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I \\ \ eN .. iiktior . . x r O ...„....ii if liaMli 8 [ departments ] Speaking Clearly A word from Blue Cross President and CEO Mark W.Banks,M.D. 14 ClearBlue Essay I Making a world of difference in India Lynn Brown,senior communications consultant,traveled to Porur,India,to assist children at the Dazzling Stone Orphanage.She reflects on her life-changing experience in this special essay. 26 The ClearBlue Interview I Fred Dickson When Chief Information Officer and Vice President Fred Dickson moved to the United States from Ghana,West Africa,he began an exciting journey, which ultimately brought him to Blue Cross. 32 Special Feature I A lesson in living life well 19-year-old Tamar Green helps us understand what it really means to live life well with a chronic medical condition. 38 Investment in Prevention I Supporting community health workers Community health workers are important members of the health care team. A new training program has been developed to create more opportunities for these valued health professionals. 6o Engage Mary Jo Prinsen is a dedicated volunteer who launched Bundles of Love, a program to comfort families in special ways. 61 2004 Annual Financial Highlights clearblue 3 1 H I1 • tents2oo5 4, A IL //1' 1rr 110. s 4, I , A ' IL:41e:: ' ' ,- ' -: . Teelk i ip,4, 10 ika I i , '' . ..,.. *.: ''• ' 1. i j4 - -, • 4, i •A I 4 [ features ] 6 Talk time: The value of dialogue in the doctor's office Providers and patients explain why it's important to keep the lines of communication open. 10 Empowering parents and children The Minnesota Association for Children's Mental Health is a statewide advocacy organization that supports parents and children. 20 Giving back to the community Blue Cross and Blue Shield of Minnesota agent Jenny Riley gives from the heart in her work and life. On the road with Rob Blankenfeld Rob Blankenfeld,community account manager,covers about 11,000 square miles to serve Blue Cross customers and members in northwestern Minnesota. 24 At home in the office Denny Roy,community account manager,is a"virtual office"pioneer.For more than 30 years,he has"officed"out of his home in Grand Rapids,Minn. _, 44 Born to serve Joanne Young has dedicated her 38-year career to serving Blue Cross members. And she doesn't plan on retiring anytime soon. 48 do: Get up and get moving The Blue Cross do campaign is on the move,and the message is simple: "Groove your body for 10 minutes 3 times a day." 56 Building bridges Blue Cross employees volunteer for CaringBridge,which provides free Web sites to families who face challenging medical issues. 2 clearblue 4 [ speaking clearly ] Life. Live it well. For all of us at Blue Cross and Blue Shield of Minnesota,this simple statement embodies far more than just a catchy advertising slogan.These four words serve as our hope for all Minnesotans and our 2.6 million members:the people who count on us to be there when they need us most. But what does it mean to live life well?Even though I am a physician and a health care consumer myself,this is not a question I can answer alone.As you will find after reading this issue of ClearBlue,the answer to a life lived well is unique to each one of us. Take for example Tamar Green,who shares her secrets to living life well with Crohn's disease on page 32.On page 20,independent agent Jenny Riley explains to us why it is so important to give of ourselves and help others live life well.And on page 10,you will learn how some concerned parents formed the acclaimed Minnesota Association for Children's Mental Health to support other parents and their children.Be it through innovations in health care,careful management of chronic health conditions,or community collaboration and volunteerism,these and the many other wonderful stories within ClearBlue will highlight for you all the diverse ways people across our state are committed to living life well. This is our fourth issue of ClearBlue,which serves as our corporate annual report.We adopted this magazine format because we believe that the best way to tell our story is through the voices of the people we serve:our customer accounts,members,providers,agents,employees,and community partners.I hope their stories inspire you as much as they have inspired me. Wishing you good health, Mark W.Banks,M.D. President and CEO Blue Cross and Blue Shield of Minnesota clearblue 5 