Blue & You - Autumn 2012

Bringing doctors 

to rural Arkansas 

Meet the first Arkansas Blue Cross 

and Blue Shield Primary Care 

Scholarship recipients ... page 4 

Clinics chosen for 

federal initiative 

page 6 

Health Care 

Reform update 

page 8 

Teen drivers 

are safer now 

page 20

The doctor is in: 

How Arkansas Blue Cross 

is bringing primary 

care physicians to 

rural communities 

rkansas’ rural communities are great places 

to settle down, but the lack of primary health 

care is quickly reaching crisis proportions. Through 

Arkansas Blue Cross and Blue Shield, however, 

medical students in the University of Arkansas for 

Medical Sciences (UAMS) College of Medicine who are 

training to become primary care physicians (PCPs) 

are getting the help they need to set up practice and 

provide small communities with quality health care. 

Thanks to a $1 million grant from Arkansas Blue 

Cross, UAMS seniors Christina “Lauren” Monteith 

and Josue Daniel Gutierrez are the first recipients 

of the Arkansas Blue Cross and Blue Shield Primary 

Care Scholarship. Both students will receive $20,000 

from interest accrued from the grant toward the 

cost of medical school so they can afford to set up 

practice in the rural communities they love. 

“Lauren and Josue exemplify the qualities we were 

looking for in providing dedicated physicians to 

serve rural Arkansans,” said Mark White, president 

and chief executive officer of Arkansas Blue Cross. 

“We are excited for them, and we are particularly 

excited for the Arkansas communities that will 

benefit from their dedication to medicine.” 

Tom South, assistant dean for medical student 

finance and administration in the UAMS College of 

Medicine, said, “With the average educational 

Josue Gutierrez looks up medical information 

from resources in the UAMS library. 

indebtedness of our medical school graduates 

approaching $140,000, the Arkansas Blue Cross 

and Blue Shield Primary Care Scholarships will have 

a significant impact on reducing the debt burden 

of students who wish to pursue primary care and 

practice in medically underserved areas in Arkansas.” 

“Growing up in south Arkansas, I know all too 

well what it is like to live in a medically underserved 

area,” said Lauren. “As a child, my parents had to 

travel more than two hours to take me to specialty 

doctors’ appointments, which was very hard for 

them financially.” 

Lauren grew up in a small community 10 minutes 

south of El Dorado and has seen first hand the 

decline in jobs and population. This includes a great 

loss in primary care physicians. Her husband also 

grew up in the same area. 

“My husband spent part of his childhood in Huttig, 

one hour southeast of El Dorado, and learned that 

even small emergencies can be life threatening 

when you can’t get to medical care quickly. With the 

upcoming changes to health care, I believe primary 

care will become even more vital as the first step and 

possibly sole provider in rural areas.” 

4 Blue & You AUTUMN 2012

Being a primary care physician in a rural area can be challenging, but 

for both Lauren and Josue, that is part of the excitement of the job. 

“I love the idea of treating a wide variety of medical problems, as 

well as taking care of patients of all ages,” Lauren said. “I feel strongly 

that family medicine is one of the most rewarding fields of medicine.” 

Josue originally came to Arkansas to attend the University of the 

Ozarks in Clarksville and fell in love with the Northwest Arkansas 

region. “During my 

time in Clarksville, I 

was able to foster many 

relationships with 

individuals from the 

medical community 

and am eager to return 

and practice there. I am 

also soon to be married 

and my fiancée and I 

plan to start a family 

in Clarksville after 

completing my residency, 

as this is the perfect 

place to raise a family.” 

Josue added, “It 

has been my dream 

to become a family 

practitioner since I was 

7 years old. There are 

so many benefits to 

practicing in a small 

community. The lack of 

specialties in rural areas 

provides the family 

practitioners a unique 

environment in which 

to perform procedures 

that many of their 

urban counterparts are 

not able to. The small 

town environment, 

with its tight-knit 

community, provides 

a perfect setting in 

which to foster rapport 

with patients that will 

ultimately translate into 

better health care.” 

Focusing on 

Primary Care 

A big reason for the shortage of 

primary care physicians is the high 

cost of medical school. The 

Association of American Medical Colleges estimates that the average 

medical student ends up $162,000 in debt by graduation. To tackle 

that debt, many medical students turn their attention toward careers 

as specialists, where they are more likely to make more money. 

Arkansas Blue Cross and Blue Shield Primary Care Scholarship recipients 

are chosen from those planning to pursue post-graduate training in family 

medicine, general internal medicine or general pediatrics. The students, 

who may be in their junior or senior year, also must intend to practice 

primary care in Arkansas, preferably in the more rural parts of the state. 

The scholarship, given in honor of the Board of Directors of Arkansas Blue 

Cross, will be awarded each year, beginning with the 2012-2013 academic year. 

Other reasons for the primary care crisis are: 

Lauren Monteith researches 

information in preparation for her 

career as a primary care physician. 

• A shortage of primary care physicians, including family practice, 

pediatric and general internal medicine doctors. 

• An aging population and an illness burden higher than the national 

average, which creates high patient volume for the physicians who 

are available. 

• The potential projected influx of thousands of Arkansans to the 

Medicaid program in 2014 under health insurance reform. 

According to the Johns Hopkins Primary Care Policy Center, adults in 

the United States who had a primary care physician had 33 percent lower 

costs of care and were 19 percent less likely to die prematurely from 

their conditions than those who had received care from a specialist, after 

adjusting for demographic and health characteristics. The center found that 

the availability of primary care physicians is consistently associated with 

improved health outcomes for conditions like cancer, heart disease, stroke, 

infant mortality, low birth weight, as well as increased life expectancy and 

self-managed care. 

Sources: UAMS Center for Rural Health, Johns Hopkins Primary Care Policy 

Center, Association of American Medical Colleges, Arkansas Department of 

Health and Arkansas Center for Health Improvement 

Blue & You AUTUMN 2012 

5

Arkansas medical practices 

chosen to participate 

in 

national initiative 

T 

his spring, Arkansas was named one of 

seven markets to be part of the national 

Comprehensive Primary Care (CPC) 

Initiative, a pilot program through the 

Centers for Medicare & Medicaid Services 

(CMS) Innovation Center that fosters 

collaboration among public and private 

health plans to strengthen primary care. 

Health Advantage (an affiliate of Arkansas 

Blue Cross and Blue Shield), QualChoice and 

P rimary care physicians involved in the CPC Initiative will focus 

on five fundamental elements of comprehensive care: 

Managing care for patients with high 

health care needs – By engaging high-risk 

patients, primary care providers can create a 

plan of care that uniquely fits each patient’s 

individual circumstances and values. 

Ensuring access to care – CPC Initiative 

primary care practices must be accessible to 

patients 24/7 and be able to utilize patient 

data tools to give real-time, personal health 

care information to patients. 

Arkansas Medicaid teamed together 

to apply for the initiative. 

Medical practices within Arkansas 

were given the opportunity to apply to 

participate in the CPC Initiative and 116 

completed the application process. CMS 

chose 65 of those practices to participate 

in the first part of the initiative — other 

practices could be added later. 

Delivering preventive care – Primary 

care practices involved with CPC 

Initiative will be able to proactively 

assess their patients to determine their 

needs and provide appropriate and 

timely preventive care. 

Engaging patients and caregivers 

– Primary care practices will have 

the ability to engage patients and 

their families in active participation 

in their care. 


Medical practices chosen to participate in the CPC Initiative include: 

Baptist Health Family Clinic 

Arkadelphia 

Bradley Bibb M.D., PLLC 

Ash Flat 

Covert Clinic, P.A. 

Ashdown 

Batesville Family Practice Clinic 

Batesville 

Verona T Brown, M.D. 

Batesville 

Beebe Family Clinic 

Beebe 

Mercy Clinic Primary Care Lancashire Bella Vista 

Benton Family Clinic 

Benton 

Saline Med Peds 

Benton 

Baptist Health Family Clinic Bryant Bryant 

Bryant Family Practice 

Bryant 

Bryant Medical Clinic 

Bryant 


Cabot 

Internal Medicine Diagnostics Inc. Cherokee Village 

Ozark Internal Medicine and Pediatrics Clinton 

B. Brooks Lawrence, M.D., P.A. Conway 

Conway Family Medical Care, P.A. Conway 

Freeman Family Medicine 

Conway 

Barry V. Thompson, M.D. 

