PERMIT NO. 458 lines blue BATON ROUGE, LA Your Health. … · 2009-03-10 · • hormone...
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On average, at Blue Cross and Blue Shield of Louisiana, 85 cents of every premium dollar goes toward healthcare costs. Catch Colorectal Cancer Early Did you know that there is a non-invasive way to screen for colorectal cancer? Everyone age 50 and older should be screened for colorectal cancer, according to the American Cancer Society. If colorectal cancer is diagnosed early, more treatment options are available, and the mortality rate is much lower. HMO Louisiana has implemented a quality improvement project to increase the rate of colorectal cancer screenings for men in Louisiana. We now offer a telephone reminder service to encourage our members of the right age, gender, etc. to get screened. There are several methods of screening for colorectal cancer, including various types of rectal exams, an X-ray exam and a less- invasive fecal occult blood test. This test checks for hidden blood in the stool. Studies show that when this test is performed every one to two years, the number of deaths from colorectal cancer is reduced by as much as 30 percent in people ages 50 to 80. The fecal occult blood test requires no preparation. Samples can be collected at home, and it costs less than other screening methods. Contact your doctor to find out whether you should be screened for colorectal cancer and which option may work best for you. For more information, visit the National Cancer Institute website at www.cancer.gov or the American Cancer Society website at www.cancer.org. Sources: National Cancer Institute; American Cancer Society • Blue Cross Celebrates 75 Years • Pharmacy Copayment Changes for 2009 • Notice of Privacy Practices Available • Save Time With Self-Service • Louisiana 2 Step News • 2008 Angel Award Winners • BCBSLA Honored for Financial Strength, Innovative Programs and Workplace Wellness • Louisiana Hospitals Named Centers of Distinction • Making Sense of Healthcare Costs WHAT’S INSIDE Bluelines 2009 VOL. 12, ISSUE 1 | Blue Cross and Blue Shield of Louisiana Celebrates 75 Years of Service Colorectal Cancer What it is and how you can prevent it Colorectal cancer is cancer that starts in either the colon or the rectum. It is the third most common cancer that is found in both men and women in the United States. However, the death rate from this type of cancer has been going down for the past 15 years. That’s because prevention and screenings have led to early detection and fewer cases of colorectal cancer. Preventing colorectal cancer Although the exact cause of most colorectal cancers is unknown, it is possible to prevent many of these cancers with the following: • regular colorectal screening for men and women beginning at age 50 • genetic testing, screening and treatment for people with a strong family history of colorectal polyps or cancer • a diet high in fiber, vegetables and fruits and low in processed and/or red meats • eating plenty of whole grains • at least 30 but preferably 45 to 60 minutes of moderate physical activity on five or more days of the week • maintaining a healthy body weight • a daily multi-vitamin that contains folic acid or folate • regular amounts of vitamin D (through sun exposure or a vitamin) • higher calcium and magnesium intake • hormone replacement therapy for women (consult with your doctor before choosing this option to discuss the benefits and risks) Source: American Cancer Society bluelines P. O. BOX 98024 • BATON ROUGE, LA 70898-9024 Making Sense of Healthcare Costs Reference guide available online PRSRT STD US POSTAGE PAID BATON ROUGE, LA PERMIT NO. 458 The United States continues to spend more on healthcare than other nations, but there are some positive indicators on the horizon. As healthcare leaders in the United States, Blue Cross and Blue Shield companies continue working hard to keep healthcare quality-driven, accessible and affordable. For the fourth year in a row, growth in health insurance premiums declined across the nation in 2007. According to a report prepared by PricewaterhouseCoopers (PwC) forAmerica’s Health Insurance Plans (AHIP), the rate of growth is currently at its lowest level in seven years. The Centers for Medicare and Medicaid Services reports that about 75 percent of every private health insurance premium dollar goes to pay the costs of hospitals, physician services and prescription drugs. • Hospital stays, physician services and prescription drug costs continue to increase faster than any other health-related expense. • Dental costs, nursing home costs and home health account for another 11 percent of healthcare expenditures. • PwC’s analysis concludes that administrative costs “are not a key driver of health insurance premiums.” • Nationwide, health insurance companies use only about 14 cents of every premium dollar for administrative costs, commissions, taxes and contributions to reserve funds for emergencies. To learn more, you can read or download the 2008 Medical Cost Reference Guide from the Blue Cross and Blue Shield Association at this link: http://www.bcbs.com/blueresources/mcrg/MCRG.pdf. (You will need Acrobat Reader software to open this file.) The Guide provides comprehensive information on healthcare economics, utilization and management trends from credible, peer-reviewed sources. 