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Blue & You-WINTER 2020

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&<br />

A publication for the policyholders of the Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield family of companies<br />

<strong>WINTER</strong> <strong>2020</strong><br />

Big generation<br />

presents unique<br />

challenges and opportunities<br />

MILLENNIAL<br />

health<br />

PAGE 12<br />

Jonesboro church<br />

gets AED revival<br />

PAGE 4<br />

Calling us first<br />

has its benefits<br />

PAGE 10<br />

Gould clinic gives<br />

town “clean living”<br />

PAGE 14


Table<br />

3<br />

4<br />

6<br />

8<br />

9<br />

10<br />

12<br />

14<br />

16<br />

17<br />

17<br />

18<br />

20<br />

21<br />

21<br />

22<br />

23<br />

23<br />

24<br />

A Word with Curtis Barnett: Millennials are kind of a big deal<br />

AED donation generates a literal revival at a Jonesboro church<br />

Grant helps make Crystal Bridges more disability-friendly<br />

A picture-perfect hike – Crystal Bridges turns nature into a gallery<br />

<strong>Blue</strong> & <strong>You</strong> Foundation invests $3.4 million in Arkansas projects<br />

Call on us! <strong>You</strong>r health plan can help – in sickness and health<br />

Millennials’ health, preferences will shape the future<br />

Gould clinic puts a new spin on meeting patients’ needs<br />

Opioid problem? <strong>You</strong>’re not alone – medication-assisted treatment can help<br />

Partnership equips employers to battle opioid use<br />

Shingrix ® vaccine is now widely available<br />

<strong>2020</strong> pharmacy coverage changes<br />

<strong>Blue</strong> News<br />

of<br />

When you can’t get to the doctor, just “phone it in”<br />

I missed enrollment! What now? Stay calm – you have options for health coverage<br />

Medicare supplement has “friendlier” reports<br />

Geo<strong>Blue</strong> travel health insurance<br />

Customer Service contact information<br />

“Fam”-tastic entertainment<br />

Contents<br />

St. Elizabeth Health & Dental Center<br />

and its Wellness Center are a vibrant<br />

hub of community life in the small<br />

town of Gould in southeast Arkansas.<br />

Residents depend on the clinic for needs<br />

ranging from medical care to laundry.<br />

Read more on pages 14-15.<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield and its family of affiliates comply<br />

with applicable federal civil rights laws and do not discriminate on the basis<br />

of race, color, national origin, age, disability or sex. ATENCIÓN: si habla<br />

español, tiene a su disposición servicios gratuitos de asistencia lingüística.<br />

Llame al 1-844-662-2276. CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ<br />

trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-844-662-2276.<br />

2 <strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong><br />

&<br />

<strong>WINTER</strong> <strong>2020</strong><br />

EDITOR<br />

Greg Russell<br />

BYEditor@arkbluecross.com<br />

DESIGNER<br />

Ryan Kravitz<br />

PHOTOGRAPHER<br />

Chip Bayer<br />

CONTRIBUTORS<br />

Chip Bayer<br />

Jennifer Bridgeman<br />

Katie Eisenhower<br />

Kristy Fleming<br />

Ben McVay<br />

Suzi Parker<br />

Greg Russell<br />

Marie Trotter<br />

VICE PRESIDENT of<br />

CORPORATE MARKETING<br />

Alison Melson<br />

ON THE COVER<br />

Millennials are poised to<br />

become the largest segment of<br />

our population and workforce.<br />

Knowing what their health concerns<br />

and healthcare preferences are<br />

is a matter of vital importance.<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

has invested in research that has<br />

produced some surprising findings.<br />

This information could help shape<br />

the future of the healthcare delivery<br />

system. See page 12 to read about<br />

what we’ve learned.


a<br />

WORDwith<br />

Curtis Barnett<br />

Our President and Chief Executive Officer<br />

In case you didn’t know it, millennials are kind of a big deal.<br />

At nearly 73 million strong, millennials<br />

(those born between 1981 and 1996)<br />

are about to pass baby boomers as the<br />

nation’s largest generation. Within the<br />

next two years, they will account for<br />

50% of the American workforce. Their<br />

impact is being felt in every industry.<br />

They are our current and future leaders.<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield,<br />

more than any other healthcare<br />

company in our market, has invested<br />

in learning about this distinctive<br />

generation. We partnered with the<br />

national <strong>Blue</strong> Cross <strong>Blue</strong> Shield<br />

Association on several revealing<br />

studies that seek to understand<br />

millennials and reveal the root causes<br />

of their health challenges. <strong>You</strong> can read<br />

more about this work on pages 12-13.<br />

We’ve made some startling<br />

discoveries, including the fact that<br />

a third of millennials have health<br />

conditions that reduce their quality<br />

of life and their life expectancy. It<br />

is ironic that though this generation<br />

has witnessed many historic<br />

breakthroughs in both technology<br />

and medicine, their health is worse<br />

than prior generations. Mental health<br />

issues are much more pronounced,<br />

making up six of the 10 top health<br />

issues affecting millennials. Clearly,<br />

behavioral health services, including<br />

treatment/prevention of substance<br />

use disorders, will be a bigger issue<br />

going forward. And a jump in the<br />

prevalence of type 2 diabetes is<br />

something that warrants addressing.<br />

As a health plan leader and parent of<br />

a member of the generation following<br />

the millennials, this report was a<br />

chilling eye-opener. And if that were<br />

all we had learned about millennials,<br />

I might be discouraged. But that’s not<br />

all we learned.<br />

We also learned about millennials’<br />

perspectives, practices and<br />

preferences regarding healthcare.<br />

Through surveys and face-to-face<br />

listening sessions, we learned that<br />

millennials:<br />

• Embrace technology and<br />

value responsiveness and<br />

convenience. This signals to me<br />

that we are heading in the right<br />

direction by pursuing initiatives like<br />

telemedicine and remaining highly<br />

focused on providing excellent and<br />

personalized customer service.<br />

• Want a personal connection<br />

with a healthcare provider and<br />

value “whole person” care.<br />

This is music to my ears because<br />

it fits perfectly with integrated,<br />

coordinated care and preventive<br />

services. Primary care will play a<br />

key role in addressing millennials’<br />

health issues.<br />

• Are more likely to forego<br />

care due to cost. Nearly half of<br />

millennials said they do this – more<br />

than triple the rate among baby<br />

boomers. This finding validates<br />

our work on payment models that<br />

reward clinical effectiveness and<br />

our investment in technology to<br />

streamline processes and lower<br />

administrative costs.<br />

When I look at the results of these<br />

studies, one thing is clear: we’re<br />

going to have to do things differently.<br />

This is a clear call to action for all of<br />

us working in healthcare. Now that<br />

we are aware of the challenges and<br />

opportunities, it is incumbent on us<br />

to create better products, services<br />

and systems to meet the needs of<br />

millennials where they want to be<br />

met. No doubt, this will involve pairing<br />

personalized attention with easyto-use<br />

digital services in new and<br />

different ways. And we must work<br />

with healthcare providers to ensure a<br />

person’s physical and mental health<br />

needs are being met. At Arkansas <strong>Blue</strong><br />

Cross, we’ve already started down this<br />

path, but there is much more work to<br />

be done and we must move faster. We<br />

know that this generation – and those<br />

who follow – are counting on us.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 3


