400 IU
by Ray Bredfeldt, M.D. Regional Medical Director Northwest Region, Fayetteville (international units) for children. For adults, the RDA is 200 IU until age 50, 400 IU from age 51 to 70, and 600 IU after age 70. Most multi-vitamin supplements contain 400 IU.
Heart bypass or heart stents? When someone has blocked arteries in their heart, they usually are treated either with heart surgery or heart stents. Stents are a less invasive procedure using small tubes (stents) to help blood flow through the arteries. According to a recent study in the New England Journal of Medicine, heart bypass surgery — for people with blockage in more than one vessel — appears to give better long-term results than stents. The study found that people who receive the surgery were 20 to 30 percent less likely to die within 18 months of treatment. This does not mean that everyone with blockage should have bypass surgery. However, it does suggest that anyone undergoing a cardiac procedure for blockage of the arteries should understand their options so they can make a fully informed decision.
From the Pharmacist: oral cough and cold medicines for children You may have heard or read something recently about upcoming changes to the packaging of pediatric cough and cold medications. Overthe-counter (OTC) medicine makers have voluntarily begun transitioning labels on oral OTC children’s cough and cold medicines during the 20082009 cough and cold season. The changes will address rare, but serious events related to misuse of these medicines. According to the U.S. Food and Drug Administration (FDA), the changes to the product labeling will not affect the availability of the medicines, but this voluntary action will result in a transition period where the instructions for children’s use on some OTC cough and cold medicines will be different from others. The FDA does not typically request removal of OTC products with previous labeling from the shelves during a voluntary label change such as this one. Therefore, some medicines will have the new recommendation “do not use” for children under four years of age, while others will instruct that they not be used for children under two years of age. If parents or caregivers have purchased a product that does not have the new labeling, the FDA recommends they continue to follow the dosage instructions and warnings on the label that accompanies the medication. They should not, under any circumstances, give adult medications to children. If parents
by Trey Gardner, Pharm D. Arkansas Blue Cross and Blue Shield
or caregivers have questions, or are unsure about how to use a product, they should consult their pharmacist or doctor. It is a big responsibility for a parent to take charge of their child’s health, but it does not have to be a difficult one. The following tips from OTCsafety.org can guide you when giving your child OTC medicines: Some medicines will have the new recommendation “do not use” for children under four years of age, while others will instruct that they not be used for children under two years of age. • Always read and follow the label. • Always give the recommended dose and use the correct measuring device. Never use longer than the label instructs or at a higher dose, unless your doctor specifically tells you to do so. • Only use the medicine that treats your child’s specific symptoms. • Never give two medicines with any of the same active ingredients. • Never use cough, cold or allergy medicines to sedate your child.
• Never give aspirin-containing products to children and adolescents for cold or flu symptoms unless told to do so by a doctor. • Do not use oral cough and cold medicines in children under two. • Do not give a child any medicine only intended for adults. • Contact your doctor immediately if your child develops any side effects or reactions that concern you. • Keep all medicines out of your child’s reach and sight. • Consult a doctor, pharmacist or other health-care provider with any questions. Sources: U.S. Food and Drug Administration (fda.gov), Consumer Healthcare Products Association (OTCsafety.org).
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Dillard named vice president Gray Dillard has been named vice president of Financial Services for Arkansas Blue Cross and Blue Shield. Dillard assumed the role of vice president from Steve Short who recently was named senior vice president and chief financial officer. “This promotion is another step in the company’s ongoing governance and leadership planning for the company,” said Bob Shoptaw, recently retired CEO of Arkansas Blue Cross. “Gray has been with the Arkansas Blue Cross family of companies for many years now, learning all aspects of the business, and has grown to be a capable and skillful leader.” Dillard joined the company through HMO Arkansas in March 1994 as a senior accountant, prior to its merger with Health Advantage, and was named controller of HMO Partners in 2000. Since 2005, Dillard has served as the regional executive of the South Central Regional
Office in Hot Springs. A native of North Little Rock, Dillard is a graduate of North Little Rock Ole Main High School and received his bachelor’s degree from Harding University in Searcy. He is a certified public accountant. He recently completed the Leadership Hot Springs Program and was a member of the Hot Springs Fifty for the Future.
