As I have discussed on a previous blog, “Thoughts on Health Care Reform“ the political factors that led to passage of the ACA also led to an end result focused on access to care, with less attention paid to the cost of providing and paying for that care. In fact, many of the provisions of the ACA, if left unchanged, will have the unintended consequence of raising premium costs for individuals, families and businesses. For example, the new law imposes taxes on insurance and medical devices, which will directly increase the cost of premiums and health care. The ACA also mandates the insurance benefits that every plan must offer and restricts the ability of insurers to set rates based on age and health status. Therefore, under the law, younger, healthier people will pay more to offset the cost of insuring those in poor health. This will impact the premiums of those in the consumer and employer market alike. In such an environment, the best way to keep costs down is to keep people healthier longer. Florida Blue is a national leader in innovative health solutions to do just that.

Over the past five years, Florida Blue has saved over $1 billion for our members by working to identify efficiencies in health care delivery and improve coordination of care among groups of providers. This experience and proven commitment to quality allows Florida Blue to build upon these partnerships and strengthen our efforts to improve quality and lower costs for all Floridians. As part of this effort, we have created new payment models that allow us to optimize the link between quality and value of care.

Through innovative payment models, such as Accountable Care Organizations (ACO) and Patient Centered Medical Homes (PCMH), we have provided incentives for better communication and care coordination among all the health care providers involved in an individual’s health care delivery. We believe (and early results confirm) better communication and coordination will result in better medical results and lower costs than would have been the case in more traditional fee-for-service models. Similarly, Florida Blue has grown its presence in communities across Florida through retail centers that allow our employees to directly focus on people — understanding them and what they really need from their health care plan. These innovations and personal touches to our service will help create healthier people and healthier communities.

Another unique innovation is the creation of the new Florida Blue Center for Health Policy, directed by Carl Patten, Director, Health Care Policy at Florida Blue. This Center was created to further position Florida Blue as a national thought leader on health care policy issues, utilizing our experience and commitment to communities to identify key public health challenges and offer possible solutions. In the next blog post in this space, Carl will take a more in-depth look at ACOs, PCMHs and other innovative payment models that are already changing the face of health care delivery in Florida.

For more information, visit FloridaBlue Center for Health Policy or Health Care Reform sections on our site!

The post The ACA and Affordable Coverage by Jason Altmire appeared first on Florida Blue.

In 1989, Little League began a new baseball division for mentally and physically challenged youth called the Challenger Division.  Soon after the national launch, our local league put out the word that we were going to support this program and we quickly formed two teams with more than 40 players.

That is how I met Robbie. Robbie was physically challenged and had a severe learning disability. He was 8 years old when we met and loved to play baseball.

He was one of those kids that wanted to play every position, always cheered on his teammates, always had a smile on his face.  But he really loved being the catcher.

After knowing Robbie a couple of years, I asked him why he liked being the catcher so much. He told me it was because catchers looked like an umpire.  “Just like you, Mr. George” he said. “Maybe someday if I can’t be a baseball player, I can be an umpire. Is that OK with you, Mr. George?”

I felt like he was asking for my permission, so I told Robbie that if he worked hard enough, he could be anything or anyone he wanted to be.

As the baseball seasons passed, Robbie showed up at the park. He’d stop by the backstop and say “Hello, Mr. George. Are you having a good day?”

We talked between innings and at the end of the game he would always make his way over to me.  I’d be sweaty, dirty and tired but with a big smile Robbie would say “Great game, Mr. George!”

At the end of the 2001 season I remembered how Robbie felt about becoming an umpire. Instead of giving him one of the last game balls, I took off my umpire patch, gave it to him and told him that he was one of us now.

He was so proud.  We went over to his parents and he said, “Look, Mr. George made me an umpire.”

In September 2001 I saw Robbie away from the baseball fields for the first time.  I was the United Way captain for the IT division in our 2001 campaign and decided to go on an agency tour.

As I walked into one of the organizations I heard someone yell “Hey, Mr. George! What are you doing here?” It was Robbie.

He was working with a physical therapist on a set of parallel bars and wearing his baseball jersey.  My old umpire patch had been sewn on the sleeve.