Crossett 

Family Clinic of Ashley County 

Crossett 

Lofton Family Clinic 

De Queen 

Randy D. Walker, M.D., PLLC 

De Queen 

SAMA Healthcare Services 

El Dorado 

Washington Regional Clinic for Senior Health Fayetteville 

Shipley and Sills Family Doctors 

Fort Smith 

Glenwood Family Medicine 

Glenwood 

Coordinating care across 

the medical neighborhood – 

Under this initiative, primary 

care doctors and nurses will 

work together, and with a 

patient’s other health care 

providers and the patient, to 

make decisions as a team. 

Greenbrier Family Clinic 

Greenbrier 

Garner Family Medical Clinic 

Hardy 

Harrison Family Practice Clinic 

Harrison 

The Leslie Clinic, P.A. 

Harrison 

Cowherd Family Medical Center 

Heber Springs 

Cypert Ridge Family Practice Clinic Helena 

Fountain Lake Family Medicine 

Hot Springs 

Hamilton West Family Medicine 

Hot Springs 

UAMS AHEC Northeast 

Jonesboro 

West Washington County Clinic, P.A. Lincoln 

Autumn Road Family Practice 

Little Rock 

Baptist Health Family Clinic Baptist Health Drive Little Rock 

Baptist Health Family Clinic Hillcrest Little Rock 

Baptist Health Family Clinic West Little Rock 

Barg-Gray Clinic 

Little Rock 

Little Rock Family Clinic - West 

Little Rock 

Little Rock Family Practice - Central Little Rock 

St. Vincent Family Clinic - Chenal Little Rock 

St. Vincent Family Clinic - Rodney Parham Little Rock 

St. Vincent Medical Clinic Midtowne Little Rock 

St. Vincent Medical Group Longevity Center Little Rock 

John E Alexander Jr. M.D., P.A. 

Magnolia 


Malvern 

Tilley Diagnostic Clinic 

Malvern 


Maumelle 

North Central Arkansas Medical Associates Mountain Home 

Dr. Andy’s Family Practice PLLC 

Mountain View 

Baptist Health Family Clinic Lakewood North Little Rock 

Burchfield Family Medicine 

Paragould 


Perryville 

Mercy Clinic Internal Medicine 

Rogers 

Sherwood Family Medical Center 

Sherwood 

Siloam Springs Medical Center 

Siloam Springs 

UAMS Family Medical Center 

Springdale 

UAMS AHEC Southwest 

Texarkana 

Foscue Medical Clinic 

Warren 

Michelle Weaver M.D. 

Warren 

Senior Health Clinic 

West Memphis 


7

In June, the U.S. Supreme Court ruled that the 

Patient Protection and Affordable Care Act (PPACA) 

is constitutional. Arkansas Blue Cross and Blue 

Shield had been working to prepare for health care 

reform even before the law was signed, so we are 

well prepared to move forward in implementing the 

reforms within the law. 

We know you may have questions regarding how 

the ruling affects your health plan. Various Web 

sites and e-mails circulating lately have contained 

misinformation about reform. We’ve been a trusted 

source of health care information for more than 

60 years, and we want you to be well informed 

about health care reform so you can make the 

right decisions for yourself and your family. 

Because we want to be available to you, we have 

created a new e-mail address just for your questions 

on health care reform. If you have questions, feel free 

to contact us at HCRinfo@arkbluecross.com. We will 

be gathering questions and responding to them on a 

regular basis and including the questions and answers 

in future issues of Blue & You magazine. 

While some things still are unknown, I can tell you 

that Arkansas Blue Cross will continue to provide the 

products and services our members value and that 

we are expanding our involvement in health care in 

innovative ways to increase quality and contain costs. 

We have a lot of work to do between now and late 

2013 to get ready for the health insurance exchanges 

and the new insurance market. 

The insurance exchange will be a new, online location 

for people to purchase insurance products. If your 

income is below a certain amount, you may receive 

significant subsidies to help cover your insurance 

premium, but most people still will have to pay 

for coverage. 

If you choose not to have insurance, the penalty per 

person is $95 for the first year, or 1 percent of your 

adjusted gross income, whichever is greater, with the 

penalty capped at four family members. The maximum 

penalty in 2016 is $695 or 2.4 percent. 

Cal Kellogg, 

Senior Vice President 

and 

Chief Strategy Officer 

Arkansas Blue Cross’ work toward the exchanges will 

focus on how our systems will interact with the federal 

system. We are working with the state and other 

stakeholders to determine the best ways to facilitate 

what will be a state/federal exchange partnership. 

The Arkansas Insurance Department has taken 

on the responsibility to design the exchange and 

is deciding which companies can sell on it and how 

consumers can be assisted. Arkansas Blue Cross, 

however, has membership on the steering and plan 

management committees involved in planning 

for the exchange. We have been able to make 

recommendations on topics like essential health 

benefits, but ultimately it will be the Insurance 

Department that determines how the exchange is run. 

Many employer-based insurance plans (group 

plans) under reform will be looking at whether they 

should change plans, or if it is in their best interest 

to drop their plan and pay the penalty. We do know 

that for many it will cost more to pay the fine than to 

keep their plan, but there still is a lot of uncertainty 

about pending regulations and the likely potential 

for continuing political debate and change. The main 

message we want to share is that no one has to make 

those decisions right now. 

The next year will provide the detailed regulations 

and guidelines we will need to provide valuable and 

meaningful advice for our members ahead of the 

January 2014 implementation. As soon as we have 

information on these changes we will be sharing it 

with you. In the meantime, feel free to ask us your 

questions at HCRinfo@arkbluecross.com. We love 

to hear from you. 


For the past eight years, 

I’ve had the honor of caring 

for hundreds of patients at 

Hospice Home Care who are at 

the end of their life. I’ve heard 

stories that almost made 

me choke with laughter and 

others which made my soul 

ache with despair. I’ve heard 

the most sacred confessions 

and witnessed love that could 

almost be touched. 

What has never been 

requested include the 

following: more chemotherapy, 

more radiation, more 

MRIs, more biopsies, more 

surgeries, more blasts of 

electricity through the chest, 

more life support, more time 

away from home and separated 

from family and friends, or 

more time in an institution. 

This serves as a wake-up 

call on how all members of 

the health care team can 

help patients achieve what 

is important for them at the 

end of life: quality! It’s about 

quality of life and ensuring 

patients achieve their goals 

with the life they have left. 

This is where the growing 

trend of hospice is saving 

patients from artificial 

prolongation of the dying 

process. There are studies 

which show that hospice not 

only improves quality of life 

for dying patients, but helps 

patients live longer. Isn’t 

longer, happier life the entire 

goal of health care? 

Hospice care is a team 

approach for supporting the 

patient and family during 

the end of life in a variety 

of settings, including home, 

assisted living facilities, 

nursing homes, and hospice 

facilities. Sometimes events 

happen quickly, like a severe 

stroke or heart attack, and 

hospice care is invaluable 

during these times. Hospice 

is even more effective when 

patients have two to three 

months of hospice care. 

This takes a realistic 

approach to life expectancies 

and selected treatments by 

the medical team. Proper 

channels of communication 

should be respected, so if 

one team member is not 

comfortable or skilled at 

discussing end-of-life care, 

utilizing other team members 

who are comfortable with 

these situations can be 

helpful. It is most important 

that the team always 

remember the guiding 

principle of medical ethics: 

the Principle of Autonomy. 

Patients have the right to 

hear all information of 

their care in an unbiased 

manner. Fortunately, hospice 

care considerations may 

be started by anyone in the 

team, including patients, their 

families or friends, doctors, 

nurses, social workers, 

chaplains or case managers. 

My life is going to end one 

day. When it is time, please, 

love me enough not to prolong 

the agony of dying. Follow 

these guidelines for me to 

honor my life: 

• Make any pain nonexistent. 

If anyone thinks 

I am in pain, give me 

whatever it takes to keep 

me comfortable, even if 

I have to be asleep. 

Don’t let me hurt! 

• Make any other symptoms 

non existent. Don’t let 

me suffer! 

• Treat me with dignity, 

respect, and 

unconditional love. 

• Keep me clean. 

• Support my friends and 

family while I am dying 

and after I am gone. 

Reviewing these five goals 

can help health care providers 

recognize the beauty of 

hospice and how it is enriching 

and rewarding for patients. 

Morgan Sauer, M.D., with the 

Longevity Center at St. Vincent 

Infirmary Medical Center, 

is board certified in 

family and preventive 

medicine, geriatric 

medicine, and 

hospice and 

palliative care. 

He also is the 

medical director 

for Chenal Heights 

Memory Center and 

Hospice Home Care 

Inpatient Center and 

serves on the 

Governor’s 

Task Force for 

Alzheimer’s 

disease. 