04100 00270 0309R Prestigious national and state organizations have honored Blue Cross and HMO Louisiana in recent months for excellence in financial strength, innovation and wellness. National rating service Standard & Poor’s has given Blue Cross and its subsidiaries a 12th consecutive “A” rating for financial strength, citing our strong competitive position in the Louisiana health insurance market, very strong capitalization, very strong liquidity supported by high-quality investments and return on revenue that is consistent with what it expects from an “A” rated not-for-profit company. “We are very pleased to have been recognized again for what we can offer to our current and future customers, including outstanding service and high-quality health insurance,” said Mike Reitz, Blue Cross’ interim president and CEO. “The fact that we have remained financially sturdy and stable, despite the impact of the recent hurricanes on the local economy and healthcare delivery system, speaks volumes about the strength of our company and our Blue brand.” Standard & Poor’s is the world’s foremost provider of benchmarks for measuring corporate financial health. Smart Bodies, the educational program developed by the Blue Cross and Blue Shield of Louisiana Foundation and the LSU AgCenter to fight childhood obesity, was recognized as a 2008 winner of the BlueWorks ® program. BlueWorks is a unique collaboration between the Blue Cross and Blue ShieldAssociation (BCBSA) and the Harvard Medical School Department of Health Care Policy, honoring successful approaches to improving health and wellness for members and consumers. “Blue Cross and Blue Shield of Louisiana should be applauded for its efforts to improve the quality of healthcare for consumers,” said Scott P. Serota, BCBSA president and CEO. The goal of the Smart Bodies program is to promote lifelong healthy eating patterns and a physically active lifestyle to children in Louisiana and their families. BCBSLA helped launch the program in 2005 with a five-year grant. By the end of 2007, Smart Bodies had been implemented in 52 of Louisiana’s 64 parishes, with the goal to reach every parish by the end of 2009. For more information, visit www.SmartBodies.org. Blue Cross and Blue Shield of Louisiana was named the winner of the 2008 Well Workplace Award for large Louisiana employers by the Louisiana Health Care Alliance (LHCA). This was the second straight year that Blue Cross’ Healthy You, Healthy Blue employee wellness program was recognized by LHCA, which recognizes employers that champion the health of their employees, work to create a culture of physical activity in the workplace and inspire change by looking beyond the criteria to new and innovative ways to inspire health. BCBSLA Honored for Financial Strength, Innovative Programs and Workplace Wellness The Blue Cross and Blue Shield Association has named several Louisiana facilities as centers of special distinction in certain areas of healthcare. Southwest Medical Center of Lafayette and Women & Children’s Hospital of Lake Charles have completed the evaluation process and met the criteria necessary to be designated as 2008-2009 Blue Distinction Centers for Bariatric Surgery. Blue Distinction is a nationwide program that has so far recognized 800 specialty centers in 42 states for providing quality care. These specialty areas include cardiac care, bariatric surgery, transplants and complex and rare cancers. The Blue Distinction program is raising the quality of care being delivered across the country by recognizing medical facilities that meet objective, evidence-based thresholds for clinical quality developed in collaboration with expert clinicians and leading professional organizations. In addition to the two hospitals mentioned above, six Louisiana hospitals are currently recognized as Blue Distinction Centers for Cardiac Care and two are noted as Blue Distinction Centers for Transplant. For more on Blue Distinction, including the most up-to- date lists of recognized facilities, visit the following link: http://www.bcbs.com/innovations/bluedistinction/. Louisiana Hospitals Named Centers of Distinction 5 Your Health. Our Commitment.
Transcript of PERMIT NO. 458 lines blue BATON ROUGE, LA Your Health. … · 2009-03-10 · • hormone...
On average, at Blue Cross and Blue Shield of Louisiana, 85 cents of every premium dollar goes toward healthcare costs.