I spent some time talking to Robbie. The physical therapist shared that Robbie was not doing well but that his spirits were always high.  She said he was a very happy kid and he was so proud of his umpire patch.

A few months later, Robbie passed away.

In looking back, I realize what a real difference each of us can make.  We are all very blessed.  We have our families.  We work for a great company.  We live in the greatest country in the world.  But most of all, we are blessed because we have the ability to share and to give back. That is a gift.

The post Making a Difference with Field of Dreams appeared first on Florida Blue.

The JCC is a nonprofit organization which has over 400 children involved with its programs. Its purpose is noble and far-reaching.  The mission of the JCC is to provide a high-quality, choral music education for children of diverse backgrounds, fostering teamwork, self-discipline, accomplishment and pride while filling an important cultural need in the community and sharing the beauty of the choral art form through artistically excellent performances.

Children who receive music instruction from an early age go on to be better students, thanks to the discipline and stimulation it provides. Recent studies suggest that the entire community benefits when its people embrace the arts and generate civic pride. Within the health care field, arts appreciation and music therapy are now established practices for treating ailments ranging from PTSD to Alzheimer’s.

The JCC recently hosted a Dancing with the Stars competition and our very own Susan Towler, the Vice President of the Florida Blue Foundation and Executive Director of Community Affairs, won the competition. In her six months of practice leading up to a performance in front of a packed house, Susan undoubtedly burned major calories as she unleashed her inner disco queen to “Boogie Oogie Oogie” from Taste of Honey. “My best complement came from a woman in the audience who told me I looked exactly like the girl from Saturday Night Fever – and I thought yes, I did it! That was exactly the look I was going for!” Susan’s daughter, Emma, a participant in the practice chorus and a dancer herself, was especially thrilled to see her mom own the stage that night.

Susan is a role model who’s stepping out for charity and improving her overall well-being. Her leadership of The Florida Blue Foundation and community outreach takes her from the dance floor to the 2013 Eve Awards. Susan was recently named as a finalist for the employment category. As remarkable as all the nominees were, we doubt there are many who could make disco come alive as well as Susan Towler.

How community volunteer projects or fine arts improved your overall health? We’d love to hear your story in the comments below.

The post Connecting Community and the Arts with Your Health appeared first on Florida Blue.

1. Myth: All fats are equal—and equally bad for you.

Fact: Saturated fats and trans fats are bad for you because they raise your cholesterol and increase your risk for heart disease. But monounsaturated fats and polyunsaturated fats are good for you, lowering cholesterol and reducing your risk of heart disease.

2. Myth: Fat-free means healthy.

Fact: A fat-free label doesn’t mean you can eat all you want without consequences to your waistline. Many fat-free foods are high in sugar, refined carbohydrates and calories.

3. Myth: Eating a low-fat diet is the key to weight loss.

Fact: The obesity rate for Americans has doubled in the last 20 years, coinciding with the low-fat revolution. Cutting calories is the key to weight loss, and since fats are filling, they can help curb overeating.

4. Myth: All body fat is the same.

Fact: Where you carry your fat matters. The health risks are greater if you tend to carry your weight around your abdomen versus your hips and thighs. A lot of belly fat is stored deep below the skin surrounding the abdominal organs and liver, and is closely linked to insulin resistance and diabetes.

5. Myth: There is no “superfat” for the brain and heart.

Fact: Especially beneficial are Omega-3 fatty acids, a type of polyunsaturated fat. Research has shown that they can: reduce the risk of heart disease, stroke, and cancer; protect against memory loss and dementia; ease joint pain and inflammatory skin conditions; and support a healthy pregnancy.

Did You Know…..

That if you’re a Florida Blue Member, you can login to our site and find personalized tips, tools and recipes for healthy living?

The post 5 Myths and Facts About Fats appeared first on Florida Blue.

The United Way’s Women in Local Leadership (WILL) affinity group would periodically email a calendar of events and volunteer opportunities.  I attended a meeting and started working with what I call the coolest women on the planet.  They just get it!