9

Clinical 

Partnership 

Award 

Arkansas Blue 

Cross and Blue Shield 

employees (pictured, 

from left: Roberta 

Monson, M.D., 

associate medical 

director, Connie 

Meeks M.D., corporate 

medical director, 

Internal Affairs, 

Alicia Berkemeyer, 

director of Enterprise 

Networks Special 

Projects, Vic Snyder, 

M.D., corporate medical 

director, External 

Affairs) were recently honored as the recipients of the Clinical Partnership Award given by 

the Community Health Centers of Arkansas, Inc. (CHCA). The award is given to a group 

or individual who has remained a steadfast supporter of CHCA and community health 

centers (CHCs), and has focused on the goal of providing quality care to all Arkansans. 

Arkansas Blue Cross received the award for its dedication to the development of patientcentered 

medical homes throughout the state. Arkansas Blue Cross exhibited leadership 

in merging existing programs/projects to align with the goals and strategic plan of CHCA 

and the CHCs, acting as a partner, advocate, liaison and mentor. 

Case management receives 

URAC accreditation 

Arkansas Blue Cross and Blue Shield, Health Advantage 

and BlueAdvantage Administrators of Arkansas, recently 

received reaccreditation for case management from 

URAC, a Washington, D.C.-based health care accrediting 

organization that establishes quality standards for the 

health care industry. 

In its notification of reaccreditation, the URAC 

Accreditation Committee said, “Arkansas Blue 

Cross and Blue Shield, Health Advantage, and 

BlueAdvantage Administrators of Arkansas have been granted FULL accreditation,” 

and all three organizations are “commended for their commitment to promoting quality 

health services.” 

URAC’s case management accreditation standards require companies to establish 

a process to assess, plan and implement case management interventions. 

10 12 Blue & You AUTUMN 2012

Red, White and ArkansasBlue summer family fun 

Arkansas Blue Cross and Blue Shield kept kids and their families watchin’, rockin’, and 

packin’ this summer with lots of family-oriented activities at ArkansasBlue, Arkansas 

Blue Cross’ health insurance store, located in the Shackleford Crossings shopping center. 

In June, we sponsored a special showing of the 

new Disney/Pixar movie “Brave” on the movie’s 

premiere weekend. More than 100 families 

picked up tickets at ArkansasBlue and 330 

attended the movie. 

“We had lots of young moms come in to 

ArkansasBlue to pick up tickets to the movie,” said 

Sara Harris, ArkansasBlue team leader. “Many were 

pleasantly surprised when they walked in to the 

location. They said they were not aware we were 

here, asked about what the store was for and if we 

sold insurance here. It was a great opportunity to 

tell them about the kinds of policies we sell and 

that we are available to visit face-to-face to discuss 

any questions they have about insurance.” 

BlueAnn Ewe greets two eager fans at 

the special Arkansas Blue Cross and 

Blue Shield screening of Disney/Pixar’s 

“Brave” held at The Rave. 

In July, we rocked the parking lot with a Blue 

Beach Party at ArkansasBlue. Adults and kids 

got moving and played games with Radio Disney outside the ArkansasBlue store, received 

complimentary sunscreen, then cooled down with tasty shaved ice and made their own leis 

inside the store. Two tickets to the sold-out Justin Bieber concert in Little Rock in January 

were given away, compliments of Radio Disney. 

In August, the Pack’n it in – Lunchbox Prep event had kids getting ready for a happy, 

healthy school year. Faith Anaya from Kids Cook! demonstrated two easy, economical 

and healthy food preparations perfect for packing a healthy lunchbox. She also discussed 

the importance of healthy eating and encouraged kids to try new foods. Parents were 

invited to participate in a nutrition label exercise designed to teach them about what 

kinds foods they are offering their children. 

“We were thrilled to spend the summer with our members and guests, focusing 

on nutrition, health and family fun,” said Sara. “We look forward to even 

more exciting events this fall and during the holidays.” 

Happy Birthday ArkansasBlue! 

ArkansasBlue, Arkansas Blue Cross and Blue Shield’s 

health insurance store in Little Rock, celebrated its first 

birthday on October 1! Since opening, Arkansans’ have 

dropped in to speak face-to-face with our staff and learn 

more about health insurance. If you have questions about 

health insurance, stop by ArkansasBlue in the Shackleford 

Crossings Shopping Center. We’d love to visit with you. 


11 13

12 Blue & You AUTUMN 2012 

Foundation Awards 35 Mini-grants to Health Programs 

The Blue & You Foundation for a Healthier Arkansas has awarded 

$1,000 grants to 35 health improvement programs in Arkansas 

Mini-grant recipients in 2012 include: 

• Arkansas Department of Emergency 

Management, North Little Rock, 

work-site wellness and obesity. 

• Arkansas Hospice, North Little Rock, 

Alzheimer’s, hospice and end-of-life planning. 

• Arkansas Voices for the Children Left 

Behind, Little Rock, healthy lifestyles 

and mental health. 

• Arthritis Foundation Southeast Region, 

Little Rock, arthritis and chronic disease 

self-management. 

• Camp Aldersgate, Little Rock, senior wellness. 

• CARTI Foundation, Little Rock, patient 

transportation. 

• Christian Health Ministry of White 

County, Searcy, charity clinic operation 

and electronic medical records. 

• City of Cammack Village, swimming pool 

wheelchair access. 

• Delta Community Based Services, 

Little Rock, girls’ empowerment conference. 

• Delta Presents Outreach Foundation, 

Little Rock, aspiring college students project, 

addressing substance abuse. 

• Donald W. Reynolds Cancer Support 

House, Fort Smith, skin cancer education. 

• Eagle Mountain Magnet Elementary, 

Batesville, nutrition and obesity (nutrition 

and exercise). 

• East Arkansas Area Agency on Aging, 

Jonesboro, exercise/physical activity and 

healthy lifestyles. 

• Elizabeth Richardson Center, Springdale, 

disabilities and autism. 

• Forrester-Davis Development Center, 

Clarksville, disabilities and heart health. 

• Friends of the Timberwolves, Newark, 

nutrition, exercise and healthy lifestyles. 

• Hearth, Jonesboro, nutrition, food costs 

and parenting. 

• Hip Hop Tumblers, Harrison, nutrition 

and exercise. 

• Historic Harrison Business Association, 

Harrison, physical activity and substance 

abuse. 

• Hometown Health Coalition Network, 

Warren, healthy lifestyles and exercise/ 

physical activity. 

• Hope Cancer Resources, Springdale, 

healthy lifestyles and cancer. 

• LifeHouse Ministries, Paragould, 

STDs and HIV/AIDS. 

• Marion County Hometown Health, Inc., 

Yellville, prenatal/pediatrics and safety. 

• Mid-Delta Health Systems, Clarendon, 

tobacco-related health conditions. 

• Newton County Resource Council, 

Jasper, nutrition, exercise and parenting. 

• Northwest Arkansas Community College, 

Bentonville, CPR/first aid/AED and medical 

professional education. 

• Old High Middle School, Bentonville, 

chair-free classrooms. 

• Ozark Guidance, Springdale, mental 

health, wellness education and prevention. 

• Ozarka College, Melbourne, Australian 

Walkabout Fitness Challenge. 

• Paragould School District, Paragould, 

nutrition, exercise and mental health. 

• Pediatrics Plus Connections, Conway, 

nutrition, exercise and disabilities. 

• S.W. Chance, Maumelle, obesity, nutrition, 

exercise and disabilities. 

• University of Central Arkansas, Conway, 

preschoolers and the USDA MyPlate project. 

• Washington Regional Medical Foundation, 

Fayetteville, cancer support. 

• Wildwood Park for the Arts, Little Rock, 

healthy lifestyles and nutrition. 

Nonprofit and charitable organizations, schools and government institutions in 

Arkansas are eligible to apply for two different programs: a $1,000 mini-grant program 

and a regular grant program of $5,000 to $150,000. New applications will be accepted 

beginning in March 2013. Grant guidelines and the online applications can be found at 

blueandyoufoundationarkansas.org. 

The Blue & You Foundation was established in 2001 by Arkansas Blue Cross and Blue 

Shield to help support community organizations that are implementing programs to 

improve the health of Arkansans.

New at the Blue 

New people and new positions 

Bryan Dorathy 

Bryan Dorathy has joined Arkansas Blue Cross 

and Blue Shield as an agency market manager for 

our offices in Little Rock and Pine Bluff. Bryan is 

responsible for Arkansas Blue Cross’ relationships 

with agents and partners as well as producing 

contracts for groups from two to 100. Bryan has 

more than 15 years of experience in the insurance 

industry. 