Catch Colorectal Cancer Early
Did you know that there is a non-invasive way to screen for colorectal cancer? Everyone age 50 and older should be screened for colorectal cancer, according to the American Cancer Society. If colorectal cancer is diagnosed early, more treatment options are available, and the mortality rate is much lower.
HMO Louisiana has implemented a quality improvement project to increase the rate of colorectal cancer screenings for men in Louisiana. We now offer a telephone reminder service to encourage our members of the right age, gender, etc. to get screened.
There are several methods of screening for colorectal cancer, including various types of rectal exams, an X-ray exam and a less-invasive fecal occult blood test. This test checks for hidden blood in the stool. Studies show that when this test is performed every one to two years, the number of deaths from colorectal cancer is reduced by as much as 30 percent in people ages 50 to 80.
The fecal occult blood test requires no preparation. Samples can be collected at home, and it costs less than other screening methods. Contact your doctor to find out whether you should be screened for colorectal cancer and which option may work best for you.
For more information, visit the National Cancer Institute website at www.cancer.gov or the American Cancer Society website at
www.cancer.org.
Sources: National Cancer Institute; American Cancer Society
• Blue Cross Celebrates 75 Years• Pharmacy Copayment Changes for 2009• Notice of Privacy Practices Available• Save Time With Self-Service • Louisiana 2 Step News• 2008 Angel Award Winners• BCBSLA Honored for Financial Strength,
Innovative Programs and Workplace Wellness• Louisiana Hospitals Named Centers of
Distinction• Making Sense of Healthcare Costs
What’s INsIDE
Bluelines2009 VOL. 12, ISSUE 1 | Blue Cross and Blue Shield of Louisiana Celebrates 75 Years of Service
Colorectal Cancer What it is and how you can prevent it
Colorectal cancer is cancer that starts in either the colon or the rectum. It is the third most common cancer that is found in both men and women in the United States. However, the death rate from this type of cancer has been going down for the past 15 years. That’s because prevention and screenings have led to early detection and fewer cases of colorectal cancer.
Preventing colorectal cancerAlthough the exact cause of most colorectal cancers is unknown, it is possible to prevent many of these cancers with the following:
• regular colorectal screening for men and women beginning at age 50
• genetic testing, screening and treatment for people with a strong family history of colorectal polyps or cancer
•adiethigh in fiber, vegetables and fruits and low in processed and/or red meats
•eatingplentyofwholegrains
•at least 30 but preferably 45 to 60 minutes of moderatephysical activity on five or more days of the week
•maintainingahealthybodyweight
•adailymulti-vitaminthatcontainsfolicacidorfolate
• regular amounts of vitamin D (through sun exposure or a vitamin)
• highercalciumandmagnesiumintake
• hormonereplacementtherapyforwomen(consultwithyourdoctor before choosing this option to discuss the benefits and risks)
Source: American Cancer Society
bluelinesP. O. BOX 98024 • BATON ROUGE, LA 70898-9024
Making sense of healthcare CostsReference guide available online
PRSRT STDUS POSTAGE
PAIDBATON ROUGE, LA PERMIT NO. 458
The United States continues to spend more on healthcare than other nations, but there are some positive indicators on the horizon. As healthcare leaders in the United States, Blue Cross and Blue Shield companies continue working hard to keep healthcare quality-driven, accessible and affordable.
For the fourth year in a row, growth in health insurance premiums declined across the nation in 2007. According to a report prepared byPricewaterhouseCoopers(PwC)forAmerica’sHealthInsurancePlans(AHIP),therateofgrowthiscurrentlyat its lowest level inseven years.
The Centers for Medicare and Medicaid Services reports that about 75 percent of every private health insurance premium dollar goes to pay the costs of hospitals, physician services and prescription drugs.
• Hospital stays, physician services and prescription drug costs continue to increase faster than any other health-related expense.
• Dental costs, nursing home costs and home health account for another 11 percent of healthcare expenditures.
• PwC’s analysis concludes that administrative costs “are not a key driver of health insurance premiums.”
• Nationwide, health insurance companies use only about 14 cents of every premium dollar for administrative costs,commissions, taxes and contributions to reserve funds for emergencies.