Blue &You Fitness Challenge group registration under way Now’s the time to prepare for the 2009 Blue & You Fitness Challenge contest and get ready to have fun and get fit for the new year! The preparation already is under way at blueandyoufitnesschallenge-ark.com. Group administrators have started preliminary work by creating the group structure for 2009 competitors. The Web site is live, and there’s still time to sign up for the contest. A group administrator is needed to be the contact for your group of 10, 1,000 or more, and you have until January 31 to sign up a group. Then, individuals who will be participating in Challenge groups will begin registration in February.
New for the 2009 contest A team feature is available that allows a group to form both locations and teams within their group. Also, participants now can join the contest at age 13. That means that schools, companies and organizations and others may form teams within their larger body of participants, so they can compete internally and track their progress. It also means that students aged 13 and older can form teams and challenge other schools or other Blue & You Winter 2008
teams within their schools. (Note: group administrators must be age 18 or older for any team to form.) All individuals must be registered on a team by Feb. 28, 2009. We will begin exercising on our virtual tour on March 1, traveling across America the beautiful. 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 114 groups – large and small — with more than 10,600 participants took part in the 2008 Challenge. There will be several categories for group size again in 2009. There is a Quick Reference Guide available to help you understand how to organize a group in your community or workplace and an Employee Fitness Contest Kit available to take you through every step of how to hold a contest. For more information or to get a free Kit, call toll free 1-800-686-2609. You may download the Kit in PDF at arkansasbluecross.com, healthadvantage-hmo.com or blueadvantagearkansas.com (select the “Employers” tab). Whether you participate in an internal or external contest … get up to the Challenge and have fun getting fit!
Blue & You Foundation
awards $1 million in grants to improve health The Blue & You Foundation for a Healthier Arkansas has awarded a total of $1,056,320 in grants to 21 health improvement programs in Arkansas. “Our grants this year went to programs across the state that address such issues as obesity, healthy lifestyle choices, medical and prescription drug care for low-income individuals, prenatal education, dental health, safety, nurse education 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 non-profit or governmental organizations and programs that positively affect the health of Arkansans. In its seven years of operation, the Blue & You Foundations has awarded more than $8.5 million to 129 health improvement programs in Arkansas. The grants awarded for 2009 are: • American Diabetes Association, Little Rock ($20,400) • Arkansas Mission of Mercy, Sherwood ($25,000) • Beebe Public Schools, Beebe ($14,014) • Boston Mountain Rural Health Center, Marshall ($36,000) • Boys and Girls Club of Central Arkansas, Little Rock ($48,499) • Chicot Memorial Hospital Foundation, Lake Village ($37,560)
• Christian Community Care Clinic, Benton ($72,269) • Christian Health Center, Camden ($34,000) • CityYouth Ministries, Jonesboro ($79,439) • Communication Arts Institute, Eureka Springs ($100,000) • Community Clinic Rogers Medical, Springdale ($115,000) • Crittenden Regional Hospital, West Memphis ($31,385) • Helen R. Walton Children’s Enrichment Center, Bentonville ($14,049) • Kimmons Junior High, Fort Smith ($47,287) • Madison County Health Coalition, Huntsville ($56,300) • Museum of Discovery, Little Rock ($28,594) • NEA Clinic Charitable Foundation, Jonesboro ($23,959) • Northwest Arkansas Free Health Center, Fayetteville ($50,000)
• PE4life, Kansas City, MO ($148,565) • River City Ministry of Pulaski County, North Little Rock ($24,000) • Southern Good Faith Fund, Pine Bluff ($50,000) The Blue & You Foundation will accept proposals for its next funding cycle any time between Jan. 1 and July 15, 2009. For more information about the grant application process, visit the foundation Web site at blueandyoufoundationarkansas.org or write to Blue & You Foundation, 320 West Capitol Ave., Suite 200, Little Rock, AR 72201. 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 Foundation honored for support of respiratory health The Blue & You Foundation for a Healthier Arkansas recently was honored by the Arkansas Respiratory Health Association (ARHA) for its financial support of asthma programs in Arkansas. The ARHA presented its first Lung Health Advancement Award to the Blue & You Foundation, in recognition of $300,000 in grants given during three years to support asthma
Bob Shoptaw (left), recently retired CEO of Arkansas Blue Cross, and Patrick O’Sullivan, executive director of the Blue & You Foundation, display the Lung Health Advancement Award.