Arkansas <strong>Blue</strong> Cross donation generates<br />

a literal revival at a Jonesboro church<br />

hurch is where some people go to experience new life, in the<br />

spiritual sense. But for one Jonesboro man, it was the place<br />

where a device donated by the local Arkansas <strong>Blue</strong> Cross<br />

and <strong>Blue</strong> Shield team literally brought him back to life.<br />

On a Wednesday evening in April, Deacon Phil Cook was<br />

standing just outside the First Free Will Baptist Church<br />

sanctuary when he experienced a strange sensation. “I felt a<br />

fuzzy kind of feeling in my head, and I reached back to catch<br />

myself,” Cook recalled. “That’s the last thing I remember until I<br />

was being loaded in the ambulance.”<br />

No warning<br />

Cook, 79, a retired tool-and-die maker, had been diagnosed<br />

with an irregular heartbeat more than 20 years ago but was<br />

under treatment and said he had never experienced any<br />

serious heart problems. It had been a normal Wednesday ...<br />

he was preparing to plant a garden and he and Gloria, his wife<br />

of 60 years, were planning to visit family the following week<br />

in New Mexico.<br />

“All of a sudden, Brother Phil’s eyes rolled back in his head and<br />

he dropped like a sack of potatoes,” said fellow deacon Ronald<br />

Wheeless, who was standing nearby.<br />

Stunned church members rushed to help. Gloria, a retired<br />

nurse, checked for a pulse and found none. CPR was started.<br />

For the first few seconds, Wheeless was frozen with shock as<br />

he saw his fallen mentor lying motionless, perhaps dead. Then<br />

Wheeless’ wife reminded him of the church’s new AED.<br />

Cook (left) and Wheeless share a special<br />

bond, both as fellow deacons and as a<br />

result of Cook’s “Lazarus” experience.<br />

A lifesaving gift<br />

Last January, employees at the Arkansas<strong>Blue</strong> location in<br />

Jonesboro (a regional office for Arkansas <strong>Blue</strong> Cross) donated<br />

the automated external defibrillator (AED) to the church<br />

4<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong>


through the Jonesboro-based Community<br />

Health Education Foundation (CHEF) AED<br />

Placement Program. The lifesaving devices<br />

cost anywhere from $1,200 to $3,000.<br />

An AED, which can deliver an electrical<br />

shock to restart a heart that has stopped<br />

beating, is designed to be used in<br />

emergency situations by virtually anyone.<br />

Wheeless actually had picked the spot to<br />

install the AED box and was among the<br />

members who had been trained only a<br />

month before the incident.<br />

“When you get something like an AED, it’s kind<br />

of like buying insurance – you hope you’ll never<br />

have to use it, but it’s just a relief to have it<br />

there,” Wheeless said.<br />

After his wife’s prompting, Wheeless sprang<br />

into action. The device led him through<br />

each step as crucial seconds ticked by.<br />

Simultaneously, a group of congregants<br />

formed an impromptu prayer circle and began<br />

earnestly praying.They needed a miracle.<br />

Shock and awe<br />

“It told me there was no heartbeat, so I asked<br />

Mrs. Gloria if she wanted me to shock him,<br />

and she said, ‘yes,’ so I did,” Wheeless said.<br />

“We had to do that two more times. Right<br />

after we shocked him the third time, the fire<br />

department arrived and took over. That’s when<br />

I heard Phil start talking. He wasn’t really sure<br />

where he was – but he was alive!”<br />

“We were thankful ... glad ... joyous – but still<br />

in shock,” Wheeless explained.<br />

“The first thing I remember when I started to<br />

wake up was hearing this voice in the distance<br />

hollering, ‘Sit me up! I can’t breathe,’ “Cook<br />

recalled. “At first it sounded far away, but it<br />

‘‘<br />

When you get<br />

something like<br />

an AED, it’s kind<br />

of like buying<br />

insurance –<br />

you hope you’ll<br />

never have to<br />

use it, but it’s<br />

just a relief to<br />

have it there.<br />

‘‘<br />

Deacon<br />

Ronald<br />

Wheeless<br />

gradually got louder and louder ... until I<br />

realized it was me! That is when I realized I<br />

was being loaded into an ambulance.”<br />

Wheeless is reluctant to take any credit<br />

for saving his friend’s life. “We are not in<br />

the life-saving business – God is,” said<br />

Wheeless, a plumbing supplies dealer.<br />

“If we had not had the AED, or if Phil had<br />

gone home that night, the outcome could<br />

have been a lot different.”<br />

Paying it forward<br />

The church was so impacted by the incident that<br />

they later decided to fund an AED for another<br />

local church, again through CHEF. The AED was<br />

presented to First Christian Church (Disciples<br />

of Christ) in October. “If I can use an AED<br />

successfully, anyone can,” Wheeless said. “If<br />

you have any kind of public gathering of people,<br />

an AED is just as valuable as fire extinguishers<br />

– or even more valuable. Buildings can be<br />

replaced, but with people, if that opportunity is<br />

missed, a life can be lost forever.”<br />

Andrea Fleer, who leads Arkansas <strong>Blue</strong><br />

Cross’ marketing team in Jonesboro, said<br />

Cook’s revival makes her team even more<br />

committed to community involvement. “When<br />

we heard that a piece of equipment we had<br />

donated had saved a life, the overwhelming<br />

joy we felt was unbelievable. And the fact<br />

that the church ‘paid it forward’ to another<br />

congregation was just the icing on the cake.”<br />

As for Cook, he feels extremely blessed.<br />

“When I stop and think about the debt I owe<br />

my wife for what she did and how much my<br />

church folks love me and how God loves me<br />

and caused things to happen like they did, it<br />

just brings tears to my eyes,” he said. “I am<br />

just grateful to be alive.”<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 5


the<br />

ART<br />

of<br />

Arkansas <strong>Blue</strong> Cross grant<br />

helps make Crystal Bridges<br />

friendlier for all ability levels<br />

6<br />

Artist Joan Brown’s “Self-<br />

Portrait with Fish and Cat”<br />

has a miniature “touchable<br />

map” that can be used to<br />

help people with sight loss<br />

“see” the painting through<br />

representative textures.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong><br />

A young girl in a museum runs her fingers<br />

over the surface of an art display. Instead<br />

of painted brushstrokes, she feels the<br />

tickling bristles of a paintbrush ... the<br />

texture of a paint-smeared smock ... the<br />

silkiness of the artist’s blond hair ... a cat’s<br />

furry coat ... and a cool, scaly fish.<br />

The girl has vision loss. She is “seeing”<br />

the painting by touching a miniature<br />

version – a “touchable map” – of the<br />

original, 8-foot-tall artwork, which hangs<br />

on the wall. In the self-portrait, artist Joan<br />

Brown stands in a paint-covered smock<br />

and pants, holding a brush in one hand and<br />

a huge fish cradled in the other arm as a<br />

black cat strolls by.<br />

Art for everyone<br />

The museum is Crystal Bridges Museum<br />

of American Art in Bentonville. And<br />

the interactive display that allows<br />

the visually impaired youngster to<br />

experience a visual medium was made<br />

possible, in part, by a $10,000 grant from<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield.<br />

“In order to create a more welcoming<br />

environment for guests with all levels<br />

of sight, we have developed what we<br />

call touchable paintings,” said Kim<br />

Crowell, senior museum educator and<br />

accessibility coordinator. “I firmly believe


“A Tight Fix – Bear Hunting, Early Winter [The Life of a Hunter: A Tight Fix]” by artist<br />

Arthur Fitzwilliam Tait (1856) is a popular attraction at Crystal Bridges because of<br />

the dramatic “story” it depicts. Now people with vision loss can experience the<br />

harrowing scene through the sense of touch and descriptive displays.<br />

I firmly believe that everyone should have access to arts and<br />

culture, regardless of whether or not they have a disability.<br />

– Kim Crowell, senior museum educator and accessibility coordinator<br />

that everyone should have access to arts<br />

and culture, regardless of whether or not<br />

they have a disability.”<br />

A different way to “see”<br />

A touchable painting is a sensory a map<br />

of a work of art. Different textures are<br />

used to represent the subject matter the<br />

artwork depicts.<br />

“When someone feels this touchable map,<br />

they can get an idea of where objects in<br />

the original artwork are located,” Crowell<br />

said. “This is always combined with a<br />

highly detailed verbal description of the<br />

artwork, which enables the listener to<br />

paint a mental picture of what the artwork<br />

looks like in their mind’s eye.”<br />

Access for all<br />

The touchable paintings are one aspect<br />

of the Access and Inclusion Program, a<br />

comprehensive attempt to make Crystal<br />

Bridges a welcoming and inclusive<br />

environment for guests of all abilities<br />

and backgrounds. Crystal Bridges is<br />

wheelchair accessible, has provisions for<br />

people who have hearing and sight loss<br />

and welcomes service animals. There are<br />

programs for youth with autism and people<br />

who have Alzheimer’s disease/dementia.<br />

The museum also provides 3D-printed<br />

miniatures of selected sculptures and<br />

large-print and braille explanations of<br />

exhibits during specific programs and<br />

by request.<br />

According to Crowell, this kind of<br />

accommodation is unusual for a museum<br />

the size of Crystal Bridges. “Typically,<br />

when I see these kinds of multi-sensory<br />

tours, they are in larger museums in<br />

cities like New York or Washington,<br />

D.C.,” she said.<br />

Broader strokes<br />

But Crowell is not content with the<br />

museum’s current level of accessibility.<br />

“There has been significant work in<br />

this area, but we have a lot more work<br />

to do in order to create the welcoming<br />

environment for everyone that we really<br />

want. One thing I am really excited about<br />

in the future is ways to make our North<br />

Forest Trail more accessible for all levels<br />

of sight. We are creating 3D scans of<br />

some of the works of art on the trail<br />

which we will use to create touchable<br />

bronze scale models.”<br />

The North Forest Trail is one of eight<br />

trails that wind through the 120-acre<br />

museum campus. (See Outside in<br />

Arkansas on page 8 for more).<br />

Want to see a video about this program? https://vimeo.com/396050310/ed347cd7c2<br />

