Tag Archives: Capital Blue Cross

A Tough Battle: The costly, often-deadly truth about eating disorders

February 13, 2024 | by THINK Capital Blue Cross

Low section of woman checking her weight on the scale at home

Jane is a highly respected professional in her 30s. She’s smart, successful, and driven.

She also deprives herself of food for days at a time. Twice a week or so when Jane gets home from work, she binge-eats uncooked, frozen TV dinners.

Jane layers her clothing, both to keep warm and to hide her troublesome thinness. She avoids any work or social gatherings involving food.

It’s all part of Jane’s anorexia, an eating disorder she’s strived to keep secret since she was 14.

“When she first came to me, she was desperate and distraught,” said Suzanne I. Eyer, a Chambersburg-based licensed professional counselor specializing in eating disorders. “Most of the first session was crying. She knew full well she had a problem, but she had no idea how to begin controlling it.”

When Jane began visiting Eyer in 2017, she carried a cocktail of common factors that lead to eating disorders: self-loathing; a distorted self-image, stemming in part from sexual and physical childhood abuse; a Type A – or perfectionist – personality; and an impossible-to-please mother.

“In fact, she initially started dieting to receive positive messages from her mother,” Eyer said.

‘Highest Mortality Rate’

The final week of February is National Eating Disorders Awareness Week, a time to cast a spotlight on these serious psychological illnesses. Anorexia, specifically, is the deadliest mental health disease in America, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD) .

While 15% of U.S. women will have an eating disorder by their 40s or 50s, only about one-fourth of those women will receive treatment.

“That’s a big reason they have the highest mortality rate,” Eyer said. “For so many, an eating disorder is a dirty little secret they want covered up, even in death.”

Anorexia, bulimia and binge-eating disorders can hurt the heart and kidneys, cause osteoporosis, disrupt menstrual cycles, and toss electrolytes off-balance – to the point where the heart can stop.

Because so many people hide their eating disorders, statistics almost certainly underestimate their harm. But existing data is still distressing: About 9% of the U.S. population — nearly 30 million – will have an eating disorder during their lives, according to ANAD. Most, 85% to 90%, are women.

The Cost and the Coverage

Eating disorders cost America’s economy at least $64.7 billion in treatments and lost wages/productivity in 2018-19, according to a study published in the International Journal of Eating Disorders. The authors said the price tag likely is steeper due to reduced physical and mental well-being.

Employers can help through educational initiatives and by providing healthcare plans with access to behavioral health and nutritional counseling.

Capital Blue Cross offers a VirtualCare telehealth option and a behavioral health toolkit for certain employers, and Capital can connect you to a behavioral health professional online or by calling 866.322.1657. Some companies, including Capital, offer employee assistance programs that make it easy for employees to access mental health professionals for any issue.

Capital’s registered dietitians offer free nutritional consultations – in person and virtual, to members and nonmembers – and offer members covered follow-up medical nutrition therapy and health coaching at Capital Blue Cross Connect health and wellness centers.

Coping through Counseling

Eyer says eating disorders like Jane’s can only be contained, not cured.

“It’s an addiction,” Eyer said, “and like any other addiction, you need healthcare support through counseling, as well as inpatient and outpatient treatment programs.”

She said Jane will always have to fight hard to control her condition.

“She is improving, and doing well,” Eyer said. “But eating disorders are an ongoing struggle, and for Jane, as with most any eating disorder client, continued counseling and monitoring of her disorder are critical.”

For more health and wellness news and information that can benefit your business and employees, visit thinkcapitalbluecross.com.

The Road Back: Treatment and recovery programs bring hope to those suffering addictions

January 30, 2024 | by Capital Blue Cross Staff

Samantha Osterlof & family

It took four years of addiction to opioid painkillers and heroin to transform Samantha Bixler from a wholesome, high school honors student and athlete with a bright future into a drug-addicted, 22-year-old hospital ventilator patient with a 10% chance of survival.

Thankfully, the 2005 Palmyra High School graduate’s story did not end in an intensive care unit.

Today, Samantha Osterlof—her married name—is a wife, working mother of three and a passionate advocate for treatment and recovery programs like the one that she said saved her life.

In 2021, more than 46 million Americans had at least one substance use disorder, while just more than 6% had treatment, according to the National Institutes of Health.