The value of dialogue in the doctor's office Curiosity may have killed the proverbial cat, but it's helping patients improve their health. Armed with new information sources and an increased appetite for managing their own health, consumers are talking with their doctors more often and more openly about every aspect of their health. well-informed With her doctor's support,Beyers did some research patient is an asset to their own health care,"said Paul and developed an exercise program and eating plan."My McGinnis,M.D.,family practice physician at Hudson doctor gives me choices.She understands that I have ideas Physicians and medical director of the Western Wisconsin of my own.I'm not always right,but she's receptive to my Medical Association."Patients have become partners in ideas and willing to give them a try.She's also there with a their care,rather than recipients of care." safety net if things don't work out;'Beyers said. Lorna Beyers,from Holland,Minn.,agreed.At 5 feet 5 Beyers'approach and her active role in managing her inches and 230 pounds,"I knew I needed to eat healthy and health have led to an 80-pound weight loss in just over a exercise more.My doctor told me I was headed for a heart year."My doctor is thrilled with the results,"she said. attack if I didn't do something about my high cholesterol More and more often,conversations in the doctor's and blood pressure.On her recommendation,I tried office are taking place,producing dramatic—and even medication but was uncomfortable with the side effects?' life-saving—results for patients. [ by Julie Lee I illustration by Katherine Streeter] clearblue 7 r y rr III■ ..r Homework helps Beyers does her research on the Internet and talks with Today's doctor isn't surprised when patients pull out an ad her doctor and her pharmacist."If the three agree,"she said, from Parade magazine,a health publication they received "I know I have something worth trying." in the mail,a newspaper article announcing a breakthrough treatment or test,or an article from the Internet. More talk, more walk "It can be very tough for patients to wade through Does more talking really make a difference for doctors what they're reading or hearing,"said John Oujiri,M.D., and patients? family practice physician at St.Mary's/Duluth Clinic in "Medical knowledge doubles every five years,"said Ashland,Wis."Some information is credible and helpful. Oujiri."Continued education is a normal part of the day Some isn't.I can help them determine what's relevant to for doctors,but having educated patients ask questions is their condition and guide them,but ultimately they need an added incentive to stay current.And when patients are to make the decisions about their health,"he said. involved with researching and making decisions,they're McGinnis agreed,"As a result of the Internet,patients more likely to carry through with the treatment plan are receiving information the instant doctors do.Most stories we've agreed to." can't provide the depth to help a patient understand possible Increased dialogue has helped some patients better benefits or drawbacks of a treatment or medication in the shape their questions. context of their situation.That's my job:' "I've learned to ask more specific questions over the past Much of what's in the medical news is very preliminary couple years.I now take my doctor's recommendations to as far as research goes."It's a great headline to say that a the next step,"said Michael Coolican,a resource materials cure has been found for arthritis,for example,"said manager for Cargill in Watkins Glen,New York,who was Oujiri."The problem is that many of these sensational diagnosed with diabetes in 2003."So I'm a diabetic.Now, stories aren't yet well-proven in the medical community." for example,what do I do about diet and exercise?" Reputable information sources are the key,said McGinnis. Doctors and patients agree that the increased amount "Work with your doctor to find three or four sources you of time they spend talking is helpful for everyone can regularly go to for more information,through books involved.But what is it doing to appointment schedules? at the library or trusted Web sites,such as the National "I've never had any trouble with appointments,"said Institutes of Health:' Coolican."My doctor always leaves enough time for me to ask questions.If I ask them,he'll answer them." Scheduling procedures haven't changed