To learn more, you can read or download the 2008 Medical Cost Reference Guide from the Blue Cross and Blue Shield Association at this link: http://www.bcbs.com/blueresources/mcrg/MCRG.pdf. (You will need Acrobat Reader software to open this file.) The Guide provides comprehensive information on healthcare economics, utilization and management trends from credible, peer-reviewed sources.
04100 00270 0309R
Prestigious national and state organizations have honored Blue Cross and HMO Louisiana in recent months for excellence in financial strength, innovation and wellness.
National rating service Standard & Poor’s has given Blue Cross and its subsidiaries a 12th consecutive “a” rating for financial strength, citing our strong competitive position in the Louisiana health insurance market, very strong capitalization, very strong liquidity supported by high-quality investments and return on revenue that is consistent with what it expects from an “A” rated not-for-profit company.
“We are very pleased to have been recognized again for what we can offer to our current and future customers, including outstanding service and high-quality health insurance,” said Mike Reitz, Blue Cross’ interim president and CEO. “The fact that we have remained financially sturdy and stable, despite the impact of the recent hurricanes on the local economy and healthcare delivery system, speaks volumes about the strength of our company and our Blue brand.”
Standard & Poor’s is the world’s foremost provider of benchmarks for measuring corporate financial health.
smart Bodies, the educational program developed by the Blue Cross and Blue Shield of Louisiana Foundation and the LSU AgCenter to fight childhood obesity, was recognized as a 2008 winner of the BlueWorks®
program. BlueWorks is a unique collaboration between
theBlueCrossandBlueShieldAssociation(BCBSA)andthe Harvard Medical School Department of Health Care Policy, honoring successful approaches to improving health and wellness for members and consumers.
“Blue Cross and Blue Shield of Louisiana should be applauded for its efforts to improve the quality of healthcare for consumers,” said Scott P. Serota, BCBSA president and CEO.
The goal of the Smart Bodies program is to promote lifelong healthy eating patterns and a physically active lifestyle to children in Louisiana and their families. BCBSLA helped launch the program in 2005 with a five-year grant. By the end of 2007, Smart Bodies had been implemented in 52 of Louisiana’s 64 parishes,with the goal to reach every parish by the end of 2009. For more information, visit www.SmartBodies.org.
Blue Cross and Blue Shield of Louisiana was named the winner of the 2008 Well Workplace award for large Louisiana employers by the Louisiana Health Care Alliance (LHCA). This was the second straight yearthat Blue Cross’ HealthyYou, Healthy Blue employeewellness program was recognized by LHCA, which recognizes employers that champion the health of their employees, work to create a culture of physical activity in the workplace and inspire change by looking beyond the criteria to new and innovative ways to inspire health.
BCBsLa honored for Financial strength, Innovative Programs and Workplace Wellness
The Blue Cross and Blue Shield Association has named several Louisiana facilities as centers of special distinction in certain areas of healthcare.
Southwest Medical Center of Lafayette and Women & Children’s Hospital of Lake Charles have completed the evaluation process and met the criteria necessary to be designated as 2008-2009 Blue Distinction Centers for Bariatric Surgery.
Blue Distinction is a nationwide program that has so far recognized 800 specialty centers in 42 states forproviding quality care. These specialty areas include cardiac care, bariatric surgery, transplants and complex and rare cancers. The Blue Distinction program is
raising the quality of care being delivered across the country by recognizing medical facilities that meet objective, evidence-based thresholds for clinical quality developed in collaboration with expert clinicians and leading professional organizations.
In addition to the two hospitals mentioned above, six Louisiana hospitals are currently recognized as Blue Distinction Centers for Cardiac Care and two are noted as Blue Distinction Centers for Transplant.
For more on Blue Distinction, including the most up-to-date lists of recognized facilities, visit the following link: http://www.bcbs.com/innovations/bluedistinction/.
Louisiana hospitals Named Centers of Distinction
5
Your Health.Our Commitment.