Crowell (right) shows a young patron the<br />

miniature “touchable map” of the 8-foot-tall<br />

Joan Brown self-portrait (shown on page 6).<br />

The display<br />

of William<br />

Wetmore Story’s<br />

“Sappho” (1867)<br />

has a 3D-printed<br />

miniature version.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 7


Crystal Bridges trails turn nature into a gallery<br />

C<br />

Crystal Bridges Museum of American Art in Bentonville has artfully<br />

merged fine art with the great outdoors. Eight trails wind a total<br />

of 4 miles through the museum’s 120-acre site, and the Ozark<br />

landscape beautifully frames some amazing art installations.<br />

Many of the trails are accessible to people with disabilities.<br />

For example, the North Forest Trail has a wheelchair-accessible<br />

elevator to take guests to the trailhead and is being made more<br />

user-friendly for people who have vision loss.<br />

“We are creating 3D scans of some of the works of art on our<br />

North Forest Trail which we will then use to create touchable<br />

in<br />

Arkansas<br />

A picture-perfect hike<br />

The Trails<br />

at Crystal<br />

Bridges<br />

Art Trail: Paved walking/biking trail with a<br />

moderate slope (0.5 miles)<br />

Crystal Spring Trail: Crushed granite hiking<br />

trail with a moderate slope and steps (0.5 miles)<br />

Crystal Bridges Trail: Paved walking/biking<br />

trail with some steep inclines (1 mile)<br />

North Forest Trail: Paved walking/biking loop<br />

trail with a moderate slope (1.1 miles)<br />

North Lawn Trail: Paved walking/biking trail<br />

with a moderate slope (0.25 miles)<br />

Orchard Trail: Paved walking/biking trail with<br />

a gentle slope (0.5 miles)<br />

Rock Ledge Trail: Crushed granite hiking trail<br />

with a moderate slope and steps (0.5 miles)<br />

Tulip Tree Trail: Crushed granite hiking trail with<br />

a moderate slope and steps (0.75 miles)<br />

bronze 3D models,” said Kim Crowell, senior museum educator<br />

and accessibility coordinator. “The scaled-down models can be<br />

touched by everyone. We will also provide a large-print version<br />

of the label text next to a braille version, so everyone can read<br />

about the art on the trail.”<br />

The museum trails, which have paved and crushed-granite<br />

surfaces, are part of the Bentonville Trail System and connect<br />

to the Razorback Regional Greenway, a 37.6-mile shared-use<br />

trail that connects Fayetteville and Bella Vista.<br />

So if you want to get some culture while you exercise and take<br />

in some fresh air and gorgeous scenery in the process, this<br />

northwest Arkansas masterpiece may be in the picture.<br />

8<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong>


Better health – granted<br />

<strong>Blue</strong> & <strong>You</strong> Foundation invests $3.4<br />

million in Arkansas projects for <strong>2020</strong><br />

What do a splash pad, a nurse case manager, a cooking<br />

class and a telemedicine system have in common?<br />

These are just four examples of health-promoting<br />

requests funded by the <strong>Blue</strong> & <strong>You</strong> Foundation for a<br />

Healthier Arkansas as part of $3.4 million in annual<br />

grant awards for <strong>2020</strong>. The grants will fund 40<br />

initiatives in 23 of Arkansas’ 75 counties.<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield established<br />

the <strong>Blue</strong> & <strong>You</strong> Foundation in 2001. Since then, it has<br />

awarded more than $36 million to nonprofits and<br />

governmental agencies for 1,922 health-improvement<br />

programs in 248 communities and in all 75 counties.<br />

To see the full list, go to blueandyoufoundationarkansas.org. Here’s a sampling:<br />

• Ashdown Community Foundation<br />

($150,000) – to build a splash pad<br />

in the city park<br />

• McGehee Hospital ($150,000) –<br />

to hire nurses to help 300 patients in<br />

southeast Arkansas manage chronic<br />

conditions<br />

• Arkansas Council on Economic<br />

Education, Little Rock ($23,460) –<br />

to teach 120 schoolteachers from<br />

throughout the state how to prepare<br />

nutritious, low-cost meals<br />

• Baxter Regional Medical Center,<br />

Mountain Home ($149,997) –<br />

to create a telemedicine system for<br />

healthcare providers in north central<br />

Arkansas<br />

Benton County<br />

$155,400<br />

Baxter County<br />

$203,247<br />

Randolph County<br />

$148,387<br />

Cutting costs<br />

$<br />

351,679<br />

Washington<br />

County<br />

$160,000 Van Buren County<br />

$83,796<br />

Mississippi County<br />

$58,000<br />

H<br />

Better access<br />

$<br />

1,479,997<br />

Sebastian County<br />

$6,686<br />

Johnson County<br />

$4,964<br />

Yell County<br />

$150,000<br />

Hot Spring County<br />

$150,000<br />

Conway County<br />

$55,000<br />

Faulkner County<br />

$299,991<br />

Pulaski County<br />

$745,989<br />

Woodruff County<br />

$10,000<br />

Phillips County<br />

$45,382<br />

New services<br />

$<br />

345,175<br />

Little River County<br />

$150,000<br />

Clark County<br />

$149,265<br />

Jefferson County<br />

$162,878<br />

Drew County<br />

$150,000<br />

Desha County<br />

$150,000<br />

Chicot County<br />

$169,752<br />

Wellness<br />

$<br />

1, 291,021<br />

Columbia County<br />

$169,035<br />

Union County<br />

$90,100<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 9


Call<br />

on us!<br />

There are many ways your<br />

health plan can help you –<br />

in sickness and in health<br />

Here are a few situations where a quick<br />

call to your health plan could help:<br />

When you have health concerns, you should call<br />

your doctor, but did you know your health insurance<br />

company can help you too? Even when you aren’t sick?<br />

The most obvious reasons members call Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield and our affiliates are to<br />

check on a medical claim or get a new ID card. But our<br />

customer service representatives are here to help you<br />

get the most value out of your health plan.<br />

“The way we see it, we exist to help people be as<br />

healthy as they can be,” said Erin Maxwell, who<br />

leads the customer service team for <strong>Blue</strong>Advantage<br />

Administrators of Arkansas. “We want to help our<br />

members avoid getting sick and to ensure that any<br />

health problems they have are caught early.<br />

10<br />

Finding<br />

healthcare<br />

providers<br />

It’s important to find out<br />

before you go to a doctor<br />

or hospital whether they<br />

are part of your health<br />

plan’s network. If you<br />

choose a healthcare<br />

provider outside your<br />

network, it could cost<br />

you more out of your<br />

own pocket. If you want<br />

to choose a primary<br />

care physician who<br />

participates in qualityfocused<br />

initiatives like the<br />

Patient-Centered Medical<br />

Home (PCMH) program<br />

or the Comprehensive<br />

Primary Care Plus (CPC+)<br />

program, we can also help<br />

you find one near you.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong><br />

Filling<br />

prescriptions<br />

Does the medicine your<br />

doctor prescribed come<br />

in a less-expensive<br />

generic form? Does it<br />

matter where you get<br />

prescriptions filled? Are<br />

there supply limits on<br />

your medicine? Is the<br />

medicine eligible for<br />

“step therapy?” Do you<br />

qualify for financial help<br />

for your medicine? All<br />

of these are questions<br />

we can help answer, and<br />

those answers could<br />

save you big dollars and<br />

lots of frustration. Often,<br />

the key is asking before<br />

that prescription is filled.<br />

Managing<br />

a disease/<br />

condition<br />

If you have a health<br />

condition that you<br />

struggle to live with<br />

and manage, you don’t<br />

have to do it alone. Our<br />

specially trained nurse<br />

case managers can help<br />

with chronic or complex<br />

condition management<br />

(diabetes, heart disease,<br />

asthma, lung disorders,<br />

etc.). These nurses,<br />

along with our dedicated<br />

social workers, can help<br />

you map out a plan,<br />

teach you about selfcare<br />

techniques and<br />

connect you to helpful<br />

support services. But<br />

we can’t help unless we<br />

know you need help. The<br />

first step is to call the<br />

customer service number<br />

on the back of your card.<br />

Hospital stays/<br />

outpatient<br />

procedures<br />

A hospital stay or<br />

outpatient procedure<br />

can lead to a number<br />

of healthcare claims.<br />

Contacting us beforehand<br />

may cut down on<br />

confusion about what’s<br />

covered and what is<br />

your share of the cost.<br />

Plus, you may qualify<br />

for services like case<br />

management. Nurse<br />

case managers can help<br />

coordinate your care, give<br />

you tips about what to<br />

do before your medical<br />

procedure, what to expect<br />

during and after your<br />

procedure and arrange<br />

for home health services,<br />

therapies and/or or<br />

special equipment to help<br />

you have the fastest and<br />

fullest recovery possible.