Sam Vorderstrasse 

Sam Vorderstrasse recently was promoted to vice 

president of Actuarial Services. He is responsible 

for providing decision support and direction 

related to the pricing and development of products, 

actuarial management, rating programs and 

determining/estimating outstanding liabilities. 

He is a Fellow of the Society of Actuaries and a 

member of the American Academy of Actuaries. 

Dr. John Brineman 

Dr. John Brineman has accepted the position of 

regional medical director for our Little Rock office 

and associate medical director for Health Advantage. 

He is a graduate of the College of William and Mary 

in Williamsburg, Virginia, and received his doctorate 

in medicine from Eastern Virginia Medical School. 

He completed a residency in Anatomic and Clinical 

Pathology at Walter Reed Army Medical Center and 

is a diplomat of the American Board of Pathology 

in Combined Anatomic and Clinical Pathology. He 

had a distinguished career in the active Army and 

the U.S. Army Reserve, rising to the rank of Colonel, 

serving two tours in Iraq. 

“In its first 10 years of grantmaking, the Blue & You Foundation has awarded 

a total of $14 million to 293 health improvement projects in Arkansas,” said 

Patrick O’Sullivan, executive director. “ These include programs to address 

obesity, diabetes, healthy lifestyles, medical and dental care for the uninsured, 

and dozens of other health issues that are affecting our state’s population.” 

The Blue & You Foundation is an independent licensee of the Blue Cross and 

Blue Shield Association and serves the state of Arkansas. 

Blue & You AUTUMN 2012 13

Sleep and mindlessly munching 

Have you ever found yourself hitting the afternoon 

slump then reaching for a bag of chips? What about 

sitting on the couch watching your favorite show, 

yawning and feeling the urge to snack on something 

less than healthy? You might need to get more sleep 

to prevent mindless munching. 

According to researchers, there may be a link between 

“sleep-related hunger and food cravings.” And not just 

any food cravings, but fatty, high-calorie foods. 

Marie-Pierre St. Onge, Ph.D., suggests that when you’re 

tired, you gravitate towards high-calorie foods because 

your body is looking for energy. Additionally, sleep 

deprivation seems to increase activity in the areas of the 

brain that seek pleasure, which can include enjoyment 

from junk foods. 

And if that’s not enough, research also suggests that being 

sleep deprived impairs decision-making. Therefore, you’re 

less likely to think through the repercussions of reaching for 

the junk foods. You’re literally mindlessly munching. 

Source: Health.com 

Diesel fumes officially declared 

to cause cancer 

The World Health Organization (WHO) recently 

elevated diesel to the “known carcinogen” level, 

officially declaring that diesel fumes cause lung 

cancer. Experts also concluded that the fumes were 

more carcinogenic than secondhand cigarette smoke. 

Diesel is a type of fuel derived from crude oil, and 

exposure to diesel exhaust is widespread in today’s 

world. Health concerns about diesel exhaust relate 

not only to cancer, but also to other health problems 

such as respiratory and heart diseases. 

Diesel exhaust now shares the WHO’s Group 1 

carcinogen status with smoking, asbestos, ultraviolet 

radiation, alcohol and other elements that pose 

cancer risks. 


SPECIAL NOTICE: 

*Arkansas State and Public School 

Employees can enroll in a weightloss 

program administered by the 

Employee Assistance Program’s 

vendor. Call 1-877-247-4621 to enroll. 

**Medi-Pak Medicare supplement 

insurance policyholders are not eligible 

for The Healthy Weigh! program. 

Lose weight 

The Healthy Weigh! Education 

Program is free for members of 

Arkansas Blue Cross and Blue Shield, 

Health Advantage (except ARBenefits 

members*), Blue Cross and Blue Shield 

Service Benefit Plan (Federal Employee 

Program), Medi-Pak® Advantage 

(PFFS), Medi-Pak Advantage PPO, and 

eligible members of BlueAdvantage 

Administrators of Arkansas.** 

To enroll, complete the attached 

enrollment form and return it in the 

self-addressed, postage-paid envelope 

included in this magazine. The 

program starts when you enroll. 

After enrollment, you will begin to 

receive information through the mail, 

which you can read in the privacy of 

your own home and at your own pace. 

The program is completely voluntary, 

and you may leave the program at any 

time. If you have further questions 

about the program, call the Health 

Education Program’s toll-free number 

at 1-800-686-2609. 

Simply complete, sign and return 

the attached enrollment form in the 

self-addressed, postage-paid envelope 

to join The Healthy Weigh!

SHINGLES 

Avoid the pain, get vaccinated 

Almost one in three people in the United 

States will develop shingles during their 

lifetime. This painful illness is a possibility 

for anyone who suffered with chickenpox 

and is more likely to occur if you are stressed 

or older. 

The good news is you can protect yourself 

against shingles. Talk with your doctor about 

the shingles vaccine. Arkansas Blue Cross 

and Blue Shield covers the shingles 

vaccines for members age 60 or older 

as a one-time vaccination based on 

Advisory Committee for Immunization 

Practices (ACIP) recommendations. 

Shingles, also known as herpes zoster, 

is caused by the varicella zoster virus 

(VZV). This is the same virus that causes 

chickenpox. The painful, blistering skin rash 

from shingles can last two to four weeks. 

If you have had chickenpox in the past, 

then VZV is inside you. It never leaves your 

body and stays in a dormant state. For 

reasons that are not fully known, the virus 

can reactivate years later and cause shingles. 

Some people may develop severe nerve 

pain that can last for months or even years 

after the rash goes away. This is called postherpetic 

neuralgia (PHN). Older adults are 

more likely to get PHN. Shingles can lead 

to other serious complications, including 

eye problems. 

Pain from shingles has been described 

as excruciating, aching, burning, stabbing, 

and shock-like. It has been compared to 

the pain of childbirth or kidney stones. 

The pain from shingles can cause depression, 

anxiety, difficulty concentrating, loss of 

appetite and weight loss. Shingles can 

interfere with activities of daily living 

like dressing, bathing, eating, cooking, 

shopping and travel. 

The only way to reduce your risk of 

developing shingles and PHN is to get 

vaccinated. Some people should wait to 

get vaccinated, or they should not get 

vaccinated at all if they have a weakened 

immune system. Shingles vaccine is available 

in pharmacies and doctors’ offices. Talk with 

your doctor if you have questions about the 

shingles vaccine. 


15

October is Open Enrollment Period for individual family policies 

Arkansas Blue Cross and Blue 

Shield’s Open Enrollment Period 

(OEP) for individual and family 

health plans began October 1 and 

runs through Oct. 31, 2012. 

During this OEP, members may 

apply for changes to their policy 

and individuals age 18 or younger 

may apply for a child-only policy. 

Making changes to 

individual and 

family policies 

Members may request changes to 

their policy, such as: 

• Adding or deleting dependents. 

• Increasing or decreasing 

the deductible. 

• Adding or deleting maternity. 

• Requesting the removal of 

surcharges or exclusions. 

Change forms related to 

OEP must be received (not 

just postmarked) by Arkansas 

Blue Cross no later than Oct. 31, 

2012. Changes to existing 

policies will be effective Jan. 1 

or 15, 2013, depending on the 

policy billing cycle. 

An underwriting change form 

is required if you are: 

• Adding a dependent 

to your policy 

- Dependents age 18 

or younger cannot be 

declined coverage but will be 

medically underwritten and 

may be surcharged based on 

medical conditions. Children 

eligible for Medicaid or 

ARKids First are not eligible 

for coverage under an 

individual policy. 

- Dependents age 19 or 

older will be medically 

underwritten and may 

be surcharged or denied 

coverage based on medical 

conditions. 

• Increasing your 

policy benefits by: 

- Lowering the deductible. 

- Raising the coinsurance 

percentage. 

- Lowering the calendar-year 

coinsurance maximum. 

- Adding the maternity rider. 

• Requesting that an 

exclusion be removed 

• Requesting that a surcharge 

be reduced or removed. 

A non-underwriting change 

form is required if you are: 

• Deleting a dependent 

from your policy. 

• Decreasing your policy 

benefits by: 

- Raising the deductible. 

- Lowering the coinsurance 

percentage. 

- Raising the calendar-year 

coinsurance maximum. 

- Deleting the 

maternity rider. 

Both underwriting change 

forms and non-underwriting 

change forms are available online 

at arkansasbluecross.com or 

you can call Customer Service at 

1-800-238-8379. 