About 107,000 people died. The economic burden of drug-related productivity losses, medical costs, crime and more is close to $530 billion, according to Georgetown University’s Health Policy Institute.

“No matter how you calculate it, substance abuse disorder is an enormous disruption to the lives of the employees and others,” said Karie Batzler, Capital Blue Cross’ director of behavioral health. “Anytime is the right time for companies to open up a clear dialogue with employees about the issue. Put it out there. Let it become a topic of discussion. The more we talk about it, the more we work to reduce the stigma and support treatment and recovery.”

Capital Blue Cross’ Health Promotion and Wellness team works with employer groups on ways to create awareness of substance use disorders.

Some companies, including Capital, offer an employee assistance program (EAP) that makes it easy for employees to access mental health professionals for any issue.

The Substance Abuse and Mental Health Disorders Services Administration (SAMSHA) publishes an evidence-based resource guide that educates employers on the merits of creating recovery-friendly employment policies.

The Biden administration’s American Rescue Plan created, among other things, a Recovery-Ready Workplace Resource hub through the Department of Labor.

“Just letting the employee know that their recovery comes first is important,” Batzler said.

Osterlof’s 10-year addiction took her right to the cliff’s edge.

A 37-day stay at an addiction treatment center, seven months of outpatient therapy and group meetings pulled her back from that edge, and a lifetime of being in recovery will keep her from falling down again.

Clean and with a new chance at life, Osterlof set out to redefine herself.

She earned a bachelor’s degree in criminal justice from Elizabethtown College in 2016, and a master’s degree in criminal justice and behavior management from Saint Joseph’s University in 2017, all while working as an outreach specialist and therapist at the same recovery facility that helped save her life.

In March, took a position as a marketing director with a company that specializes in outpatient treatment and recovery at several locations in southeast Pennsylvania.

She is certified as both a recovery specialist and a family recovery specialist and is an approved trainer who works with the Pennsylvania State Police and other organizations.

The tragedy of substance use disorder is well documented. By eagerly sharing her story of addiction and recovery, Osterlof hopes to let the world hear another message.

“Everything good in my life today, I have as a result of my recovery,” said Osterlof, who hasn’t taken a mood or mind-altering substance since Dec. 21, 2011. “The message is hope. The promise is freedom. Treatment works, and recovery is possible.”

For more information, visit www.capitalbluecross.com.

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Intuitive Eating Focuses On Why We Eat Rather Than What We Eat

January 9, 2024 | by THINK Capital Blue Cross

Nearly half of all Americans are obese, and the population of severely obese people has nearly doubled in the last two decades, according to the Centers for Disease Control and Prevention (CDC).

With the added weight comes an added risk for heart disease, stroke, diabetes, and certain cancers, and adds hundreds of billions of dollars in costs stemming from those conditions, the CDC says.

While many turn to fad diets that rely on vilifying and eliminating certain foods, a different approach, intuitive eating, is taking hold.

That approach focuses less on what we eat and more on why we eat, and the concept is getting attention from folks like Kaitlyn Miele and Debra Garzon, registered dietitians with Capital Blue Cross’ Health Promotion and Wellness team.

Introduced in 1995 by dietitians and authors Evelyn Tribole and Elyse Resch, intuitive eating is known to some as the anti-diet. It revolves around 10 principles designed to help people become mindful and self-aware while eating:

Reject the diet mentality.
Honor your hunger.
Make peace with food.
Challenge the food police.
Respect your fullness.
Discover the satisfaction factor.
Honor your feelings.
Respect your body.
Movement—feel the difference.
Honor your health with gentle nutrition.

Restricting foods, especially ones you enjoy, can increase cravings for those foods, according to Miele. “Deprivation can lead to a binge-and-restrict cycle known as yo-yo dieting. Intuitive eaters are governed by internal cues rather than external diet plan rules,” she explained.

“Obesity is not always just about calories in and calories out,” Miele said. “That is oversimplifying a complex issue. … Many other factors can contribute to weight gain and obesity. It is not just a matter of will power or laziness. That, unfortunately, seems to be the stigma.”