We have programs and services built into our health plans<br />

that are designed to do just that. <strong>You</strong> might not realize<br />

what is available to you, but a quick call to our team can<br />

direct you to additional benefits and ways we can help.<br />

“If something is going on with your health or a family<br />

member’s health, a quick call to find out what services<br />

might be available to you or just to give us a ‘heads<br />

up’ can help us provide you with the best value from<br />

your benefits. Whether it is finding a specialist in your<br />

network or connecting you to a nurse case manager,<br />

we want to help as early as possible.”<br />

For these reasons and more, we encourage members<br />

to contact us (by calling the customer service number<br />

on the back of their member ID card) to ensure they<br />

are getting the most value from their health plan.<br />

Pregnancy<br />

If you’re expecting,<br />

our Special Delivery<br />

program’s pregnancyfocused<br />

nurse case<br />

managers are here to<br />

help you and your baby<br />

have the best pregnancy<br />

and delivery journey<br />

possible. All Special<br />

Delivery moms-to-be<br />

receive free educational<br />

materials and resources.<br />

Moms at a higher-risk<br />

for complications can<br />

have a nurse case<br />

manager work with<br />

them all the way,<br />

monitoring progress<br />

and arranging special<br />

services, when needed.<br />

The first step is to<br />

contact us and let us<br />

know you have a bundle<br />

of joy coming.<br />

Wellness<br />

visits / health<br />

screenings<br />

<strong>You</strong>r health plan<br />

likely covers annual<br />

wellness visits<br />

or certain health<br />

screenings (for<br />

conditions like breast<br />

cancer, colorectal<br />

cancer, diabetes, etc.).<br />

If you’re not using the<br />

preventive benefits<br />

your health plan<br />

provides, you could be<br />

“leaving money on the<br />

table” and opening<br />

yourself to the risk<br />

that a condition might<br />

not be caught early,<br />

when it’s easier to<br />

treat ... or even cure.<br />

Healthy living<br />

If you’re looking to<br />

be healthier, call us!<br />

Chances are your<br />

health plan includes<br />

health-and-wellness<br />

benefits like discounts<br />

on health-and-fitness<br />

products and/or services,<br />

smoking-cessation<br />

assistance, nutritional<br />

counseling, educational<br />

resources and tools for<br />

healthy living. We can<br />

show you what your<br />

health plan offers and<br />

help you get connected.<br />

Behavioral /<br />

emotional<br />

health<br />

<strong>You</strong>r health plan may<br />

include coverage for<br />

services related to your<br />

behavioral/emotional<br />

health. If you need to<br />

know what’s covered,<br />

we can help.<br />

<strong>You</strong>r health plan website has lots of information about<br />

the services available to you and how you can access<br />

them. But if you still have questions or just want to talk<br />

it through with someone, call the customer service<br />

number on the back of your member ID card. There’s<br />

a friendly voice on the other end who is eager to help.<br />

For a handy reference of other helpful phone numbers,<br />

check out page 23 of this magazine.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 11


Generating change<br />

Millennials’ health, preferences will shape the future of healthcare<br />

Millennials (born 1981-1996) are the most educated 1 generation in<br />

history, the most diverse and at 73 million strong, they are quickly<br />

becoming the largest portion of today’s workforce. Unfortunately,<br />

millennials also face challenges from crippling debt, increased stress<br />

and declining health.<br />

To understand the current health status of millennials, the <strong>Blue</strong><br />

Cross <strong>Blue</strong> Shield Association (of which Arkansas <strong>Blue</strong> Cross and<br />

<strong>Blue</strong> Shield is an independent licensee) dove deep into its national<br />