Applying for a 

child-only policy 

During the OEP, individuals age 

18 or younger may apply for a 

child-only policy. Applications for 

child-only policies must be received 

(not just postmarked) by Arkansas 

Blue Cross no later than Oct. 31, 

2012. If approved and accepted, 

all new child-only policies will be 

effective Jan. 1, 2013. 

You may apply for a child-only 

individual policy: 

• Online at 

arkansasbluecross.com 

• By calling us at 

1-800-392-2583; or 

• By contacting your 

independent or 

Farm Bureau agent. 

Outside the OEP, individuals 

age 18 or younger can be 

considered for coverage only 

as a dependent on a parent or 

guardian’s policy or as a result 

of a “qualifying life event.” 

Qualifying life events 

Requesting a change 

to an existing policy 

Changes may be made to 

existing policies at any time 

throughout the year as a result 

of a “qualifying life event” — 

such as a marriage, divorce, 

death, birth of a child, or loss of 

other health insurance coverage. 

There are specific notification 

periods and documentation 

requirements associated with 

qualifying life event changes. 

To get information, go to 

arkansasbluecross.com/ 

members/making_policy_ 

changes.aspx or call Customer 

Service at 1-800-238-8379. 

Applying for a new 

child-only policy 

In addition, there are two 

qualifying life events that allow 

individuals age 18 or younger 

to apply for a child-only policy 

outside of the OEP. 

Those are: 

• The loss of employersponsored 

health 

insurance coverage; or 

• An involuntary loss 

of any other health 

insurance coverage. 

In either case, the application 

must be submitted within 30 

days of the loss of coverage 

and documentation is required 

to verify the loss of coverage. 

Children eligible for Medicaid 

or ARKids First are not eligible 

for coverage under an individual 

policy. 

Should you have any questions, 

call Customer Service at 

1-800-238-8379. 


Medicare Annual Election Period 

October 15 through December 7 

Medicare’s Annual Election 

Period (AEP) will begin October 

15, and will run through 

December 7. During AEP, 

Medicare beneficiaries can 

purchase a Medicare Advantage 

plan and/or a Medicare Part D 

prescription drug plan. You also 

may switch from your existing 

plans. If you join a plan during 

AEP, or make changes to an 

existing plan, your new benefits 

will be effective Jan. 1, 2013. 

Affordable products 

and peace of mind 

Generations of Arkansans have 

trusted Arkansas Blue Cross and 

Blue Shield for peace of mind. 

Our Medicare products offer 

members low monthly premiums. 

And, in 2013 you can expect the 

same great selection of Medicare 

products you’ve come to expect 

from us through the years. 

• $0 premiums for Medi-Pak® 

Advantage MA-PD Private 

Fee-for-Service (PFFS) 

(includes drug coverage) in 

27 counties and affordable 

premiums in all Arkansas 

counties. Medi-Pak Advantage 

(PFFS) members have access 

to our extensive network of 

more than 7,000 doctors and 

hospitals across the state. 

In addition, Medi-Pak 

Advantage MA-PD members 

receive a membership in 

the popular SilverSneakers® 

Fitness Program* at no 

additional cost. 

• $0 premiums for Medi-Pak 

Advantage MA (PFFS) (does 

not include drug coverage) in 

50 counties. These plans offer 

all the health benefits of our 

Medi-Pak Advantage MA-PD 

plans, but do not include drug 

coverage. Members have the 

same access to our network of 

doctors and hospitals, and a 

SilverSneakers membership. 

• Two Medi-Pak® Rx 

Prescription Drug Plans 

(PDP) – Basic and Premier 

– with competitively priced 

monthly premiums. More 

than 95 percent of Arkansas 

pharmacies are in our 

network. 

• Four Medi-Pak® supplement 

plans including Plan F, 

our most comprehensive 

supplement plan, and Plan 

N, one of our lowest-priced 

supplement plans. 

Attention Medicare 

Advantage plan members 

If you have a Medicare 

Advantage or Medicare Part D 

plan, during October you will 

receive an Annual Notice of 

Change (ANOC) which will explain 

any changes to your current plan 

that will become effective in 

January. If you are satisfied 

with your current plan, you 

are not required to change 

anything. Every year, the Centers 

for Medicare and Medicaid 

Services (CMS) require companies 

to inform members of these 

changes prior to AEP so they may 

shop their coverage. 

If you would like to 

learn more about our 

Medicare plans … 

Call your local Medi-Pak® 

Choice licensed agent or 

1-800-392-2583 to learn 

more. You also can visit our Web 

site, arkansasbluecross.com/ 

Medicare. We’d love to hear from 

you. If you have a friend or family 

member who doesn’t have one of 

our Part D prescription drug plans 

or Medicare Advantage plans, we 

hope you’ll recommend Medi-Pak 

Rx and Medi-Pak Advantage. 

*See disclosure on page 28 

2013 Open Enrollment for Arkansas State and Public School members 

October 1 through October 31 

The Arkansas State and Public and 

School Employee and Retiree Open 

Enrollment Period began October 1 

and run through October 31. Please 

refer to the Employee Benefits 

(EBD) newsletter, The Buzz, for plan 

information or go the EBD Web site, 

ARBenefits.org. 

This year will be a passive 

enrollment – meaning that if you 

do not wish to change plans you 

automatically will be enrolled 

in the plan you selected for the 

2012 plan year. However, if you 

want to change plans, add or drop 

dependents or update demographic 

information, you must complete an 

election form. 


17

with Dr. David 

David A. Lipschitz, 

M.D., Ph.D. 

You can reduce the risk of a serious fall 

Falls become more prevalent with age 

After age 65 about 30 percent of people fall at 

least once annually. And, if a hip fracture occurs, 25 

percent will die in a year and 50 percent will become 

dependent, frequently requiring nursing home care. 

Fortunately, much can be done to reduce the risk of 

a fall, the need for lengthy hospital stays or the loss 

of independence. 

Causes of falls 

Increased fall risk with age frequently is due to 

declines in balance, mobility and gait, and a high 

risk of fainting caused by blood pressure drops 

when attempting to stand up. Visual difficulties, 

dizziness, inappropriate shoe choices and side effects 

of drugs often contribute to falls. Tripping due to 

environmental hazards in the home or elsewhere 

remains the major cause of falls at any age. 

An evaluation by a physician is 

essential 

If you or a loved one is at risk of falling, an 

evaluation by a physician is essential. Medical 

conditions that contribute to falls must be identified 

and treated and problems with gait and balance 

evaluated. There are standardized tests that can 

be done that identify major problems with the way 

someone walks. First, can the patient get up from 

the chair without assistance? Does he have to use his 

hands to stand, or does someone have to help him? 

Can he walk without using an assistive device such 

as a cane or a walker? Can he walk in a straight line? 

How long does it take him to walk 

10 meters, turn around and sit back down. 

If it is longer than 20 seconds, a serious 

problem exists. 

A careful assessment of all medications 

must be done. Many medications can 

increase the risk of falling by causing 

drowsiness, confusion, worsening weakness 

and balance difficulties and significant 

dizziness. This particularly occurs if a person 

is taking medications to lower blood pressure. 

Whenever possible, keep medications to a 

minimum and avoid sleeping pills, tranquilizers 

and alcohol. Medications to treat hypertension 

(high blood pressure) also can lead to dangerous 

drops in blood pressure. If your loved one takes 

blood pressure medication, remind them to stand 

up slowly and always have something to hold on to 

in case he feels faint. 

Exercise is the key to preventing falls 

No matter your health, aging is associated with 

a relentless loss of muscle mass, an increased 

proportion of weight as fat and progressive weakness 

that slows gait speed, affects balance and increases 

the risk of falls. The more we do to maintain strength 

the better. Physical therapy can help reduce falls. 

Treatment includes balance exercises and working 

with weights that builds muscle, bones and most 

importantly strength. The older the patient, 

the longer the time it will take to see tangible 

improvements, but they will occur and the results are 

well worth the effort. When physical therapy ends, it 


is important to keep moving and consider 

joining a health club to continue exercise 

and maintain and improve strength 

and balance. 

Use assistive devices if needed 

Do not be embarrassed to use a cane, 

walker or a wheelchair, but walk as much as 

possible. The more time spent being immobile 

or sitting in a wheelchair, the greater the loss of 

muscle and the increased chance of a fall. Electric 

wheelchairs are great, but should only be used if 

needed and if walking is impossible. 

Assess your house for fall risk 

Most serious falls occur in the bathroom. 