At about the same time, Florida Blue scheduled a parenting class for employees on the Jacksonville campus.  I attended and was introduced to a program that would change my life and view of the world forever.

The program coordinator for the United Way’s Born Learning initiative taught me to share learning tips and tools with parents who are court ordered to attend parent education classes I teach year-round.  Materials for the workshops—“Ages & Stages”, “Effective Communication”, “Effective Discipline”, “Parent Responsibility”, “Abuse & Neglect”, “Learning on the Go”, “Playing the Games” and “Food & Nutrition”—are offered by the United Way.  And WILL gives me all the materials that I use to facilitate each session.

Because so many parents are court ordered to attend my class, they are a “spirited” group.  They are not always happy to see me, but I bring them a no-nonsense approach that not only challenges them to think higher than their condition of drug and alcohol abuse and violence but also encourages them to focus on the opportunity an agency like the United Way has provided them free of charge, so that they can reclaim their gift of parenting.

I remind them that no healthy parent wants to lose their child and the legal system will never knowingly allow an unhealthy parent to keep a child.  The mothers, fathers and caregivers in the Born Learning program inspire me to do additional research on the latest federal and state laws, resources and programs to assist them in reaching their goal of raising happy children.

I help to edit and rewrite life stories every week.  And I am a big fan of happy endings.

The post Florida Blue Employee – An Advocate for Children and Families appeared first on Florida Blue.

1.    Cholesterol

This soft, fat-like, waxy substance is found in the bloodstream and cells. Cholesterol is important because it’s part of cell membranes and used to produce some hormones while serving other necessary bodily functions. Too much cholesterol can cause a thick, hard plaque to grow in the arteries making it difficult for blood to flow to the heart. Abnormal cholesterol levels (high LDL and low HDL) increase your risk for heart disease and stroke.

 2.    Blood Pressure

Blood pressure refers to the force of blood pushing against the walls of the arteries as it is carried from the heart to various tissues and organs throughout the body. Your blood pressure reading is the result of two numbers: the systolic pressure (or top number) which is the force that creates pressure on the arteries, and the diastolic pressure (bottom number) which indicates the pressure in the arteries when the heart rests between beats. High blood pressure (called hypertension) can cause damage the arteries, heart, brain, and kidneys.

3.    Blood Glucose

Also referred to as blood sugar, your blood glucose number measures the amount of glucose (sugar) in the blood. Glucose is the body’s main source of energy and it comes from carbohydrates. Insulin helps your body use the glucose, and too much can cause damage the eyes, kidneys, nerves and blood vessels. Diabetes occurs when your body doesn’t produce enough insulin, or doesn’t use it correctly.

4.    Body Mass Index (BMI)

Your BMI is based on your height and weight and is used as a screening tool to determine if you are obese, overweight, normal weight, or underweight. Generally speaking, a higher BMI correlates to a greater risk of some weight-related diseases, including high blood pressure, coronary artery disease, stroke, osteoarthritis, some cancers and type 2 diabetes.

BMI is calculated by dividing your weight and height using this formula. You can also use WebMD’s interactive calculator which includes your activity level.  You can look into the new BMI scale, which was recently created by Oxford University professor, Nick Trefethen.

BMI = (Weight in pounds) x 703  / (Height in inches)²

5.    Waist Circumference

Along with your BMI score, your waist circumference is an indirect indicator of intra-abdominal fat tissue, often called visceral fat. A large waist circumference is associated with an increased risk of type 2 diabetes, high cholesterol, high blood pressure and cardiovascular disease. To find your waist circumference, place a tape measure around your body at the top of your hipbone. This is usually at the level of your belly button.

Schedule a checkup with your doctor. Members, to find a doctor, call a Florida Blue Care Consultant at (888) 476-2227 or log onto floridablue.com and select “Find a Doctor”.Knowing your numbers can help you make some simple lifestyle changes today that will reduce your risk and improve your health tomorrow. Here’s how to start:

Members, visit one of our 11 Florida Blue Centers to meet with a nurse who can help you find out your numbers free of charge. Non-members can receive a free screening during our monthly health fairs. Visit Florida Blue to locate the center nearest you.