data to understand which diseases and conditions most impact<br />

millennials. They also hosted 16 listening sessions and had more<br />

than 8,000 participants in six surveys. Here are some highlights of<br />

what they found.<br />

Here are the TOP 10<br />

conditions affecting<br />

millennials<br />

(ages 21-36 in 2017)<br />

1<br />

MAJOR DEPRESSION<br />

2<br />

SUBSTANCE USE DISORDER<br />

3<br />

ALCOHOL USE DISORDER<br />

4<br />

HYPERTENSION<br />

83%<br />

of millennials consider<br />

themselves in good<br />

or excellent health<br />

63%<br />

of millennials have<br />

a primary care<br />

physician (PCP)<br />

5<br />

6<br />

HYPERACTIVITY<br />

PSYCHOTIC CONDITIONS<br />

1/3<br />

of millennials have<br />

HEALTH CONDITIONS THAT<br />

AFFECT THEIR QUALITY OF LIFE<br />

12<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong><br />

AmeriSpeak ® survey conducted in 2018 by NORC<br />

at the University of Chicago using a probabilitybased<br />

panel designed to be representative of the<br />

U.S. household population.<br />

However, our data<br />

show that A MAJOR<br />

DECLINE IN HEALTH<br />

TYPICALLY BEGINS<br />

AT AGE 27 –<br />

IMPACTING<br />

MILLENNIALS<br />

TODAY<br />

7<br />

8<br />

9<br />

10<br />

CROHN’S DISEASE/<br />

ULCERATIVE COLITIS<br />

HIGH CHOLESTEROL<br />

TOBACCO USE DISORDER<br />

TYPE 2 DIABETES<br />

Conditions significantly impact<br />

health if they reduce future healthy<br />

life by more than six months.<br />

1<br />

Pew Research Center


Double-digit increases for<br />

8 OF THE TOP 10 CONDITIONS<br />

AFFECTING MILLENNIALS<br />

6 OF THE TOP 10 CONDITIONS<br />

DEAL WITH BEHAVIORAL HEALTH<br />

and affect mental health and<br />

emotional well-being<br />

* Other endocrine conditions include<br />

parathyroid, ovary, adrenal, pituitary and<br />

other endocrine system-related conditions.<br />

Examples include PCOS, parathyroid<br />

disorders, hypoglycemia, vitamin or<br />

mineral deficiencies and many others.<br />

Total adverse health for<br />

MILLENNIAL WOMEN<br />

IS 20% HIGHER<br />

than for men, mainly driven by:<br />

major depression, type 2 diabetes<br />

and other endocrine conditions*<br />

MAJOR DEPRESSION,<br />

HYPERACTIVITY AND<br />

TYPE 2 DIABETES<br />

increased the most<br />

The healthcare<br />

millennials want<br />

Surveyed millennials view the healthcare<br />

system very differently than past generations,<br />

and said they want:<br />

• Fast and easy access to care –<br />

including short waits, online scheduling,<br />

extended clinic hours, digital access to<br />

records, etc.<br />

• Face-to-face care and virtual options –<br />

including text, email, video chats, etc.<br />

• A personal relationship with a<br />

healthcare provider – ironically, many said<br />

the lack of this relationship was why they<br />

had not sought care<br />

• A holistic, culturally sensitive approach –<br />

with a central contact guiding the process<br />

The good news?<br />

Arkansas <strong>Blue</strong> Cross is already supporting<br />

and/or implementing initiatives that align with<br />

millennials’ preferences (like virtual health and<br />

patient-centered medical homes). Others are<br />

on the drawing board. We hosted two listening<br />

sessions, one in Cave Springs in northwest<br />

Arkansas and one in Little Rock and plan to<br />

do more to address millennials’ concerns. Our<br />

goal is to change the health of people in this<br />

generation for the better.<br />

COEUR D’ALENE<br />

MINNEAPOLIS<br />

SAN<br />

FRANCISCO<br />

BOISE<br />

SIOUX FALLS<br />

DES MOINES<br />

CAVE SPRINGS<br />

KANSAS<br />

CITY<br />

CEDAR RAPIDS<br />

PHILADELPHIA<br />

HARRISBURG<br />

BALTIMORE<br />

LITTLE ROCK<br />

NASHVILLE<br />

Listening session<br />

Local survey<br />

National survey<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 13


Gould clinic puts a new spin on<br />

meeting patients’ needs<br />

Good hygiene is a foundation of good health. So when<br />

some folks in the tiny town of Gould (Lincoln County)<br />

struggled to find places to wash their clothes, St. Elizabeth<br />

Health & Dental Center added washers and dryers to the<br />

long list of services they provide. As a patient-centered<br />

medical home (PCMH), they recognized it’s just one more<br />

way to keep people healthy.<br />

PCMH, a program of the Centers for Medicare & Medicaid<br />

Services (CMS), encourages primary care clinics to deliver<br />

evidence-based care to patients through innovation and<br />

a holistic approach. Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

brought the PCMH program to Arkansas and is proud to be<br />

one of the payers who reward participating clinics that do<br />

well in the program.<br />

A matter of health and self-esteem<br />

“Wearing soiled clothing can actually affect your health,<br />

not to mention your self-esteem,” said Brenda Jacobs,<br />

D.N.P., APRN, chief executive officer of the Daughters of<br />

Charity Services of Arkansas, which operates the clinic<br />

and another in nearby Dumas (Desha County). “Yet we<br />

saw that for too many of our patients, a washer and<br />

dryer were ‘luxuries’ they simply could not afford, and<br />

our community has no laundromat. We decided it was<br />

worthwhile for us to give patients greater peace of mind<br />

and self-esteem to be able to fulfill this basic need for<br />

themselves and their families.”<br />

St. Elizabeth stands out against the gray landscape that<br />

pervades Gould. The clinic’s laundry access highlights<br />

its focus on meeting the community’s needs.<br />

Patients have responded to the service with gratitude,<br />

and a handful of people come each day to use the two<br />

sets of washers and dryers for the nominal fee of 50 cents<br />

a load. But laundry access is just the beginning of what<br />

the clinic offers.<br />

A changing community<br />

Gould’s population (755) is less than half of what it was 20<br />

years ago (1,600+), and abandoned and crumbling buildings<br />

dot the landscape as an endless procession of heavy-laden<br />

tractor-trailer rigs speed by on U.S. Highway 65.<br />

“I think it is extremely important to meet patients exactly<br />

14<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong>


Gould’s only grocery store<br />

closed a decade or so ago.<br />

where they are,” Jacobs said. “Gould is an economically<br />

depressed area with absolutely no local access to a grocery<br />

store – except for the one convenience store, which, from a<br />

health perspective, has all of the wrong kinds of food.”<br />

The clinic’s location on the highway perfectly illustrates<br />

Jacobs’ point: The lone convenience store sits a few dozen<br />

yards north, and a defunct Foodliner store, vacant for about<br />

10 years now, is the next neighbor to the south.<br />

A bright spot<br />

Yet, here in this fading community is a beacon of<br />

progressive healthcare. The clinic is such a light that it has<br />

become a gathering place and a community lifeline.<br />

As part of its holistic philosophy, the clinic offers family<br />

medicine, dental care, a full-service wellness center,<br />

pharmacy assistance, social services, Hispanic medical<br />

interpretation, a patient advisory committee, a community<br />

liaison and a community garden where anyone can come<br />

and pick healthy foods.<br />

Part of the Gould “family”<br />

So why do all this in Gould? “It’s pretty easy to see that<br />

the people here in Gould really need what we’re doing,”<br />

Jacobs said. “People in this community look at us as part<br />

of their family, and we feel the same way.”<br />

A vibrant spirit<br />

Residents echo Jacobs’ family metaphor and say the clinic<br />

is a crucial part of community life.<br />

Arutha White started coming to the Wellness Center about<br />

5 years ago. “After I retired, I didn’t want to just sit around<br />

and do nothing,” White said. “I was not eating healthy, so<br />

I was overweight. I’ve lost about 20 pounds and kept it off.<br />

I had a knee-replacement surgery, and now, it’s like I never<br />

had surgery.”<br />

“I am 70 years old, but I feel like I’m 40,” said Clem Arnold.<br />

“Coming here has been really good for me. And with the<br />

people here, you can feel the love when you walk in the door.”<br />

“Our whole reason”<br />

Plans for the clinic’s future include an eye clinic, expanded<br />

social work services and remotely delivered psychiatric<br />

care through a partnership with the University of Arkansas<br />

for Medical Sciences (UAMS) in Little Rock.<br />

But regardless of what new developments the future might<br />

hold, Jacobs is confident of one thing. “We will always be<br />

working to make life better for the people of Gould,” she<br />

said. “That is our whole reason for being here.”<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 15


Doctor’s<br />

NOTES<br />

by Mark T. Jansen, M.D.<br />

Vice President and Chief Medical Officer<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

Opioid problem? <strong>You</strong>’re not alone<br />

Medication-assisted treatment can help<br />

Too often, people who are dependent on opioid medications are reluctant to ask for help for fear that<br />

they will get into trouble or be denied what they need to cope. Opioid use disorder destroys lives ... recovery shouldn’t.<br />

That’s why Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield is working closely with the medical community and Arkansas businesses to address<br />

substance use disorders. We also want to work with our members, recognizing that you, or someone you love, may be struggling to<br />

live a normal life while hiding a disorder. We recognize that medication-assisted treatment (MAT), provided by qualified physicians<br />

and paired with counseling, can help people regain control of their lives without disrupting their jobs or families.<br />

Here’s a hypothetical example of how medication-assisted treatment could help:<br />

Bob had back surgery four years ago<br />

and was prescribed opioids for painmanagement<br />

during his recovery. As<br />

he struggled with pain, Bob developed<br />

an opioid use disorder. After his doctor<br />

stopped writing prescriptions for<br />

opioids, Bob turned to other sources.<br />

And now, when he can’t find opioids,<br />

he uses illicit street drugs. He is hiding<br />

his disorder, but he wants to stop.<br />

Bob is afraid that if he tells his<br />

doctor, he will be turned away, or<br />

worse, he will be reported to the<br />

police. He is worried that he will<br />

need inpatient treatment ... or be<br />

forced to go through an agonizing<br />

withdrawal. His job is already at risk,<br />

and he worries about the affect his<br />

disorder will have on his family if it<br />

is made public. He is afraid he could<br />

lose everything. But he knows if he<br />

overdoses, he could lose his life.<br />

Bob finally tells his doctor about<br />

his struggle and finds his doctor is<br />

compassionate and ready to help.<br />

His doctor has completed special<br />

training and received a federal waiver<br />

to prescribe medication-assisted<br />

treatment. With the help of his doctor,<br />

Bob can take steps toward recovery<br />

with no inpatient treatment, no “cold<br />

turkey” and no withdrawal. Bob is able<br />

to function as he and his doctor work<br />

to end his substance use disorder.<br />

Bob’s treatment is covered. As an<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />

member, his medication-assisted<br />

treatment prescriptions are filled<br />

without prior approval (<strong>Blue</strong>Advantage<br />

members should check their benefits).<br />

That means he can get the prescription<br />

he needs to start treatment right away.<br />

His doctor meets with him frequently<br />

to get his dose right and monitors him<br />

through urine tests.<br />

Bob gets connected with<br />

behavioral health counseling,<br />

which is recommended. Some of<br />

Bob’s counseling sessions are covered<br />

through his Employee Assistance<br />

Program at work. And since there’s<br />

no long work absence required for<br />

outpatient treatment, Bob can preserve<br />

his privacy. Only he, his doctor and his<br />

counselor know about his treatment.<br />

For medication-assisted treatment to work, people who need it have to speak up. Take the first step. Talk to your doctor, call<br />

the number on the back of your health plan ID card or call the New Directions Substance Use Member Hotline at 1-877-326-2458.<br />