education and self-management programs for children and adults in Arkansas. Blue & You Winter 2008
is Medi-Pak Advantage right for you? If you have a Medi-Pak plan and would like to consider other more affordable options, Open Enrollment for Medi-Pak Advantage begins January 1, and ends March 31, 2009. Medi-Pak Advantage is Arkansas Blue Cross and Blue Shield’s Medicare Advantage Private Fee
for Service (PFFS) plan. To find out if you are eligible to enroll and to learn more about Medi-Pak Advantage, please give us a call at 1-800-392-2583. Or, you can contact a Medi-Pak Choice-certified Farm Bureau or independent agent in your area.
our technology is
good for you
In today’s world, technology is everywhere, but is it always good for you? Through our technology Arkansas Blue Cross can pay your claims faster, provide you online tools to help you stay healthy and learn more about your health problems and keep you from dangerous drug interactions. Our newest technology can help you create an online Personal Health Record and help you find a specialist for many health conditions. We are always striving to find newer and better technology to help our members. That kind of dedication deserves an award, and — to date — we’ve received five! Arkansas Blue Cross and Blue Shield was recently ranked 188 in the InformationWeek 500 listing of the top technology innovators in business. This is the fifth consecutive year for Arkansas Blue Cross to be Blue & You Winter 2008
named to the list, and the highest the company has ever been ranked. The listing includes many giant corporations like AT&T, General Electric and IBM, but it also includes businesses that are considered efficient, innovative and visionary. “This is a remarkable accomplishment for everyone at Arkansas Blue Cross, because it shows that we are constantly striving to provide the best possible service to our members, whether we are in Customer Service or information technology,” said Joseph Smith, senior vice president of Private Programs and chief information officer for Arkansas Blue Cross.
our wellness discounts are good for your pocketbook Our discount wellness program connects you with resources committed to making your healthy lifestyle easier. We team up with top-notch venues like Arkansas Yoga Center (AYC) in Fayetteville that recently was featured in the September 2008 issue of Vogue as a yoga center that is doing things a little differently. Highlighted as one of the earliest adopters of the green yoga movement, the article explains how the AYC is made of mostly eco-conscious materials including newspaper insulation and a plastic bottle recycled deck.
How do I take advantage of these offers? If your insurance card carries the Arkansas Blue Cross and Blue Shield, Health Advantage or BlueAdvantage Administrators of Arkansas logo, you are eligible to use the program. Discounts are obtained by showing your individual or family health insurance card at the time of club enrollment, purchase of services or retail sales. To find
out more about available services and product discounts, please call the individual clubs, fitness specialists and other vendors.