Carefully review the bathroom to make sure 

slippery surfaces can be avoided, that water does 

not leak from the shower or tub and, if possible, 

install hand rails from the bed all the way into the 

bathroom. Often a raised toilet seat with armrests 

can prove helpful. A sturdy plastic seat should be 

placed in the tub or shower and use a hand-held 

shower head to bathe. If a wheelchair is needed 

or gait and balance are significantly impaired, 

a uniquely designed bathtub or shower may be 

needed. During the night, a bedside commode may 

be a good option rather than walking in the dark to 

a very hazardous area. 

Fall-proof the home by clearing walking areas 

of boxes and electrical phone cords. Remove low 

coffee tables and move magazines and plants out 

of the way. Loose rugs should be removed or 

taped to the floor, uneven wooden floorboards or 

carpeting must be repaired and skid proof materials 

should be used for cleaning. Many falls are caused 

by standing on a chair or attempting to remove 

something from an out-of-reach cupboard. For this 

reason, clothing, cleaning materials, dishes, utensils 

and food must be accessible and stored within easy 

reach. Adequate lighting decreases fall risk. Assure 

that each room has ambient light from outside 

during the day, is well lit at night and night lights 

are used liberally. Always switch on a light before 

climbing the stairs and install glow-in-the-dark or 

illuminated light switches. 

Consider moving 

If a fall risk is too great, consider whether living 

alone in a large house with stairs is appropriate. 

It may be time to move to a one-level home or to 

an assisted-living facility where help is available 

and people surround you. And, as you grow older, 

no matter your health, live as close as possible to 

immediate family. 

Accidents due to falls are a major cause of physical 

disability, the need for nursing home care and a 

poor quality of life. The earlier precautions are 

taken to reduce a fall risk, the better. 

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

recognized as a leader in the field of geriatrics. 

Arkansas Blue Cross and Blue Shield is 

honored to have him as a contributor to 

Blue & You magazine. 


19

ARKANSAS 

The Natural State 

LEARNER’S 

DRIVER’S LICENSE 

DL 

CLASS: 

D 

0000 

DLN: 

987654321 

DOB: 

05-30-1997 

Expires: 

05-30-2013 

Issued: 

9-27-2012 

Sex: 

F 

It is a terrifying moment for any parent — 

your teen hops in the car with a brand new 

driver’s license, leaving you to worry until the 

car pulls back into the driveway. 

Under 18 until 05-30-2015 

Under 21 until 05-30-2018 

Height: Eyes: 

5-02 HZ 

Endors: Restr: 

A T 

While parents always will have that 

nervous feeling about their teen drivers, a 

recent report from the Arkansas Center for 

Health Improvement (ACHI), a nonpartisan, 

independent, health policy center, shows that 

a 2009 Arkansas law (Act 394) is helping to 

save lives by allowing teens to gain driving 

experience through the use of restrictions 

based on age and their driving record. 

“It’s very encouraging to see these positive 

trends in our teen driver statistics,” said Mary 

Aitken, M.D., director of the Injury Prevention 

Center at Arkansas Children’s Hospital (ACH) 

and a member of the University of Arkansas for 

Medical Sciences pediatrics faculty. “There is 

still a lot of work to be done to make sure the 

roads in Arkansas are safer, however. The Injury 

Prevention Center at ACH will continue 

to advocate for 

strong policies like Graduated 

Driver License (GDL) and provide education 

for teen drivers and their parents about how 

they can reduce risk on the roads — everything 

from adhering to the GDL provisions and 

putting away the cell phone, to buckling 

up on each trip.” 

The GDL provides for teen driver’s licenses 

in three levels: learner’s license, intermediate 

license and unrestricted/regular license. A 

learner’s license permits teens that are 14-15 

years old to drive only while accompanied by 

an adult 21 years of age or older. To receive an 

intermediate license, a teen driver must have no 


serious traffic violations or accidents on record 

during the previous six months. Teens with an 

intermediate license are allowed to drive without 

an adult, but they are restricted from having 

more than one unrelated passenger under the 

age of 21. Drivers with this license also may not 

drive unsupervised between 11 p.m. and 4 a.m., 

unless they are traveling to or from a school or 

church-related activity, work or in emergency 

situations. At 18, teens are eligible to apply for 

a regular, unrestricted, driver’s license if they 

have a clean driving record (i.e., there must be 

no major traffic violations on the applicant’s 

record in the previous 12 months). 

ACHI studied the impact of the law using 

information from the Arkansas State Police 

Motor Vehicle Crash Data. What they found was 

that there was a significant reduction in crashes 

and crash-related fatalities among teens during 

that timeframe. This is especially true for 

the youngest drivers who obtained their 

intermediate license to drive for the first time 

An Arkansas mom hands over the 

car keys to her teen daughter, now driving 

with a Graduated Driver’s License. 

without an adult. Similar reductions in crashes 

or fatalities were not found for the adult 

population during this same timeframe. 

Between 2008 and 2010, fatalities involving 

teen drivers were reduced by 59 percent, from 

about 25 fatal crashes per 10,000 drivers 

in 2008 to 10 in 2010. This translates to an 

estimated 32 actual lives that were saved. 

The most drastic change was among 

16-year-old drivers. The number of crashes 

among this age group was reduced by 22 

percent (from 1,467 per 10,000 drivers in 

2008 to 1,145 in 2010). 

ACHI also found that between 2008 and 

2010, fatalities involving teen drivers from 

11 p.m. and 4 a.m. dropped by 76 percent, 

from 21 fatalities in 2008 to five fatalities in 

2010. Teens between the ages of 16 and 18 

experienced a 19 percent reduction in single 

vehicle crashes, and a 52 percent reduction 

in single vehicle fatal crashes. 

Mary Aitken, M.D., speaks at a celebration 

of the Graduated Driver’s License at 

Arkansas Children’s Hospital. 

The limit on passengers in a vehicle driven 

by a teen also helped save lives. ACHI found 

a 20 percent decrease in teen driver crashes 

with multiple passengers from 2008 to 2010. 

The most significant decrease was recognized 

in cars carrying five or more passengers. 

Sources: Arkansas Center for Health Improvement, 

Arkansas Children’s Hospital 


21

Notice: The notice below regarding Medical Loss Ratio Information is required by the federal government. 

Some readers may have received a medical loss ratio rebate because their employer’s health plan was eligible 

for a rebate. This notice is for members who did not receive a rebate because their segment of the market had 

a medical loss ratio higher than the minimum required by the Affordable Care Act. 

Medical Loss Ratio Information 

The Affordable Care Act requires health insurers in the individual and small group markets to 

spend at least 80 percent of the premiums they receive on health care services and activities 

to improve health care quality (in the large group market, this amount is 85 percent). This 

is referred to as the Medical Loss Ratio (MLR) rule or the 80/20 rule. If a health insurer 

does not spend at least 80 percent of the premiums it receives on health care services and 

activities to improve health care quality, the insurer must rebate the difference. 

A health insurer’s Medical Loss Ratio is determined separately for each State’s individual, 

small group and large group markets in which the health insurer offers health insurance. 

In some States, health insurers must meet a higher or lower Medical Loss Ratio. 

No later than August 1, 2012, health insurers must send any rebates due for 2011 

and information to employers and individuals regarding any rebates due for 2011. 

You are receiving this notice because your health insurer had a Medical Loss Ratio for 

2011 that met or exceeded the required Medical Loss Ratio. For more information on 

Medical Loss Ratio and your health insurer’s Medical Loss Ratio, visit www.HealthCare.gov. 

Congratulations to the 

winners of the 2012 

Blue & You Fitness Challenge! 

They are: 

A program of Arkansas Blue Cross and Blue Shield, 

Arkansas Department of Human Services 

and the Arkansas Department of Health 

Group Category 1 (2-5 participants) 

Jefferson County — Pine Bluff, AR 


Arkansas Education Association — Little Rock, AR 


Boys and Girls Club — Alma, AR 

Group Category 4 (12 participants) 

The RoArk Group — Rogers, AR 

Group Category 5 (13 participants) 

National Park Service — St. Paul, MN 

Group Category 6 (14 participants) - TIE 

Eagle Heights Elementary — Harrison, AR 

UAMS AHEC Northeast — Jonesboro, AR 


SFLIC — Hot Springs, AR 


Arkansas State Plant Board — Little Rock, AR 


Alliance Rubber Company — Hot Springs, AR 


Harrisburg Middle School — Harrisburg, AR 


Ben E. Keith Foods — North Little Rock, AR 


Northrop Grumman CEO — St. Charles, MO 


Group Category 13 (37-43 participants) - TIE 

Keruso — Berryville, AR 

Lamar Elementary School, Lamar AR 


Lamar High School — Lamar, AR 


Nucor Yamato Steel — Blytheville, AR 


Administrative Office of the Courts — Little Rock, AR 


Red River Credit Union — Texarkana, AR 


Transportation Security Agency — Little Rock, AR 

Group Category 19 (235+ participants) 

Simmons First National Bank — Pine Bluff, AR 

Student Winners: 

Grand-prize winner: 

• Wade Lambright of Harrisburg Middle School in Harrisburg 

won a Walmart gift card toward the purchase of a bike. 