Take the first step ... ask for help.<br />

16<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong>


New coalition empowers employers<br />

to battle opioid use disorder<br />

Employers in Arkansas have some new weapons in the<br />

fight against the opioid crisis’ devastating impact on our<br />

state’s workforce.<br />

According to the American Action<br />

Forum, between 1999 and 2015:<br />

• Opioid use disorder took 43,400<br />

workers out of the state’s workforce<br />

• A staggering 574 million work hours<br />

were lost to substance use disorder<br />

• Opioid use in Arkansas caused<br />

$33.5 billion in lost productivity<br />

Currently, opioids take one life in Arkansas<br />

every two days 1 .<br />

Together Arkansas (togetherarkansas.com) is an opioid<br />

“The opioid epidemic is one of the biggest threats to the<br />

response initiative developed by the Arkansas State Chamber foundation of business and our economy today,” said Curtis<br />

of Commerce/Associated Industries of Arkansas, Arkansas<br />

Barnett, president and chief executive officer of Arkansas<br />

<strong>Blue</strong> Cross and <strong>Blue</strong> Shield and the Arkansas Foundation<br />

<strong>Blue</strong> Cross. “Providing Arkansas employers tools to address<br />

for Medical Care (AFMC). Walmart is its digital outreach<br />

a problem as pervasive as opioid use disorder is critical.<br />

sponsor. The website provides employers a toolkit of free<br />

Helping employees break the bonds of addiction and get and<br />

resources for prevention and response and covers a range of stay healthy keeps them creative, innovative and productive.<br />

issues, including legal concerns, drug-testing, policymaking, And that makes Arkansas strong.”<br />

assisting employees in getting help, returning to work, etc.<br />

For more, visit togetherarkansas.com.<br />

1<br />

According to the National Institute on Drug Abuse’s (NIDA) Arkansas Opioid Summary.<br />

Shingrix ® : Don’t miss your second dose!<br />

Supply of shingles vaccine is<br />

now widely available<br />

If you received one dose of the<br />

Shingrix ® vaccine but a shortage kept<br />

you from getting your second dose – a<br />

painful case of shingles still could be<br />

in your future.<br />

The makers of Shingrix claim its<br />

protection is sustained at a high<br />

level for at least four years – but only<br />

if you get both doses 2-6 months<br />

apart. Many people rushed to get<br />

the Shingrix vaccine after it was<br />

introduced in 2017, but shortages<br />

left some people without the<br />

crucial second dose. Supplies have<br />

rebounded, and the vaccine is now<br />

widely available.<br />

Shingles is a painful rash that<br />

follows nerve pathways. It is caused<br />

by the varicella zoster virus (which<br />

also causes chickenpox). The virus<br />

can lie dormant in the nerves for<br />

many years. People older than age<br />

50 (or whose immune systems are<br />

compromised) have a greater risk of<br />

developing shingles.<br />

Who should get vaccinated?<br />

Shingrix is recommended for adults<br />

age 50 and older who have normal<br />

immune systems. The Centers for<br />

Disease Control & Prevention (CDC)<br />

recommends that people previously<br />

vaccinated with the less-effective<br />

Zostavax ® vaccine, be revaccinated<br />

with Shingrix – even if they<br />

have never had<br />

chickenpox. Many<br />

patients who could not<br />

take Zostavax may be<br />

able to receive Shingrix.<br />

Because the vaccine is<br />

preventive, it often is fully<br />

covered (no out-of-pocket<br />

expense) for members who<br />

fit the CDC prescribing<br />

guidelines (age, etc.).<br />

If you have questions or need<br />

help locating a pharmacy or clinic<br />

with the Shingrix vaccine, call<br />

the customer service number on<br />

the back of your ID card or on<br />

page 23 of <strong>Blue</strong> & <strong>You</strong>.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 17


<strong>2020</strong> pharmacy coverage changes<br />

Prescription drugs make up a<br />

big chunk of the overall cost<br />

of healthcare. Arkansas <strong>Blue</strong><br />

Cross and <strong>Blue</strong> Shield works<br />

hard to make sure you get the<br />

safest drugs at the lowest cost.<br />

Almost every year, some members<br />

face decisions about changing drugs because<br />

of cost. The tables below show changes to our<br />

formularies (covered drug lists) that are effective<br />

as of January 1, <strong>2020</strong>. Check them out to see if<br />

there are changes that could save you money or<br />

bring about adjustments in your treatment plan.<br />

The Standard Formulary is used by Arkansas <strong>Blue</strong><br />

Cross, Health Advantage and some <strong>Blue</strong>Advantage<br />

Administrators of Arkansas health plans. Call the<br />

customer service number on your member ID card to<br />

verify which formulary your health plan uses.<br />

The Metallic Formulary is used by Arkansas <strong>Blue</strong> Cross<br />

members with our metallic health plans, which are<br />

compliant with the Affordable Care Act (ACA). These<br />

plans are available on and off the federally facilitated<br />

marketplace (exchange) and through Arkansas Works.<br />

Standard formulary<br />

additions:<br />

Therapeutic<br />

drug class<br />

Indication/therapeutic<br />

drug class<br />

Aimovig Central nervous system Migraine prophylaxis<br />

Fasenra Respiratory agent Treatment of severe asthma<br />

Mayzent Central nervous system Relapsing forms of multiple sclerosis<br />

Nubeqa Antineoplastic agents Treatment of prostate cancer<br />

Rinvoq Autoimmune agents Treatment of moderate to severe rheumatoid arthritis<br />

Symproic Gastrointestinal Treatment of opioid-induced constipation<br />

Temixys Antiretroviral agents Combination agent for the treatment of HIV-1 infection<br />

Tremfya Autoimmune agents Treatment of moderate to severe plaque psoriasis<br />

Xultophy Incretin mimetic agent/<br />

insulin combination<br />

Type 2 diabetes mellitus<br />

Yonsa Antineoplastic agents The treatment of prostate cancer<br />

Standard formulary tier<br />

change (to nonpreferred):<br />

Therapeutic<br />

drug class<br />

Alternatives<br />

Elidel Topical dermatology Generic available<br />

Letairis Pulmonary arterial hypertension Generic available<br />

Retin-A mico Acne vulgaris Generic available<br />

Reyataz Antiretroviral agents Other protease inhibitors for treatment of HIV-1 infections<br />