Garzon, a registered dietitian with more than 20 years of experience, began her intuitive eating journey about nine years ago. She took a continuing education course that included an exercise in which students were asked to eat lunch in silence while being mindful of how they felt during the meal.

“It was an eye-opening experience even for a seasoned dietitian,” Garzon said. “I was astounded that during this exercise I was only able to get through half of my meal – a sandwich, fruit, pretzels, and water – when I realized I was so full I did not want to take another bite. This was the beginning of a wonderful journey to better health.”

Garzon started slowly by practicing intuitive eating during just one meal a day.

“It was difficult at first with family schedules, kids, sports, and working full time,” she said. Soon enough, she was practicing mindful and intuitive eating at every meal and, as a result, eating less.

In just a couple of months, she lost some weight, her clothes fit easier, she was sleeping better at night, and she was feeling more confident overall during the day.

“I really started to see how simply slowing down with eating a meal, being self-aware, and respecting my body’s hunger and fullness responses was changing my entire outlook on food and healthier eating overall,” she said.

“It doesn’t cost anything,” Garzon said. “There are no special meals and no calorie counting. It is simply a mindset adjustment and a path on a healthy lifestyle journey.”

For more health and wellness news and information that can benefit your business and employees, visit thinkcapitalbluecross.com.

If you like what we do, please support our work. Become a Friend of TheBurg!

A Mental Health Expert’s Plan to Battle Her Holiday Blues

December 11, 2023 | by THINK Capital Blue Cross

Karie Batzler

Karie Batzler isn’t exactly savoring this holiday season.

For starters, it will be her first without her sister, Judy, who died Aug. 7 in a house fire.

“It was incomprehensible,” recalled Batzler, director of behavioral health at Capital Blue Cross. “I had just spoken with her the night before, making plans for a visit. It was such an incredible shock that it didn’t feel like it was possible. Judy was the most generous, kind-hearted person I’ve ever met.”

Judy’s loss isn’t the only emotional struggle Batzler faces this holiday season. Her niece, Judy’s daughter, lost her battle with alcoholism in 2021. In addition, she and her family are dealing with serious medical issues.

As so many do this time of year, Batzler must cope with the compounded challenge that comes when acute loss, grief, or sadness collides with what’s supposed to be a joyous season. But Batzler can take something from her coping toolbox most people cannot: She’s spent decades as a psychotherapist.

“One of the things about being a behavioral health professional,” she said, “is it helps me understand that I’m NOT going to be OK. I’m not expecting to walk through my everyday life in the same way that I did before my sister passed.”

’Tis the Season

It’s hardly “the happiest season of all” for everyone.

According to the National Alliance on Mental Illness, 64% of people with a diagnosed behavioral health condition say the holidays make things worse. And the American Psychological Association says that 38% reported higher stress levels when the holidays hit.

Batzler said acknowledging your sadness, rather than avoiding it, is critical to coping with holiday depression.

“People worry that if they give into the sadness and let themselves sink into it more deeply, they’ll go too far into the sadness to come back from it,” she said. “Avoiding the feelings doesn’t work. The feeling will find a way to resurface, often when you least expect it. Making time and space for your emotions and leaning into the grief allows you to acknowledge and work through it.”

Additional Coping Advice

Batzler also urges people to schedule time to talk about their sadness with loved ones, friends, or a behavioral health professional.

“Be with other people,” she said. “That makes a big difference.”

She suggests those with diagnosed behavioral health conditions pre-assess their holiday needs by talking to their provider about the possibility of adjusting medications or therapy sessions during the holidays.

Other coping suggestions include:

Begin a new tradition – Perhaps plan a family outing or vacation, instead of staying home.
Don’t succumb to the season’s pressures – It’s OK to limit uncomfortable social events. Sometimes smaller holiday gatherings feel more manageable.
Volunteer – Helping others can be uplifting.
Immerse yourself in nature – A walk, run or drive in the woods or a park can work wonders.

Batzler said Capital Blue Cross helps its members cope with the holiday blues via its Virtual Care telehealth option and a behavioral health toolkit for certain employers. Capital also can connect you to a behavioral health professional online, or by calling 866.322.1657.

Karie’s Plan

Following her own advice during this year’s holidays, Batzler intends to lean into her pain.