Pharmacy Copayment Changes for 2009
tier 3 Medication (higher Copayment)
tier 2 alternatives(Lower Copayment)
tier 1 alternatives(Lowest Copayment)
Avodart® finasteride
Betoptic S® betaxolol, brimonidine, carteolol, levobunolol, metipranolol, timolol
Vytorin® Crestor®, Lipitor® lovastatin, pravastatin, simvastatin
Recent Pharmacy Copayment tier Changes
Save money with the power of choiceIn many cases, you can minimize your out-of-pocket medication expenses by considering an alternative medication in a lower-copayment tier. Check the HMO Louisiana formulary on our website at www.bcbsla.com or ask your doctor to find out if a lower-cost brand-name medication or a generic drug would be clinically appropriate for you.
04HQ3636 8/08*Express Scripts, Inc. (ESI) is an independent company that serves as the pharmacy benefit manager for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc
A brand promise is more than just an advertising slogan. It’s a way to strongly communicate to you, our customers, that we understand your needs and are deeply committed to meeting them. As a health guidance company, we take your health and wellness very seriously, and we’ve designed the Your health. Our Commitment. campaign to give you information and tools to live a healthier life and to manage your healthcare benefits effectively.
Morethan40wellnessprogramsOur goal for this new campaign is to educate our customers about the more than 40 value-added wellness programs, health tools and services we offer. The Your health. Our Commitment. section of our website at www.bcbsla.com is the foundation of our efforts, giving visitors more detailed information about our coverage plans, preventive medicine and care management programs, online health tools, personal health records and walking programs.
Please visit the website to learn more or download a brochure listing these 40+ services. You can also pick up a copy at your nearest District Office.We’re proud to look back on 75 years of commitment to the health of all Louisianians. And we’ll keep looking forward, with a vision for a healthy Louisiana for many years to come.
1934-2009: Blue Cross Celebrates 75 Years of Commitment to LouisianaContinued from page 2.
Federal regulations govern the privacy of your medical information and how Blue Cross uses and shares that information in the course of our regular business activities.YoureceivedaNoticeofPrivacyPractices regarding theprivacyofyourmedical information when you enrolled with us or when the federal regulations went into effect.
The Notice of Privacy Practices explains:
• How we may use and share your medical information
• Yourrightsandhowtoputthemtouse
• How to voice complaints about our privacy practices
If you need a copy of the “Notice of Privacy Practices,” you can:
• Visit our website at www.bcbsla.com/web/pdf/PrivacyPractice.pdf
• E-mail the Blue Cross Privacy Office at [email protected]
• CallthePrivacyOfficeat225.298.1967
Notice of Privacy Practices available
save time with self-serviceDid you know that you can handle certain
routine customer service needs yourself, either
by phone or online? It’s your choice!
Our new voice-recognition technology allows
HMO Louisiana group members to request a
duplicate ID card or Explanation of Benefits
(EOB) at any time by phone — quickly, easily
and toll-free. Just call 1.800.495.BLUE (2583)
and be ready to enter your member ID number
(foundonyourIDcard)without the three-letter
prefix.
You can also handle several routine functions
online, through our self-service web portal,
AccessBlue.Youcan:
• Review the status of your claims
• Order a replacement ID card or benefits booklet
• Change your address
• Add or delete dependents, as allowed by your employer
• Open and maintain a Personal Health Record
• And more … check it out today!
Register for or log in to AccessBlue from any
page at www.bcbsla.com.
The year 1934 was a notable time in Louisiana history:Huey P. Long served in the U.S. Senate, Bonnie and Clyde were ambushed near Shreveport . . . and Blue Cross opened its doors in New Orleans with two employees to serve our customers.
Today, Blue Cross and Blue Shield of Louisiana and our subsidiary, HMOLouisiana,Inc.,employmorethan1,600residentsacrossthestate. And that small one-room company now makes a $3.5 billion impact on the state’s economy.
Alothaschangedsince1934,butourcommitmenttoLouisianahasnever wavered. We’re celebrating our 75th anniversary this year as a symbol of strength and stability in Louisiana. We’re proud to provide
our customers with health guidance and affordable access to quality healthcare. It’s our mission to help all Louisianians live healthier, happier lives.
New campaign demonstrates our commitmentEarlier this year we launched a new branding campaign, complete with new TV and radio ads and a comprehensive new website section, all designed to promote the company’s brand promise: Your health. Our Commitment.
Continued on page 3.
1934-2009: Blue Cross Celebrates 75 Years of Commitment to Louisiana
Chef John Folse, acclaimed Louisiana chef and restaurateur, is stirring up something new with the Louisiana 2 Step.