Safyral Oral contraceptives Other monophasic contraceptives<br />

Tarceva Antineoplastic agents Generic erlotinib and Iressa<br />

Tekturna Pulmonary arterial hypertension ambrisentan, bosentan and Opsumit<br />

Tracleer Pulmonary arterial hypertension ambrisentan, bosentan and Opsumit<br />

Standard with step<br />

formulary deletions:<br />

Therapeutic<br />

drug class<br />

Alternatives<br />

18<br />

Jublia<br />

Lo Loestrin Fe<br />

Natazia<br />

Taytulla<br />

Asmanex<br />

Combivent Respimat<br />

Antifungals<br />

Oral contraceptives<br />

Oral contraceptives<br />

Oral contraceptives<br />

Asthma<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong><br />

Anticholinergic/beta agonist Combinations for<br />

COPD (chronic obstructive pulmonary disease)<br />

Generic oral options available to treat toenail fungus<br />

Other biphasic contraceptives<br />

Other four-phase contraceptives<br />

Other monophasic contraceptives<br />

Arnuity Ellipta, Flovent Diskus, Flovent HFA, Pulmicort<br />

Flexhaler Pulmicort Respules and Qvar RediHaler<br />

ipratropium-albuterol inhalation solution, Anoro,<br />

Bevespi Aerosphere and Stiolto Respimat


Standard with step<br />

formulary deletions:<br />

Avonex, Plegridy<br />

Butrans<br />

Carafate tablet<br />

and solution<br />

FreeStyle Libre<br />

continuous glucose<br />

monitoring system<br />

Hysingla ER, OxyContin,<br />

Zohydro ER<br />

MoviPrep powder<br />

for oral solution,<br />

OsmoPrep oral tablet<br />

ProAir HFA and<br />

RespiClick<br />

Qtern<br />

Other:<br />

Kevzara<br />

Therapeutic<br />

drug class<br />

Multiple sclerosis agents<br />

Opioid analgesics<br />

Gastrointestinal<br />

Diabetes supplies<br />

Opioid analgesics<br />

Colonoscopy prep<br />

Short-acting beta agonists<br />

SGLT2 inhibitor<br />

Autoimmune agents<br />

Alternatives<br />

glatiramer, Aubagio, Betaseron, Copaxone, Gilenya,<br />

Mayzent, Rebif and Tecfidera<br />

Belbuca and buprenorphine tablets<br />

Generic sucralfate<br />

Dexcom continuous glucose monitoring system<br />

fentanyl transdermal, hydromorphone extended-release,<br />

methadone, morphine extended-release, Embeda,<br />

Exalgo, Kadian, MS Contin, Nucynta ER and Xtampza ER<br />

GoLytely, NuLytely, MiraLax and Suprep<br />

albuterol sulfate and levalbuterol inhalers<br />

Glyxambi<br />

Now only preferred after two preferred agents<br />

have been tried<br />

Metallic formulary deletions:<br />

Lyrica capsules – all strengths<br />

ProAir HFA and RespiClick<br />

Asmanex<br />

Combivent Respimat<br />

Indomethacin capsules<br />

Acyclovir ointment 5%<br />

Taytulla<br />

Balcoltra<br />

Carafate suspension<br />

Transdermscop patch<br />

Tradjenta 5mg tablet<br />

Apriso capsule<br />

Colesevelam tab<br />

Myrbetriq tablet 50mg<br />

Alternatives<br />

Generic Pregabalin, Gabapentin<br />

albuterol and levalbuterol inhalers<br />

Arnuity Ellipta, Qvar RediHaler<br />

ipratropium-albuterol inhalation solution, Bevespi Aerosphere<br />

Other generic non-steroidal anti-inflammatory drugs<br />

Denavir cream, acyclovir, valacyclovir<br />

Other monophasic contraceptives<br />

Oral contraceptives<br />

Sucralfate tablets<br />

Scopalamine patch<br />

Alogliptin and Januvia<br />

Mesalamine caps and tabs<br />

Colestipol, cholestyram powder<br />

Darifenacin, oxybutynin, solifenacin, tolterondine and trospium<br />

Metallic formulary utilization management added:<br />

Eucrisa ointment 2%<br />

Step therapy<br />

Diclofenac gel 1%<br />

Quantity limits<br />

Mupirocin ointment 2% Quantity limits<br />

Triamcinolone 0.1% cream Quantity limits<br />

Triamcinolone 0.1% ointment Quantity limits<br />

Xifaxan<br />

Quantity limits<br />

Vyvanse<br />

Quantity limits<br />

Creon<br />

Prior approval<br />

Daraprim<br />

Prior approval<br />

Depen Titratabs<br />

Prior approval<br />

Noxafil<br />

Prior approval<br />

Zenpep<br />

Prior approval<br />

Metallic formulary additions:<br />

Anoro Ellipta<br />

Arnuity Ellipta<br />

Mesalamine tablet/capsule<br />

Silenor<br />

Tremfya injection<br />

Xeljanz<br />

Xultophy<br />

Note: The <strong>2020</strong> formulary changes listed above are partial listings and<br />

include the medications most used by our members. For complete listings<br />

of all covered medications and utilization management requirements,<br />

see the complete Standard and Metallic lists at arkansasbluecross.com/<br />

members/employer-coverage/pharmacy-information.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 19


<strong>Blue</strong>NEWS<br />

The Governor’s I-40 Showdown<br />

adds a new color<br />

The Governor’s I-40 Showdown is a battle between the purple<br />

and gray of the UCA Bears and the maroon and silver of the Little<br />

Rock Trojans. This year, a new color has joined the fray – <strong>Blue</strong>!<br />

Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield recently signed on as<br />

presenting sponsor of the head-to-head rivalry series between<br />

the athletic programs of the University of Central Arkansas and<br />

the University of Arkansas at Little Rock. The annual 11-sport<br />

competition fits perfectly with Arkansas <strong>Blue</strong> Cross’ emphasis on<br />

health and fitness ... and all that team building represents.<br />

The university that<br />

accumulates the<br />

most points during<br />

the athletic season wins bragging rights<br />

and gets its name permanently engraved on the Governor’s<br />

Trophy, which will reside on the reigning champion’s campus the<br />

following year. The trophy will be awarded this spring, when the<br />

two schools meet for a baseball game at Dickey-Stephens Park<br />

in North Little Rock.<br />

Up for a Challenge?<br />

Mark your calendar for one of the sure signs of spring<br />

– the <strong>2020</strong> <strong>Blue</strong> & <strong>You</strong> Fitness Challenge. The contest,<br />

held March 1-May 31 each year, asks participants to<br />

log their exercise to see who can earn the most points.<br />

Groups of colleagues, friends or family members compete<br />

against other similarly sized groups, and although the<br />

competition can be intense, when overall community<br />

health and wellness improves, everyone is a winner.<br />

Registration for the Challenge is open until mid-<br />

February, and you can find out more and/or sign up at<br />

blueandyoufitnesschallenge-ark.com.<br />

Little Rock Marathon – Walk, run ... and fun!<br />

There’s something for everyone during Little<br />

Rock Marathon Race Weekend (Friday, February<br />

28-Sunday, March 1). The iconic event, sponsored<br />

by Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield, includes<br />

a marathon, half marathon, 10K, 5K run/walk,<br />

a children’s mile and a free two-day health and<br />

fitness expo. Visit littlerockmarathon.com to<br />

learn more or to register for one of the weekend’s<br />

events. Arkansas <strong>Blue</strong> Cross is giving away 14 free<br />

registrations to the race. Stop by the Arkansas<strong>Blue</strong><br />

location at Shackleford Crossings in Little Rock<br />

during in the month of January to register. Winners<br />

will be announced February 1!<br />

20<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong>


Gone viral?<br />

Virtual health can help<br />

When you can’t get to the doctor during cold-and-flu season ... “phone it in”<br />

Cold-and-flu season is in full swing. When you have a “bug”<br />

but can’t get to the doctor’s office, virtual health can get you<br />

the care you need to get back on your feet a little faster.<br />

Virtual health (powered by MDLIVE) is expert medical care<br />

(for nonemergencies) that’s as close as your computer or<br />

smartphone ... around the clock and around the world.<br />

Easy to sign up, simple to use<br />

Virtual health is user-friendly. Simply go to<br />

MyVirtualHealth.com and follow the instructions.<br />

Go to MyVirtualHealth.com see the full list of<br />

eligible conditions.<br />

Of course, for emergencies (like broken bones,<br />

excessive bleeding, dangerously high fever, bad<br />

burns, symptoms of heart attack or stroke, etc.) get<br />

to the nearest emergency room.<br />

Virtual health is healthcare.<br />

Anytime. Anywhere.<br />

The deadline to enroll in a health<br />

plan came and went in December. If you<br />

missed your chance but still need coverage, we have several<br />

possibilities that may work for you. Just answer these questions:<br />

• Do you qualify for Arkansas Works? People who qualify<br />

for the Medicaid expansion in Arkansas (Arkansas Works)<br />

can enroll for health coverage anytime. <strong>You</strong> can apply at<br />

access.arkansas.gov.<br />

• Do you have a qualifying life event? Circumstances that can<br />

enable you to enroll in a new plan (or make changes to your<br />

existing plan) outside the annual enrollment period * include:<br />

– Marriage – Divorce – Moving to another state<br />

– Birth/adoption/new guardianship<br />

– Involuntary loss of health coverage<br />

– Death of a person covered under your policy<br />

What can virtual health treat?<br />

Virtual health is intended for common nonemergency conditions.<br />

<strong>You</strong> can use it if you have:<br />

• A bad cold • Stomach troubles<br />

• A child with a high fever (Yes, pediatricians are available!)<br />

Virtual Health is for members with medical coverage but is not available to all health plans at this<br />

time. Members whose coverages include virtual health should be able to successfully register online.<br />

A check of your benefit summary will indicate whether virtual health is available to you.<br />

Copyright © 2018 MDLIVE Inc. All Rights Reserved. MDLIVE does not replace the primary care physician and<br />

is not an insurance product. MDLIVE may not be available in certain states and is subject to state regulations.<br />

MDLIVE does not prescribe DEA controlled substances and may not prescribe non-therapeutic drugs and certain<br />

other drugs, which may be harmful because of their potential for abuse. MDLIVE does not guarantee patients<br />

will receive a prescription. Healthcare professionals using the platform have the right to deny care if based on<br />

professional judgment a case is inappropriate for telehealth or for misuse of services. MDLIVE and the MDLIVE<br />

logo are registered trademarks of MDLIVE, Inc. and may not be used without written permission. For complete<br />

terms of use visit welcome.mdlive.com/terms-of-use/. MDLIVE is an independent company which provides<br />

telehealth services on behalf of Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield.<br />