“My plan is to tell my sister’s story,” Batzler said. “To reminisce with others. To wear Judy’s perfume, display things she loved and sing her favorite song. To bring her with me, instead of leaving her behind.

“It’s bittersweet, but it also can be comforting to remember those times, or to hear that song or wear that scarf. I’m carrying a little bit of her forward into the future.”

(For more health and wellness news and information that can benefit your business and employees, visit thinkcapitalbluecross.com.)

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From Stubborn to Statin: A Cholesterol Journey

October 5, 2023 | by Jerry Reimenschneider, THINK Capital Blue Cross

Jerry Reimenschneider, his wife, Terese, and daughter, Alyssa, this spring

I bristled at my doctor.

“A statin?” I huffed. “For me?”

It was during a telehealth appointment in 2021, months after a medical exam for my new life insurance policy flagged an elevated overall cholesterol level of 244 and an alarming LDL (or “bad cholesterol”) level of – gulp – 167. As reference points, anything above 200 overall or 100 LDL is considered high.

Naturally my doctor was concerned, particularly after we’d worked together the previous few years to control my cholesterol through diet. He told me that since that hadn’t worked, it was time to put me on the statin, a well-known class of drugs that can lower cholesterol by blocking a substance the body uses to produce it.

I should have felt good about taking a medication I already knew was affordable and wildly effective. Instead, I was frustrated – and felt like a failure.

Over the previous four years, I’d dropped more than 30 pounds to get to the healthy weight my doctor wanted; intensified my exercise; and limited my intake of high-LDL culprits like cream and cheese.

And still I needed these pills? Weren’t statins for people struggling more with their weight, exercise, and diet? Weren’t they for smokers?

My doctor doubled down.

“Jerry, listen,” he said. “This could just be something out of your control. I can tell you just by looking at your cholesterol number and your demographics – your age (55 at the time), your race, your gender – that your probability of having a heart attack or stroke over the next decade is something like 12%. It shouldn’t be higher than 5%.

“It’s time to take the statin.”

Sufficiently terrified, I finally took the statin.

Not Always about Lifestyle

Turns out I’m far from alone.

My story serves as a reminder that while high cholesterol is often the result of the aforementioned lifestyle factors, it can simply be hereditary.

That’s the case for me and tens of millions of Americans, and a reason the American Heart Association (AHA) recommends all adults 20 and over have preventive cholesterol screenings every four to six years.

An estimated 12% of Americans, about 94 million, have high cholesterol. Because it comes without noticeable symptoms, it’s particularly perilous if left untreated – excess LDL can build and ultimately block a coronary artery, triggering heart disease and strokes.

Costly but Containable

An AHA-funded report found that high cholesterol would cost the United States $276 billion in lost productivity by 2030. But it need not cost so many lives and so much money, because experts agree on several effective approaches:

Take medications when prescribed. I finally succumbed to reality and did what was best for my health. But according to the Centers for Disease Control and Prevention, 45% of U.S. adults who could benefit from cholesterol medications don’t take them.
Maintain a diet low in saturated fats. Saturated, or “bad,” fats are the main culprits leading to high LDL.
Manage your weight. Excess body fat often means higher cholesterol.
Don’t smoke. It makes LDL “stickier,” and more likely to clog arteries.

Health insurance that covers screening, counseling, and treatment is critical to containing high cholesterol.

Capital Blue Cross offers a variety of preventive services with no cost share to members who have standard benefit coverage. Services related to healthy cholesterol levels may include:

An annual preventive visit to review health, as well as family and personal risk factors.
Preventive medications such as statins. See a full covered medication list at capbluecross.com.
A lab test, called a lipid panel, to check cholesterol levels.
Blood pressure screenings.
Screening and behavioral counseling for cardiovascular disease prevention.

So My Statin Worked

My statin – a generic of Lipitor – slashed my numbers to healthy levels within months, making me feel silly for being so prideful and waiting so long.

I’m lucky the issue didn’t create chronic problems, or worse, before I started the prescription, and urge anyone whose doctor recommends medication to take it as prescribed, in addition to doing the other good stuff: Eat healthy, exercise and kick those cigarettes to the curb.

High cholesterol can cause huge problems. But as my journey shows, there’s really no need to let it reach that point.