These are numbers worth knowing. Here’s to yours adding up to better health!

These are numbers worth knowing. Here’s to yours adding up to better health!

The post 5 Important Health Numbers You Should Know appeared first on Florida Blue.

1. People under age 30 or those exempt from the individual mandate, may qualify for a “catastrophic” health plan, which offers preventive health services.
2. Annual dollar limits on benefits are no longer allowed.
3. Low- and middle-income families may qualify for federal subsidies to help pay for their health insurance premiums.
4. The Insurance Marketplace (formerly known as the Exchange) will offer four levels of health insurance plans (called “metal” plans because their names are Bronze, Silver, Gold and Platinum). They will offer the same benefits, with different out-of-pocket costs and premiums.
5. Financial assistance may also be available to help qualifying individual’s pay for out-of-pocket health care costs.
6. Individuals enrolled in a health plan that took effect before March 23, 2010 may be able to keep their plan, even if it has fewer benefits than the Affordable Care Act requires (called “grandfathering”).
7. Health plans can no longer refuse to provide coverage to you because of your health history.
8. Special provisions apply for Native Americans and Alaskan Natives to help provide health insurance.
9. You cannot be turned down for coverage for any new health plan sold in 2014 or later.
10. Health benefits include dental and vision care for children under 19.

If you still have confusion, there’s not need to worry as Florida Blue has places you can go to get your questions answered.  Ask Blue Reform is one place you can visit, as well as the health care reform section on our site. If you are wishing to ask a question that you cannot find on either of those sites, feel free to email us at TakePartFlorida [at] BCBSFL [dot] com.

The post 10 Things that Will Happen in 2014 Under the Affordable Care Act appeared first on Florida Blue.

During our visit, I realized the thousands of Hillsborough County residents that the Crisis Center touched each year. There was one section of the facility specifically built for sexual assault/rape victims. I had always assumed all rape victims were taken to the emergency room to be treated and forensic evidence was taken there. However, I learned that in Hillsborough County, victims are driven to the Crisis Center where they are treated very privately, given immediate counseling and treatment and important forensic evidence is gathered in a quiet, sensitive environment. The compassion of that approach had a great impact on me.

As I moved through the tour, I learned that the Crisis Center offers free crisis counseling by operating a crisis hotline that handles suicide prevention, suicide crisis calls and any other call that may cause a traumatic event. They provide specialized trauma counseling and therapy for children, adults and families who have experienced abuse, sexual assault, domestic violence, recent loss of a loved one or any other type of emotional trauma.

Last November, 12-year-old Matthew came to the center after repeatedly telling his mom that he wanted to jump out of the car window while they were speeding down the highway. His Dad and best friend, a Hillsborough County teacher, had recently died of a heart attack.  Mom was distraught, as well. She’d lost her life partner and was feeling the pressure of keeping the family together. A physician referred her, Matthew and his older sister to the Crisis Center. Today, all three see counselors and are doing amazingly well.

I recently heard a story about a woman who accidentally killed a man who ran out in front of her car unexpectedly.  The trauma practically crippled her.  She didn’t want to leave her house, or drive, or be social.  The only thing she would do is go to work.  For nearly six months a friend of hers insisted she call the Crisis Center to get help.  She finally called.  Through counseling she discovered she had post-traumatic stress disorder.

If she had not sought treatment, her condition would have become steadily worse, possibly crippling her daily life and leaving her to consider suicide.  She was a single mom, just like me.  She had a great job, just like me.  She was involved in the community, just like me.

Trauma can hit anyone, at any time, regardless of race, sex, gender, income.  I support the Crisis Center because of the many people they help that never thought they would need help. By supporting the Crisis Center, I’m helping those people. It just feels good.

The post Helping People at Crisis Center of Tampa Bay – Wendy Bowman’s Story appeared first on Florida Blue.

Q: Where do I go to get a Personal Health Assessment?

A:  You can visit one of 11 Florida Blue Centers located throughout Florida for your free health assessment. Call 1-877-352-5830 to make an appointment or just stop by.  One of our nurses will be happy to assist you!

Q: Should I bring anything like a list of my current medications when I go?