Folse has joined with us at Blue Cross and HMO Louisiana to promote wellness and healthy eating by creating his own Chef’s Corner in the Eat Right section of the 2 Step website, www.Louisiana2Step.com. Folse fans can check out a calendar of his upcoming appearances and even choose the popular chef as their personal virtual coach – hearing motivational messages recorded in his own voice.
Folse’s key contributions to his Chef’s Corner will be his weekly blogs and tips to help website visitors learn that healthier cooking can be delicious. By using recipes from his heart-healthy cookbook, Something Old, Something New: Louisiana Cooking with a Change of Heart, Folse and the 2 Step give program members more Louisiana-focused methods to eat right.
More than 11,500 users have registered with the Louisiana 2 Step website at www.Louisiana2Step.com. All website visitors can find resources for getting healthy and staying healthy, but registered members have access to a wider variety of free interactive tools and motivational support. Organizations, families,
companies and other groups can also sign up as teams and set team goals to help motivate one another.
The Louisiana 2 Step program was developed by Blue Cross and HMO Louisiana and the Pennington Biomedical Research Center to help educate and inspire Louisianians to improve their health by making two small changes in their daily routines: eating right and moving more.
Other features of the Louisiana 2 Step website include:
• Interactive trackers to help members record their weight, daily activity, calories consumed, key lab test results and more
• Exercise tips and guides
• Lists of healthy foods and snacks
• Healthy recipes and a nutrition guide
• A calendar of health- and wellness-related events statewide
• Health news
• A list of Louisiana 2 Step Participating Restaurants
• Bonus programs, such as discounts on Jenny Craig membership and the Junior League of Baton Rouge’s cookbook River Road Recipes III: A Healthy Collection
Chef John Folse adds Cajun Flair to healthy Cooking on the Louisiana 2 step Website
For their outstanding volunteer service on behalf of Louisiana’s children, eight men and women from across the state were named the 2008 winners of the Angel Award presented by Blue Cross and Blue Shield of Louisiana.
A committee of past recipients of the Angel Award, now in its 14th year, considered more than 50 nominations from throughout the state before selecting Chris Broussard of Minden, Raymond hicks of Shreveport, Cherry seal of Glenmora, Ellen “Deedee” suthon of Covington, and Baton Rouge residents Carolyn Carnahan, shirley Porter, Dee Robinson and Ella Rein Wheeler.
You can read more about all of the winners on ourwebsite at www.bcbsla.com. Click on Community then Angel Award to find nomination criteria, an online nomination form and a searchable database of all past nominees, finalists and winners.
The 2008 Angel Award winners were honored by Louisiana First Lady Supriya Jindal at a presentation ceremony in October in Baton Rouge. They joined more than 100 men and women from all walks of life and all corners of the state who have been recognized since the program’s inception in 1995. Grants to the charitable causes chosen by honorees over the years now total more than $880,000. Each honoree receives a $20,000 grant from the Blue Cross and Blue Shield of Louisiana Foundation to be donated to a charity that benefits children.
Blue Cross Names 2008 angel award Winners
HMO Louisiana is committed to the health and wellness of our customers. We work hard to offer high-quality medical care coverage that is also responsible and cost-effective.
To that end, our Pharmacy and Therapeutics Committee, a group of Louisiana doctors and pharmacists, updates our preferred medication list or formulary each year. As new drugs – branded and generic – are introduced into the marketplace and new or updated clinical information is published, they may recommend that certain drugs be moved to different copayment tiers.
Where to find the latest drug copayment informationThe latest preferred medication list is always available for you to
read or download on our website at www.bcbsla.com/pharmacy. Customers also may call the Express Scripts* Customer Service Department toll-free at 1.866.781.7533, which is also printed onyour ID card, to request a printed copy by mail.
Highlights of our formulary changes effective Jan. 1, 2009The copayment tier for the following drugs changed from a Tier 3 copayment to aTier 2 (lower) copayment level: Gleevec®, Intelence™, Isentress®, Kuvan™, Lipitor® and Nexavar®.
The medications listed below have moved to a Tier 3 copayment level, but lower-cost alternatives are available that you can discuss with your physician.
2 3 4