Runners-up prize winners 

(fitness-related gift bags and gift cards): 

• Dalton Parnell of Lamar High School in Lamar, 

• Alexis Whitten of Watson Chapel Junior High FBLA in Pine Bluff, 

and 

• Jonah Hyman of HAAS Hall Academy in Fayetteville.

Arkansas Blue Cross joins 

new state payment initiative 

Arkansas Blue Cross and Blue 

Shield and QualChoice have 

joined with Arkansas Medicaid 

to create the Arkansas Health 

Care Payment Improvement 

Initiative (AHCPII), which will 

transform the state’s payment 

system for doctors, hospitals and 

other medical facilities and put 

Arkansas on the leading edge of 

national efforts to improve health 

care quality and cost efficiency. 

Under our current payment 

system medical providers are 

paid for each activity, regardless 

of value. The system is called 

“fee for service.” For every 

medical service provided, the 

doctor or hospital receives 

a pre-determined fee. There 

are many drawbacks to this 

system. For example, doctors 

are not motivated to coordinate 

patient care. You may go to your 

primary care doctor (PCP) and 

have an imaging study. Your 

PCP may refer you to a specialist 

who repeats the imaging study 

because he is unaware that it 

was previously conducted. 

With the AHCPII model, 

health care providers are paid 

based on an agreed upon set 

of standards for the episode of 

care. Based on the cost of the 

provider’s care compared to 

pre-determined cost targets, 

they either will share in savings 

created, break even, or owe 

back money share in excess cost 

with to payers. By providing 

necessary evidence-based, high 

quality, and cost-effective care 

and better coordinating care 

across a patient’s providers care 

team, they can actually increase 

their net profit payment from 

the plan while saving money 

overall. This initiative was 

developed with input from 

physician associations, hospital 

executives, clinicians, patients, 

advocacy groups and the Center 

for Medicare & Medicaid 

Services (CMS). AHCPII is not a 

requirement of the federal health 

care reform legislation, but 

rather a state-based initiative. 

During the first phase of the 

new payment initiative, which 

began July 1, six episodes 

of care will be monitored. 

Participation in the initiative 

within the six episodes will 

vary. Arkansas Blue Cross will 

participate in the new payment 

initiative within the episodes 

with an asterisk (*): 

• Hip and knee replacements* 

• Congestive heart failure* 

• Pregnancy* 

• Developmental disabilities 

• Upper respiratory 

infections 

• Attention-deficit/ 

hyper-activity disorder 

During the first three to 

six months of the initiative, 

doctors and hospitals will have 

access to reports designed to 

help them understand their 

current practice patterns 

and the financial and quality 

outcomes they generate. 

Information for those reports 

will be pulled from existing 

claims data and from a limited 

set of data that providers will 

enter into a provider portal for 

some of the episodes. 

Arkansas Blue Cross will 

work with doctors and hospitals 

to identify ways to improve 

the new payment method. 

After the introductory period, 

reimbursement changes will be 

implemented by the insurance 

companies and Arkansas 

Medicaid. The intent is to 

develop a common method 

for reimbursement but not to 

implement a common level 

of reimbursement. 

We are all paying the price 

of an uncoordinated delivery 

system. It is essential that 

Arkansas Blue Cross take the 

lead in building a new model 

that will serve our members and 

provide the kind of high-quality, 

affordable care you deserve. 

Source: healthcare.gov/news/factsheets/2011/09/primary-care09282011a.html 


23

P. Allen Smith is an awardwinning 

designer, gardening and 

lifestyle expert. Arkansas Blue 

Cross and Blue Shield is honored 

to have him as a contributor to 

Blue & You magazine. 

Even though I am still harvesting tomatoes 

and squash, it is time to start thinking about 

planting my cool season favorites. 

I grow certain cool season vegetables 

from seeds, like arugula, spinach, and various 

types of lettuce that germinate easily and mature 

quickly. Others like broccoli, cabbage, kale and 

collards are better started from transplants. 

If you are starting from seeds it is important 

to account for the number of days it will take for 

a plant to mature versus the first below-freezing 

temperatures of the season. 

The average date of the first killing frost in your 

area is the most important thing to know when it 

comes to fall vegetable gardening. To determine 

when to start planting, find out the number of 

by 

P. Allen 

Smith 

days to maturity for the vegetable. Count back the 

number of days from the first average frost date 

and add a week or so to allow for a few extra days to 

harvest the mature produce. 

Another thing to keep in mind when planting fall 

vegetables is that the seedlings require plenty of 

moisture. Keep them well watered until fall rains begin. 

Many of the leafy vegetables such as spinach and kale 

are heavy feeders, so be generous with fertilizer. 

Plants for Your Fall Vegetable Garden 

Broccoli - Mulch to help keep 

the ground cool and moist. Feed 

the plants three weeks after 

transplanting. I blanche any extras, 

then freeze for eating in the winter. 

Broccoli is high in vitamin C, high in 

folate, a good source of dietary fiber 

and a good source of potassium. 

Brussels Sprouts – Set the 

plants out in mid-summer. It will 

take about three months before 

the sprouts appear. Harvest when 

they are firm and green. Great 

roasted in the oven with sea salt 

and olive oil. Brussels sprouts 

are high in vitamin C and a good 

source of folate. 

Cabbage – Heavy feeders that 

require fertile soil rich in organic 

matter and consistent moisture. I 

have several cole slaw recipes that 

make my mouth water as I think 

about fresh cabbage. Cabbage comes 

in a number of varieties, but all are 

rich in vitamins C and E. They also 

contain vitamins A, B1, B2, B6, K 

and folic acid as well as the minerals 

calcium, sulfur, iron, magnesium, 

phosphorous and potassium. 

Cauliflower – Fluctuations 

in temperature, moisture and 

nutrients can cause the plant 

to “button,” or produce small, 

undersized heads. Blanch the 

heads by tying the outer leaves 

together over the heads when they 

are about 2 to 3 inches across. 

Great when florets are roasted with 

olive oil and garlic in the oven! 

Cauliflower is high in vitamin C 

and a good source of folate. 

Kohlrabi - Shade young plants 

from summer sun. Delicious in 

stir-fry. Kohlrabi is an excellent 

source of vitamin C and a good 

source of fiber. 

Lettuce – Sow seeds in late 

summer. Provide the seedlings with 

consistent moisture and shade from 

the afternoon sun. Clip outer leaves 

first for salads on the leaf and looseleaf 

varieties. They will produce for 

as long as temperatures remain 

cool! Lettuce is high in vitamin A 

and a good source of folate. 

Mustard Greens – Keep the soil 

consistently moist to encourage 

rapid growth and tender greens. 

I love them sautéed with chard, 

olive oil and garlic! Mustard greens 

are an excellent source of vitamin 

A, C and K, folate and manganese. 


Radish – Quick to mature, sow 

seeds 4 weeks before the first 

frost. Sow evenly so you don’t 

have to thin them. No feeding 

necessary, but soil should be fertile 

and well drained. Radishes are 

delicious sautéed in a honey glaze. 

Radishes are high in vitamin C. 

Rutabaga – Wait to sow seeds 

until night time temperatures are 

consistently around 50 to 60 F. Keep 

the soil moist to prevent roots 

from forking. Simply toss with sea 

salt, pepper, olive oil and apple 

cider vinegar then roast. Amazing! 

Rutabaga is an excellent source of 

vitamin C. 

Spinach – An established 

spinach crop will last well 

into winter and can survive 

temperatures down into the 20s. 

Spinach prefers very fertile soil 

to encourage rapid growth and 

tender leaves. Add strawberries 

and a vinaigrette and there’s 

dinner! Spinach is an excellent 

source of fiber, vitamins A and C; 

high in iron, high in folate and a 

good source of magnesium. 

Good to Know 

Root vegetables are the “storage 

bin” for a plant’s nutrients and are 

health-promoting powerhouses. 

They are an excellent source of 

complex carbohydrates, fiber, 

potassium and antioxidants. 

Potatoes are among the highest 

in potassium of any fruit or 

vegetable commonly eaten in 

this country, while orange root 

vegetables like carrots and sweet 

potatoes are an excellent source 

of beta-carotene. 