THINK (Trusted Health Information, News, and Knowledge) is a community publication of Capital Blue Cross. Our mission is to provide education, resources, and news on the latest health and insurance issues.

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A Proactive Approach to Keeping Our Community Healthy

September 28, 2023 | by Todd Shamash

Todd Shamash

At Capital Blue Cross, we are committed to going the extra mile to serve the greater Harrisburg region as well as our customers across the country. And that means more than simply contributing to local organizations or sponsoring events. We strive to listen to concerns and look for solutions, especially when it comes to healthcare.

Take, for instance, one of the most common concerns of healthcare consumers: the ever-rising cost of prescription drugs.

Capital Blue Cross has taken bold steps to help ensure people can afford the medications they need to be healthy and, in some cases, stay alive.

According to the U.S. Centers for Disease Control and Prevention, more than 9 million Americans cite high costs as a reason they fail to take their prescribed medications, even though skipping or delaying doses can worsen health conditions and make them costlier to manage.

Earlier this year, Capital launched a program to help eligible members reduce out-of-pocket costs for expensive specialty drugs they need, like those for rheumatoid arthritis, psoriasis and Crohn’s Disease.

Within just three months after we started this effort, we had helped participating employer groups that have Capital drug coverage save about $4.5 million and cut eligible individual drug out-of-pocket costs by about $3,000 per person. That averages out to about $1,000 in individual savings every month!

And that’s just one approach Capital has taken to fight rising drug costs.

We also are the first insurer in the nation to work directly with Mark Cuban Cost Plus Drugs—a new company started by billionaire entrepreneur Mark Cuban to offer some of the most commonly used prescription drugs at the lowest possible price. By allowing our members to use their Capital ID cards at Cost Plus Drugs’ online pharmacy, we’ve helped some people cut their out-of-pocket drug costs by as much as 40%.

We have taken the same aggressive approach to combatting one of the most common and costly diseases: diabetes.

About one-third of Americans will develop diabetes sometime in their lifetime—a chronic disease can cause severe health problems, damage vital organs and shorten life expectancy. The harm diabetes does to America’s collective health is matched by the financial toll it takes. The disease costs the U.S. nearly $330 billion a year.

Capital is the first Pennsylvania health insurer to offer a unique program that works to reverse type 2 diabetes through a well-formulated diet that works to regulate blood sugar in place of costly medications. We also offer a separate program that helps our members reduce their risk of developing type 2 diabetes, and helps those with types 1 or 2 manage their disease.

Our efforts to fight the diabetes epidemic are paying off for members and employers:

Capital members using our diabetes control program collectively lost more than 26,000 pounds last year.
Capital members using our diabetes reversal program saw their A1c levels drop by more than a full point on average in just the first 90 days. Higher A1c levels are linked to diabetes complications.
On average, Capital members were able to reduce prescription medications by about 45% in the first 90 days of using the diabetes reversal strategy.
Combined, our diabetes control programs already have helped Capital customers save nearly $6 million collectively, and an average engaged member can save $1,800 to $2,000 annually.

Using innovative strategies like these to proactively address healthcare challenges is beneficial not just to individuals, but to entire communities. When we help reduce the costs of care and keep people healthy, it gives their families and friends peace of mind, saves money, and contributes to a healthier, more productive community.

That’s what we mean at Capital Blue Cross by going the extra mile—and we’ll keep going every day to ensure the Harrisburg region remains a great place for our members, our dedicated employees and everyone who calls this area home.

Todd Shamash is president and CEO of Capital Blue Cross. For more information, visit www.thinkcapitalbluecross.com.

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Coping Strategies Can Ease Workplace Meeting Anxiety

September 6, 2023 | by THINK Capital Blue Cross

There are an estimated 11 million work meetings each day in the U.S., and the thought of attending them can be nerve-jangling, sweat producing, or even debilitating experiences for some. Coping strategies can help tame butterflies, while therapy and medication can be effective for more serious cases.

Whether triggered by a fear of public speaking or discomfort in real or virtual settings, most people experience some level of anxiety about work-related meetings, according to Karie Batzler, director of Behavioral Health at Capital Blue Cross.

With an estimated 11 million work meetings each day in the U.S., there is a lot of potential for a jangling nerves, sweaty palms, rapid heartbeat, and other symptoms.