New and updated discounts ATA Martial Arts Locations: Benton, Bryant, Cabot, Little Rock (3), Maumelle, North Little Rock Discount: $100 off enrollment and 15% off tuition when paid in full Cuts Fitness Center – White Hall Discount: Waive the $100 initiation fee/15% off monthly fee Pulse Fitness Locations: Fayetteville, Farmington Discount: $10 off regularly priced single membership, $15 off regularly priced family membership. New membership only. Results Fitness – Maumelle Discount: $30 membership (discounted from $39) JP Fitness – Little Rock Revised Discount: 20% off standard 12- and 18-month membership, no joining fee
Complete list of venues with discounted services or products New Attitudes Wellness Center Beebe Fitness Center ATA Martial Arts & Karate for Kids Butterfly Life Fitness Unlimited World Gym (2 locations) Safe Beginnings ATA Martial Arts & Karate for Kids Bryant Fitness Zone Butterfly Life ATA Martial Arts & Karate for Kids Ultimate Fitness Cedar Rock Yoga Studio Jazzercise of Conway The Nautilus Center Xtreme Fitness YWCA of El Dorado Arkansas Yoga Center Jenny Craig Centre Pulse Fitness Pulse Fitness Jenny Craig Center QuailTree Health & Racquet TNT Fitness Hot Springs Athletic & Racquet Club Jacksonville Community Center Jacksonville Fitness Center Ultimate Fitness ATA Martial Arts & Karate for Kids (Highway 10, Bowman, Chenal) Bowman Fitness (Bowman, Cantrell) Butterfly Life Club Fitness For Women Elite Physique Fitness FX JP Fitness Jenny Craig Centre
Atlanta Beebe Benton Benton Benton Bentonville Mail Order Bryant Bryant Bryant Cabot Cabot Conway Conway Conway Conway El Dorado Fayetteville Fayetteville Fayetteville Farmington Fort Smith Harrison Harrison Hot Springs Jacksonville Jacksonville Jacksonville Little Rock Little Rock Little Rock Little Rock Little Rock Little Rock Little Rock Little Rock
Lady of America Fitness Club Powerhouse Gym The Female Physique The Gym & Café Weight Watchers Westside YMCA Family Center YWCA Bess Chisum Stephens Extreme Image Fitness Center Physiques Health & Fitness ATA Martial Arts & Karate for Kids Maumelle Fitness Club Results Fitness Ouachita Rehab & Fitness Center Conway County Community Center Arkansas Health & Fitness Dynabody Fitness Center ATA Martial Arts & Karate for Kids Heflin YMCA Family Center Jenny Craig Centre NLR Community Center JRMC Wellness Center Fitness Zone Northwest Athletic Club Carr's Chain Reaction Bicycle Russellville Yoga Center Upper Room Yoga Wellspring Studio – Yoga & Pilates Sheridan Water & Wellness, Inc. Northwest Athletic Club Total Fitness CHRISTUS St. Michael Health & Fitness Center Minton's SportsPlex Lady Fitness Country Squire Sports Cuts Fitness Center
Little Rock Little Rock Little Rock Little Rock All Arkansas Classes Little Rock Little Rock Magnolia Magnolia Maumelle Maumelle Maumelle Mena Morrilton Mountain Home Nashville North Little Rock North Little Rock North Little Rock North Little Rock Pine Bluff Rogers Rogers Russellville Russellville Russellville Searcy Sheridan Springdale Springdale Texarkana Texarkana Trumann West Memphis White Hall
Blue & You Winter 2008
on the street
on the money
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.
Visit “good for you” — When you visit arkansasbluecross.com, be sure and visit the “good for you” section of the site … just select the link on the home page and find out how Arkansas Blue Cross and Blue Shield is good for you and your family. Whether you are healthy or have a health concern, we have a program to serve your needs.
What do you need? — Do you need to tell us about other insurance or dependent student status? Do you need a bank draft form or a dental claim form? Are you looking for insurance for your mom who just turned 65 or your brother who owns a small business? Do you need directions to your new doctor’s office? Do you want to review your most recent claims? Whatever you need related to your health insurance plan, we have that information online available 24/7.
New imaging network — Arkansas Blue Cross and Blue Shield and its affiliates have established a high-tech imaging network, effective Jan. 1, 2009. The network will include hospitals and outpatient imaging facilities that have meet network participation standards. These standards include accreditation of the various imaging studies/tests by either the American College of Radiology or the Intersocietal Commission for Accreditation. This is to ensure
that the imaging procedures performed are of the highest technical standards and are administered by competent operators and with safe machines. Please discuss with your doctor(s) whether the imaging procedure he/she orders will be performed at an in-network facility (a complete list of in-network facilities is available on our Web sites).
Need our Web addresses? Here they are …. Arkansas Blue Cross and Blue Shield — arkansasbluecross.com Health Advantage — healthadvantage-hmo.com BlueAdvantage Administrators of Arkansas — blueadvantagearkansas.com