Annual Notice 

2013 Summary of Benefits and 

Coverage – available November 15 

for individual/family policy holders 

As required by the Patient Protection and Affordable 

Care Act (PPACA), the Summary of Benefits and 

Coverage (SBC) (OMB Control Numbers 1545-2229, 

1210-0147 and 0938-1146) provides information 

regarding coverage specifications and limitations that 

apply to the health insurance plan you have selected. 

Before the end of each year, Arkansas Blue Cross 

and Blue Shield provides members who are under 

age 65 and have individual/family health insurance 

policies* with an SBC. 

This official communication includes information 

about the coverage provided by your health insurance 

plan in a summary format for the upcoming year. 

Beginning Nov. 15, 2012, you may access this 

information: 

• Online in the “Benefits” section of the Arkansas 

Blue Cross secure member self-service center, 

My Blueprint, at arkansasbluecross.com 

• By calling Arkansas Blue Cross Customer Service at 

1-800-238-8379 to receive a printed version 

After that date, you also may log on to 

arkansasbluecross.com/sbc and enter your member 

number (found on your Member ID card) into the SBC 

locator tool to review the document online and print it. 

If you make changes to your Arkansas Blue Cross 

health plan benefits that differ from your current 

coverage, a new SBC will be created for you within seven 

work days of our receipt of your change request. It will be 

available to you in the same manner described above. 

*These are members who do not have health insurance 

through an employer, a Medicare health plan, or 

Short-Term Blue product. 

Arkansas Blue Cross, Health Advantage and 

BlueAdvantage Administrators of Arkansas members 

who receive health coverage through an employer 

group will get their SBC from their employer group 

plan administrator at the appropriate time. 


25

Women’s Preventive 

Services 

In order to comply with the new health care 

reform law (PPACA or the Patient Protection 

and Affordable Care Act), Women’s Preventive 

Services will be added to many health plans. 

On August 1, 2012, the change will be made to 

certain employer-sponsored health insurance 

plans. The change will take place on January 1, 

2013, for certain individual health plans. 

What are PPACA preventive services? 

PPACA preventive services, unlike our 

traditional preventive services, are covered 

under the employer’s plan at 100 percent with 

no member responsibility (e.g., no copayment, 

coinsurance or deductible when delivered by 

a network provider). Effective August 1, these 

benefits include Women’s Preventive Services. 

What are Women’s Preventive Services? 

The additional Women’s Preventive Services 

that will be covered without copayments, 

coinsurance or deductibles on applicable 

group policies are as follows: 

• Well-woman visits: An annual well-woman 

preventive care visit for adult women 

to obtain the recommended preventive 

services, along with additional visits if the 

woman and her doctor determine they are 

necessary. 

• Gestational diabetes screening: For women 

24 to 28 weeks pregnant, and those at high 

risk of developing gestational diabetes. 

• HPV DNA Testing: Women who are 30 years 

of age or older will have access to high-risk 

human papillomavirus (HPV) DNA testing 

every three years, regardless of pap 

smear results. 

• STI counseling, and HIV screening 

and counseling: Sexually active women will 

have access to annual counseling on HIV 

and sexually transmitted infections (STIs). 

• Contraceptives and contraception counseling: 

Coverage of prescription contraceptives on the 

drug list (brand-name contraceptives may have 

a copayment if a generic is available without a 

copayment); patient education and counseling; 

and Plan B (known as the morning-after pill) 

when prescribed for members under age 18. 

Any drugs used to cause abortion (e.g., RU 

486) are not covered. Over-the-counter birth 

control methods, even if prescribed by a 

doctor, are not covered. 

• Breastfeeding support, supplies and 

counseling: Pregnant and postpartum 

women will have coverage for lactation 

counseling from applicable health care 

providers. Manual breast pumps are 

covered; electric breast pumps and supplies 

are not covered. NOTE: Pregnancy services 

including prenatal, delivery and postnatal 

care are subject to member copayments, 

deductibles and coinsurance. 

• Domestic violence screening: Screening 

and counseling for interpersonal and domestic 

violence will be covered for all women. 


Women’s Health 

and Cancer Rights Act 

The Women’s Health and Cancer 

Rights Act of 1998 introduced changes 

in insurance coverage for a mastectomy. 

In accordance with the law, all group 

and individual health plans that provide 

medical and surgical benefits for a 

mastectomy will cover reconstructive 

breast surgery, including: 

• Reconstructive surgery on the 

breast on which the mastectomy 

was performed. 

• Reconstructive surgery on 

the unaffected breast needed 

to “produce a symmetrical 

appearance.” 

• Prostheses and treatment of 

complications of any stage of a 

mastectomy, including lymphedema 

(postsurgical fluid buildup). 

The provisions of the Women’s Health 

and Cancer Rights Act of 1998 apply to all 

group health insurance coverage effective 

on the first day of the plan year (which 

in most cases is the anniversary date of 

the group contract) after Oct. 21, 1998. 

The law went into effect on all individual 

insurance policies issued, renewed or in 

effect on or after Oct. 21, 1998. 

These provisions apply to all policies 

issued by Arkansas Blue Cross and Blue 

Shield and Health Advantage and are 

subject to the applicable copayments, 

coinsurance, benefit limitations, 

exclusions and benefit maximums. 

If you have questions about your 

insurance coverage, contact your group 

benefits administrator or a customer 

service representative at an Arkansas 

Blue Cross office near you. We’d love 

to hear from you! 

We Love to Hear From You! 

May we help? For customer service, please call: 

Little Rock 

Number (501) 

Toll-free 

Number 

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

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

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

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

Pharmacy questions 1-800-863-5561 

Specialty Rx pharmacy questions 1-866-295-2779 

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


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


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

Looking for health or dental insurance? We can help! 

For individuals, families 378-2937 1-800-392-2583 

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

*Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas 

Prefer to speak with someone close to home? 

Call or visit one of our offices near you: 

ArkansasBlue — Little Rock 

2612 S. Shackleford Rd. — Suite J 501-378-2222 

Fayetteville 

516 East Millsap Rd. — Suite 103 1-800-817-7726 

Fort Smith 

3501 Old Greenwood Rd. — Suite 5 1-866-254-9117 

Hot Springs 

100 Greenwood Ave. — Suite C 1-800-588-5733 

Jonesboro 

707 East Matthews Ave. 1-800-299-4124 

Little Rock 

601 Gaines Street 1-800-421-1112 

Pine Bluff 

1800 West 73rd St. 1-800-236-0369 

Texarkana 

1710 Arkansas Boulevard 1-800-470-9621 

Visit our Web sites for more information: 

arkansasbluecross.com • healthadvantage-hmo.com 

blueadvantagearkansas.com • blueandyoufoundationarkansas.org 


27

good for you 

events and 

activities 

saturday, october 20 

Join Arkansas Blue Cross’ BlueCares 

Team for the Komen for a Cure 

walk. Our team will be handing out 

goodies to walkers. We look forward 

to supporting finding a cure for breast 

cancer with Central Arkansans. 

saturday, november 10 

Get ready for a happy, healthy 

holiday season with P. Allen Smith! 

Join us at the ArkansasBlue 

insurance store, from 9 a.m. 

to 1 p.m. for healthy food 

growing and cooking 

demonstrations, and activities 

with SilverSneakers ® * instructors. 

*SilverSneakers ® is a registered mark of 

Healthways, Inc. The SIlverSneakers ® Fitness 

Program is provided by Healthways, Inc., 

Healthways is an independent company 

that operates separately from Arkansas 

Blue Cross and Blue Shield. 

MPI 1129 9/12 

saturday, december 1 

City Mouse, Country Mouse, Christmas 

House! Arkansas Blue Cross is hosting 

a special showing of City Mouse, 

Country Mouse, Christmas House at 

the Arkansas Arts Center. Round up 

the family and enjoy a FREE night 

of the arts. Tickets can be picked 

up at ArkansasBlue, located in the 

Shackleford Crossing shopping center, 

while supplies last. Check our Web 

site for details. 

spring 2013 

Although spring is months away, now 

is the time to plan for the Blue & You 

Fitness Challenge. Start forming your 

team or group and plan to register 

for the 2013 Challenge. 

The Blue & You Fitness Challenge 

is an exercise contest (March 1 – 

May 31) that encourages participants 

to work toward the public health 

recommendation of adult physical 

activity 30 minutes each day, most 

days of the week. 

For more information, call toll 

free 1-800-686-2609, or visit 

blueandyoufitnesschallenge-ark.com.

Blue & You - Autumn 2012

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?