“The issue with respect to symptoms is how often do they occur, for how long, and do they stop you from doing your job or living your life?” Batzler said.

Coping strategies such as checklists or focused meeting preparation can help tame the butterflies for most, while therapy or medication is the answer for some.

“Anyone who says they have never experienced (some form of meeting anxiety) is not being honest,” said Jay Solomon, director of provider operations at Capital Blue Cross.

On a nervousness scale of 1 to 10, Solomon puts himself at a “one” when meeting within his own department or with people he knows. That level jumps to about four, he said, when he is less familiar with meeting participants.

For Megan Atticks, a communications specialist at Capital Blue Cross, mild meeting anxiety lurks in the memory of a difficult experience in a previous job in which her supervisor peppered her with seemingly unrelated and distracting questions during a presentation.

Atticks puts herself at about “five” on a nervousness scale of 1 to 10, but adds, “If there’s a technical glitch, I quickly jump up to a nine.”

Batzler, Solomon, and Atticks say the absence of social cues such as body language, facial expression, and eye contact make virtual meetings more stressful.

Their feelings are supported by a March study published in “Trends in Cognitive Sciences,” and in a study on zoom fatigue published in “Technology, Mind, and Behavior.”

Whether meeting anxiety is rooted in a fear of public speaking, lack of preparation, unclear expectations, a previous negative experience, or even poor self-image, there are a host of easily accessible, non-medical coping strategies, according to Batzler. They include:

Practice public speaking – Introduce yourself or tell a story at a gathering.
Arrive early – This allows you to start out conversing with a smaller group.
Review the agenda – Prepare questions and statements ahead of time.
Rehearse statements – Practice what you want to say.
Practice mindfulnessor stress management – deep breathing exercises, meditation techniques, etc.
Make sleep a priority.
Quit smoking and reduce intake of caffeinated beverages.

For some with underlying, diagnosable anxiety disorders, meetings can trigger symptoms that can make it hard to work, according to the National Institutes of Mental Health (NIMH).

The Anxiety and Depression Association of America (ADAA) says social anxiety disorder, for example, affects about 15 million Americans and generalized anxiety disorder affects an estimated 6.8 million.

The good news, according to the ADAA, is that doctors can effectively manage anxiety disorders through psychotherapy or medication.

“The best advice is always to talk with your doctor about potential treatments,” Batzler said. “Especially in cases where you feel this anxiety is affecting your work and professional relationships.”

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How Youth Mental Health Impacts the Adult Workforce

August 29, 2023 | by Capital Blue Cross Staff

A mental health crisis among America’s children might not seem like a workplace issue at first glance.

But if your workplace is typical, about 40% of your colleagues are working parents of children under age 18. And as any working parent knows, when your child is not well, the stress and worry of home and family life often come into work with you.

About 1 in 6 children in the United States have a mental health issue, such as anxiety, depression or attention and behavior disorders. If left untreated, the consequences of these issues can range from academic or social struggles to substance abuse or self-harm.

For parents, the health and wellbeing of a child can affect their own health and wellbeing—and that can impact their job performance. A 2021 survey of more than 3,000 working parents in the U.S. found:

53% of working parents have missed work at least once a month to deal with a child’s mental health issues.
54% of working parents interrupted their work to address a child’s mental health needs.
Working parents under age 40 say they are more likely to choose employers based on access to mental health care benefits and resources.
While 85% of working parents think it’s a good idea to discuss children’s mental health, fewer than 1 in 4 have talked to their managers, human resources department or colleagues about their children’s struggles.

That last point is an important one to Karie Batzler, director of behavioral health at Capital Blue Cross.

“We all know issues at home don’t just switch off once we step into the workplace, but we often see a reluctance to talk about how that stress can carry over,” Batzler says. “Employers can play an important role in starting a dialogue around mental wellness, whether it impacts employees or their family members, and employers can help connect their employees to resources that can help.”

Capital Blue Cross, for example, offers resources for both its own employees and its members, including:

A behavioral health toolkit that employer groups can use to foster a more supportive work environment.
A devoted mental health and wellness page on Capital’s website.
A telehealth resource that goes beyond physical healthcare by offering fast and convenient access to psychologists, psychiatrists and other licensed behavioral health professionals.
A mobile app that helps users improve their mental wellness and better address anxiety, depression and other mental health needs.