A: This is not necessary, but our  personal health assessment form will have a place for you to show which health conditions you currently take medications for.  Please let the nurses at your local center know if you have questions about your medicine or its cost or coverage. Some people ask about whether they should eat before the test. Fasting is not required to participate, but if you would prefer to know what your fasting blood sugar result is, please do not eat or drink for 2 hours before your screening.

Q: What are the health screenings you’ll do as part of the PHA?

A: The Registered Nurses at Florida Blue can screen our members for Cholesterol, Blood Glucose, Blood Pressure, and BMI (Body Mass Index).  These numbers, along with your participation in answering some general questions about your health and lifestyle habits will allow us to obtain a detailed report with information about your health risks, healthy and unhealthy habits, and can even lead to discussing some risk reduction strategies with you.

Q: How much time does a personal health assessment usually take to complete?

A: An average screening usually takes about 30 minutes from start to finish. Yours may be less or a little longer, but the time you spend with us will depend on your preferences and needs.

Q: What do I do if I need follow-up care based on my results?

A: Your nurse can assist you with interpreting your results. If follow up care by a licensed physician is recommended or desired, we can assist you with understanding your options and can even assist in choosing a provider and/or scheduling an appointment. Many members also choose to schedule a follow up PHA before they leave so that they can reassess their health status after making positive lifestyle changes.

Q: Are my results shared with anyone else besides me?

A: At Florida Blue, we value your privacy and your individual results will never be shared with your employer, provider, or any third party. If your screening leads to additional questions about your health, benefits, or resources we can answer them or point you in the right direction. Remember, our purpose for being here is to help you.

Here’s the special offer we mentioned earlier: if you are a member* of Florida Blue and schedule your PHA at any of our Florida Blue Centers between now May 7^th -May 31, 2013 you’ll receive a free copy of Cook This Not That, a cookbook containing 130 recipes from your favorite restaurants, redone to be healthier! Now that you know what to expect from your PHA, it’s the perfect time to go! We’ll see you there.

*Florida Blue employees are excluded from this promotion.

The post How to Prepare for your Personal Health Assessment appeared first on Florida Blue.

I was working at Capital Regional Medical Center in Tallahassee when I met a nurse who was an employee with Big Bend Cares.  She was visiting a patient I was taking care of in the intensive care unit who had been diagnosed with HIV but had not been compliant with his recommended medical regimen and was very sick with AIDS.

She was following up with this patient and explained the amazing services that Big Bend Cares provides in education, prevention and for those currently living with HIV/AIDS. I immediately wanted to learn more.

I discovered that they were accepting applications for a facilitator for a Centers for Disease Control and Prevention-funded program called Healthy Relationships. I applied and was very fortunate to get the job.

I was responsible for interviewing HIV-positive clients discussing life choices that may have contributed to their diagnoses. Once this was complete, I enrolled and guided them in group sessions that included methods for learning how to better cope with this diagnosis, how to be empowered in disclosing their diagnosis and how to be more self-assured in making favorable life decisions.

When talking to the people that I interviewed, I was very candid about my own past and did not hold back.  I was well aware that I could easily be sitting in their seat.  All of the stories they shared with me moved me but there are a few that seemed to really call to me.

I remember one woman that moved to Tallahassee from Central Florida; her husband was a preacher and had contracted HIV from a male sexual partner. The woman became very sick and her doctor convinced her to test for HIV. She had no idea about her husband’s “other” life.  We cried together.

I also remember a female client that was a recovering crack addict and alcoholic who was infected during her years of addiction. She became motivated to leave that life behind and moved to Tallahassee to be closer to her daughter and grandchildren. We rejoiced together.

There are so many other stories that I carry in my heart.  I couldn’t possibly begin to tell all of these clients how much their trust and willingness to share the intimate parts of their lives really inspires me.  This is why I am so passionate about being a volunteer for Big Bend Cares and why I feel so strongly about the mission of this organization:  “AIDS doesn’t care who you are. We do.”

The post One Florida Blue Retail Center Nurse’s Story Working with HIV/AIDS Patients appeared first on Florida Blue.