I missed enrollment! What now?<br />

Stay calm – you have options for health coverage<br />

• Would a limited-duration plan fit your needs? Our<br />

limited-duration plans, Complete and Complete Plus, provide<br />

coverage for the length of time you need it. These plans feature:<br />

– Comprehensive coverage with plan options for a single term<br />

(up to 12 months) or a renewable term (up to 36 months)<br />

– Predictable copays for primary care doctors, with some<br />

plan options also featuring copays for specialists<br />

– Affordable monthly premiums<br />

– Prescription drug coverage<br />

To learn more, visit arkbluecross.com/complete.<br />

To view all our individual and family plans and learn<br />

more, visit arkansasbluecross.com. <strong>You</strong> can also call<br />

1-800-392-2583 or go to an Arkansas<strong>Blue</strong> location near<br />

you. Don’t worry; we’ll get you covered.<br />

* Note: This information does not apply to Medicare plans. For information on Medicare special enrollment periods, go to news.arkansasbluecross.com/medicare-basics. Also, enrollment<br />

or coverage changes must occur within 60 days of the qualifying event. Complete and Complete Plus are not required to comply with certain federal market requirements for health insurance,<br />

principally those contained in the Affordable Care Act. Complete and Complete Plus also are subject to medical underwriting. Be sure to check your policy carefully to make sure you are aware<br />

of any exclusions or limitations regarding coverage of pre-existing conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs<br />

and behavioral health and substance use disorder services). <strong>You</strong>r policy also might have lifetime and/or annual dollar limits on health benefits. If this coverage expires or you lose eligibility for this<br />

coverage, you might have to wait until an open enrollment period to get other health insurance coverage.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 21


Medi-Pak ® :<br />

Meet a kinder, gentler EOB<br />

Medicare supplement members getting more “reader-friendly” documents<br />

Medi-Pak ® Medicare supplement<br />

members are getting an upgrade!<br />

If you are a Medi-Pak member,<br />

you soon will receive a redesigned<br />

Explanation of Benefits (EOB)<br />

detailing how your benefits were<br />

applied to your healthcare claims.<br />

The new EOB is easier to read and<br />

understand and will help you keep<br />

track of your healthcare claims<br />

history and any amounts that<br />

remain to be paid to healthcare<br />

providers. Remember that the<br />

EOB is not a bill.<br />

Additional pages will group your<br />

medical charges by healthcare<br />

provider. Throughout your EOB,<br />

you’ll find helpful definitions,<br />

which help explain any confusing<br />

terminology.<br />

We hope this change makes it<br />

easier to understand how your<br />

claims are being paid.<br />

Here’s an<br />

example<br />

of the old<br />

version<br />

of the EOB:<br />

The new<br />

EOBs<br />

will look<br />

like this:<br />

What’s the<br />

frequency?<br />

In the past, members received<br />

claims documents one time each<br />

month. Medi-Pak members will<br />

receive the new EOB every two<br />

weeks, if you’ve had a healthcare<br />

claim processed during that time.<br />

The new EOB cover page summarizes:<br />

• The total amount your provider(s) charged<br />

• How much was paid by Arkansas <strong>Blue</strong> Cross, Medicare and/or other coverage<br />

• What (if anything) you owe to your healthcare provider(s)<br />

If you have any questions about the new EOB format, give us a<br />

call at 1-800-338-2312, Monday-Friday, 8 a.m.-5 p.m.<br />

22<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong>


Plans to go overseas?<br />

Don’t forget to enroll in international<br />

health insurance before you leave!<br />

Perfect for business, leisure and mission trips!<br />

1-800-392-2583<br />

arkbluecross.com/go<br />

Geo<strong>Blue</strong> health plans are offered in cooperation with many <strong>Blue</strong> Cross ® and <strong>Blue</strong> Shield ® companies, including Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />

Shield. <strong>You</strong> do not have to be currently enrolled in an Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield medical plan to purchase most Geo<strong>Blue</strong> plans.<br />

CUSTOMER SERVICE NUMBERS<br />

May we help?<br />

For customer service, please call:<br />

Visit our websites for more information:<br />

• arkbluecross.com<br />

• healthadvantage-hmo.com<br />

• blueadvantagearkansas.com<br />

• blueandyoufoundationarkansas.org<br />

TOLL-FREE Number<br />

Medi-Pak ® members 1-800-338-2312<br />

Medi-Pak ® Advantage members 1-877-233-7022<br />

Medi-Pak ® Rx members 1-866-390-3369<br />

Arkansas <strong>Blue</strong> Cross members 1-800-238-8379<br />

• Pharmacy questions 1-800-863-5561<br />

• Specialty Rx pharmacy questions 1-866-295-2779<br />

Arkansas <strong>Blue</strong> Cross Metallic members<br />

(Gold, Silver, Bronze, Catastrophic) 1-800-800-4298<br />

• Pharmacy questions 1-800-969-3983<br />

Health Advantage members 1-800-843-1329<br />

• Pharmacy questions 1-800-863-5567<br />

<strong>Blue</strong>Advantage members 1-888-872-2531<br />

• Pharmacy questions 1-888-293-3748<br />

Federal Employee members 1-800-482-6655<br />

Arkansas State Employees /<br />

Public School Employees 1-800-482-8416<br />

Looking for health or dental insurance? We can help!<br />

For individuals, families 1-800-392-2583<br />

For employer groups* 1-800-421-1112<br />

*Arkansas <strong>Blue</strong> Cross, Health Advantage and <strong>Blue</strong>Advantage Administrators of Arkansas<br />

Prefer to speak with someone close to home?<br />

Call or visit one of our offices near you:<br />

• Little Rock<br />

2612 S. Shackleford Rd., Suite J 1-501-378-2222<br />

• Fayetteville<br />

516 East Millsap Rd., Suite 103 1-800-299-4109<br />

• Fort Smith<br />

3501 Old Greenwood Rd., Suite 3 1-800-299-4060<br />

• Hot Springs<br />

1635 Higdon Ferry Rd. – Suite J 1-800-588-5733<br />

• Jonesboro<br />

2110 Fair Park Blvd. – Suite I 1-800-299-4124<br />

• Little Rock<br />

601 S. Gaines St. 1-800-421-1112<br />

• Lowell<br />

507 W. Monroe Ave. – Suite B 1-888-872-2539<br />

• Pine Bluff<br />

509 Mallard Loop Dr. 1-800-236-0369<br />

• Texarkana<br />

1710 Arkansas Blvd. 1-800-470-9621<br />

PAYING YOUR<br />

B I L L<br />

To pay by phone * ,<br />

please call<br />

1-800-354-9904<br />

*Medicare Advantage and Prescription Drug plan product<br />

members must call Customer Service to discuss available<br />

payment options. Health Advantage conversion plans are not<br />

eligible for online, mobile or pay-by-phone payment options.<br />

<strong>Blue</strong> & <strong>You</strong> <strong>WINTER</strong> <strong>2020</strong> 23


“Fam”-tastic<br />

entertainment<br />

Register for a chance to win<br />

FREE tickets for the 4p.m.<br />

March 14 show. Just go to<br />

our Arkansas<strong>Blue</strong> location in<br />

Fayetteville on Millsap Road.<br />

Want some family-friendly fun?<br />

Check out the Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield Family Fun Series at the Walton Arts Center in Fayetteville. Arkansas <strong>Blue</strong><br />

Cross sponsors the series, which features shows for the whole “fam” in February and March.<br />

By sponsoring the arts, Arkansas <strong>Blue</strong> Cross helps elevate the quality of life for<br />

everyone. For more information or to get your tickets, go to waltonartscenter.org.<br />

8852 1/20<br />

The Peking Acrobats<br />

Tuesday, February 25<br />

The Peking Acrobats perform<br />

daring maneuvers and display<br />

their technical prowess with<br />

such arts as trick-cycling,<br />

precision tumbling, juggling,<br />

somersaulting and gymnastics,<br />

pushing the limits of human<br />

ability and defying gravity with<br />

amazing displays of contortion,<br />

flexibility and control.<br />

Trike Theatre’s<br />

Sideways Stories<br />

from Wayside School<br />

March 7, 14 and 21<br />

Based on a popular children’s<br />

book, this laugh-out-loud play<br />

tells the story of a 30-floor<br />

school that accidentally was<br />

built sideways. Wayside School<br />

is full of interesting characters:<br />

Mean Mrs. Gorf; terrible Todd;<br />

and John, who can only read<br />

upside down. But you’ll never<br />

guess the truth about the new<br />

kid (Sammy) – or what happens<br />

on Halloween!

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