Capital also supports its employees through an employee assistance program and volunteer-led employee resource groups (ERGs) that foster dialogue and a sense of connection among employees who share common interests, backgrounds or demographic characteristics.

No matter the path forward for your company, it can all begin with a simple conversation, according to Batzler.

“Often times, it can go a long way just to tell someone, ‘I’m sorry to hear about what you’re dealing with and please let me know how I can help,’” Batzler said. “Once a dialogue begins, it can pave the way toward seeking help and finding resources to support the employee and their family.”

For more health and wellness news and information, visit www.thinkcapitalbluecross.com.

If you like what we do, please support our work. Become a Friend of TheBurg!

Community Comment: International medical insurance provides peace of mind, lowers financial risk

August 21, 2023 | by THINK Capital Blue Cross

International airport terminal. Asian beautiful woman with luggage and walking in airport

A 19-year-old man’s recent summer getaway to Cancun, Mexico, turned tragic when – while enjoying his pristine ocean view – he fell from three stories. Nobody saw him fall.

Later found unconscious, he was taken to a local facility – one with a reputation for refusing patient treatment and/or discharge, withholding passports until full payment is made upfront, and price gouging.

It could have been a worst-case scenario, since the man’s injuries left him in critical condition and in need of emergency surgery to reduce brain swelling. He’d need to be moved quickly to someplace that could deliver that level of care.

Fortunately, he had international medical insurance, which the Centers for Disease Control and Prevention urges Americans to purchase when traveling outside the U.S. That’s because nearly 1 in 4 Americans have had medical issues while traveling abroad, according to research from Harris Poll and GeoBlue, which provides health insurance coverage for travelers.

“It really makes sense,” says Capital Blue Cross Senior Account Executive Jackie Sariano. “It’s affordable, it’s accessible, and it provides peace of mind when traveling abroad.”

On Their Minds

According to Harris Poll and GeoBlue, Americans are increasingly thoughtful about possible medical issues when traveling internationally: Nearly two-thirds agree health concerns factor into their destination choice.

Still, too few are turning their worries into action by ensuring their health and finances while traveling internationally.

As a result, more than three-quarters of consumers either don’t know how they’d pay for or won’t have sufficient insurance to cover medical care when abroad. Too many mistakenly assume their domestic health plans will simply work the same way abroad.

Rethinking Employee Benefits

Post-pandemic, employers have been faced with a new dilemma: how to support employees who want to work remotely outside the U.S. or add leisure travel to international business trips. It’s becoming more common: 41% of companies are considering a permanent work-from-anywhere option and 80% of U.S. travelers are planning to add leisure days to future business trips.

But relying on a domestic health plan can result in increased financial burden, delayed or denied medical care, and other stressors. International providers often expect full payment at time of service; international claims are often considered out of network, making them more expensive; and most individual and employer-provided domestic health plans don’t cover medically necessary evacuation or repatriation to the U.S.

Covered Care That’s Right There

For employers, the path to safer employee travel is simple: health plans that include international health insurance coverage. These plans ensure access to quality providers who accept direct payment from the carrier, 24/7/365 multilingual support, coverage for medical evacuation, and more.

Capital Blue Cross, for instance, offers coverage from GeoBlue – a fellow member of the Blue Cross Blue Shield family – as an option for employer and individual plans. Capital also provides the option to purchase international medical plans directly at any of its five Capital Blue Cross Connect health and wellness centers, and further shows its commitment to coverage and risk management outside the U.S. by providing GeoBlue coverage to its own employees.

Quick Action, Quality Care

A GeoBlue plan covered the 19-year-old man who fell three stories in Cancun, and the people and policies behind that plan quickly kicked into action upon receiving the man’s injury report.

GeoBlue’s medical review team determined the emergency-surgery need, and within two days of being notified, GeoBlue had an air ambulance fly the man and his father to Houston in time to receive the necessary care at the appropriate cost.

In this case, the foresight to purchase international medical insurance couldn’t have paid off more.

“Life is full of unexpected events,” Sariano said. “Don’t wait until it’s too late.”

To learn more about GeoBlue, visit https://about.geo-blue.com.

(GeoBlue® is a trade name of Worldwide Insurance Services, LLC, an independent licensee of the Blue Cross Blue Shield Association.)

Community Comment: Lowering Drug Prices through Innovation, Ideals and Collaboration

July 3, 2023 | by THINK Capital Blue Cross

Samir Mistry and Alex Oshmyansky discuss how the Capital Blue Cross-Cost Plus Drugs collaboration is driving down costs for some Capital members.

When Capital Blue Cross announced in October 2022 that it had become the country’s first health plan to collaborate with the start-up Mark Cuban Cost Plus Drugs, it set a precedent for the industry. It also opened a new door for Capital members to reap sizable savings on their medications.

Capital remains the only health insurer in the nation collaborating with Cost Plus Drugs. That relationship recently brought Cost Plus Drugs founder and CEO Dr. Alex Oshmyansky to Pennsylvania to discuss drug access and affordability with members of the Lehigh Valley Business Coalition on Healthcare.

“Full credit to Capital,” Oshmyansky said. “A lot of organizations say, ‘We believe in innovation. We want to be innovative.’ But in my own experience relatively few actually are. But Capital very much is.”

Conquering the Challenge

The Cost Plus Drugs model is simple on the consumer side. Billionaire entrepreneur Mark Cuban set out to shake up the pharmaceutical industry with transparent pricing and minimal markups and fees. The online pharmacy charges consumers only 15% more than it pays to buy a drug from the manufacturer, along with a $3 per-prescription dispensing fee and $5 for shipping.

Capital’s challenge was replicating that simplicity on the health insurance side, according to Samir Mistry, Capital’s vice president of pharmacy strategy and services.

“Because (those within the healthcare industry) are used to complicated implementation, simplification actually makes it harder,” Mistry said. “So that was the hard part, figuring out a way to operationalize and reflect Cost Plus Drugs’ price on their website into our system so we can process claims.”

“The existing infrastructure is very complicated, so that’s where you do actually have to create a fair amount of true innovation,” Oshmyanksy said. “How do we reverse things from the convoluted system we have in the industry backward to simple commerce?”

Eventually, Capital and Cost Plus Drugs worked out the operational challenges, allowing Capital members to use their insurance coverage on the Cost Plus Drugs website – something no other insurer can do.

The Start of Serious Change

Capital’s collaboration with Cost Plus Drugs is doing precisely what both companies intended: saving members and employer groups money – in some cases, lots of it.

“Any member with prescription coverage that’s a part of Capital Blue Cross or in our community, anyone who signs up and sees a savings opportunity, they’re generally seeing discounts of 30% to 40% of the standard price,” Mistry said. “In some cases, especially in our Medicare population – because it’s available in Medicare Part D and commercial coverage for us at Capital – the highest I’ve seen is a 98% savings.”

Mistry said the more dramatic savings, such as the 98% example he cited, surround generic oncology and specialty drugs, and can save employers or Medicare members hundreds or thousands a month.

“One of our Medicare members is taking one of the (generic) oncology meds, and that’s roughly $34 (as of June 7, 2023) on the Cost Plus website versus $712 (at CVS through GoodRx),” he said. “This is a major savings for someone who’s on a fixed income, living paycheck to paycheck.”

Capital’s data has shown steadily increasing month-over-month member usage and savings through Cost Plus Drugs.

Still, Mistry notes, there is room to improve.

“Every drug is not available through Mark Cuban Cost Plus Drugs. That’s OK,” he said. “In innovation and disruption, it’s not going to be perfect.”

Capital’s next step is targeted outreach to members who might not yet be aware of potential savings through Cost Plus Drugs.

“We’re going to do focused initiatives towards them,” Mistry said. “If they save money through the Mark Cuban program, then our employer groups, our plan sponsors, our company, everybody saves money. … So our focus point is always on the member.”

Oshmyansky credits Capital for having the vision to break new ground.

“I hope the relationship with Capital is a spark that ignites change throughout the industry,” Oshmyansky said. “I hope it brings attention to the fact that this is a real issue, that (high drug prices are) hurting real people, and hopefully helps bring positive change, not just to the Lehigh Valley and Central Pennsylvania, but to the country.”

For more health and wellness news and information, visit thinkcapitalbluecross.com.

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