significantly to allot more time per patient,which can present time challenges, said McGinnis.But patients can help ensure that there is "WORK adequate time for discussion during their appointments. WITH YOUR DOCTOR TO FIND "If you know that you'll need discussion time for multiple THREE OR FOUR SOURCES YOU CAN topics,be sure to let the scheduler know when you're REGULARLY GO TO FOR MORE INFOR- making your appointment,"said McGinnis. MATION, THROUGH BOOKS AT THE So what kinds of questions should you ask? LIBRARY OR TRUSTED WEB SITES, "There's not a question that's too dumb to ask,"said SUCH AS THE NATIONAL Coolican."We all need to ask more questions and be fully INSTITUTES OF HEALTH." open to two-way discussion to keep our health on the best track." 8 clearblue LJJ r L LJ LJ•_I • LLB L LI 1 1 1 a 3LLJ 1 1 FaEi • DI] 1 1 �� 1 PCPCEl J 1 1 1 1 r 1 iLE 1 �1�E r L LI LEE LJ J U,J 1 E€LLL.[.pLLLJJJ��LILLLIII 1 1 1 `r ; a ' g`° sr 1 �_ L�L IIJIJ ' 10 topics to discuss with your doctor EIH 3 n J Every time you visit the doctor,pick one question I FIT' "THERE'S N OT A -1 r EC from this list to discuss.Ina year's time,you'll find 1 QUESTION THAT'S TOO DUMB � HiE that you have learned a lot about the state of your 1 1 31_1 health simply by asking these questions. �EIE� TO ASK. WE ALL NEED TO ASK MORE I n�1f�. QUESTIONS AND BE FULLY OPEN TO �1 11 O What are my blood pressure numbers, �LJLi TWO-WAY DISCUSSION TO KEEP JI�JLJJ i and what do they mean? 1 IL OUR HEALTH ON THE u 4d • I�I I�I, 0 Is my weight right for me? d 1 1 C BEST TRACK." 1 'Hi]Hi 1 Q Am I due for any screenings,tests or shots? J LJ LJ B 1 r 1 1 E,E5c Q What do cholesterol numbers mean,and what SH LJ LJLJ i- vL 1 F 1 Ec 1 1 'or-L-1 1 I are my numbers? T • EC H LJ J • F • Q Can a review of my medications and supplements? pplpl ements? • LJ-J 1 1 • E"E LJ I i HHHIR 1 F LI J • Q What are some things I can be doing that will 1 I 1 1 1 1 1 I 1 I 1 F help reduce my need for medication? 1�LLL LLR • 1 LLLIIIi � � LLL JJJ-A Q Where can I go to get help quitting smoking? D61 L1J . LJ LIJ • F, • L1J 1 I Q What resources do you recommend for me to learn more about my condition? Q What's my first step for losing weight? Where can I get help? Better communication leads Q What's the best way for me to find out what r to higher patient satisfaction kind of exercise program is right for me? In a 2004 Consumer Assessment of Health Plans Study ll--moo, I (CAHPS)®Commercial Adult Survey*,patients expressed . high satisfaction with their doctor/patient communications. IP • 95 percent of patients surveyed said that their doctors and other health care providers usually or always listened EVERY carefully to them,respected what they had to say,and TIME YOU VISIT THE explained things in a way that the patient could understand DOCTOR, PICK ONE QUESTION • 93 percent said that their doctor probably or definitely FROM THIS LIST TO DISCUSS. IN A would ask the patient to help make decisions if there YEAR'S TIME, YOU'LL FIND THAT YOU was a choice between treatments for their condition© HAVE LEARNED A LOT ABOUT THE STATE OF YOUR HEALTH SIMPLY 4 *Blue Cross and Blue Shield of Minnesota and Blue Plus routinely !' participate in the CAHPS surveys.CAHPS is a registered trademark BY ASKING THESE of the Agency for Healthcare Research and Quality. QUESTIONS. t clearblue 9 Empowering parents and children 0 P ADDRESSING CULTURAL CONCERNS, I ERASING THE STIGMA ASSOCIATED WITH CHILDREN'S MENTAL HEALTH ISSUES R 6 r . 10 Children actoutformany Introducing Minnesota Association for different reasons.They may Children's Mental Health (MACMH) be sad.They might want a toy.Maybe someone was mean to them on the play- ground.But what happens Initially launched on a small budget and with limited resources,MACMH has grown into a statewide education and advocacy organization.From hosting conferences and when your child behaves in workshops to developing publications and teachers'guides, extreme ways much of the MACMH is a leading educational resource in this state,as time and without any apparent well as the nation. reason?As a parent,you might struggle to understand Giving at-risk I<i d s and what's wrong,how to cope and where to go for help.You their families a better chance may also wonder,"Where do I even begin my search for answers?"If this sounds familiar,you are not alone. "Children with mental health,emotional and behavioral According to the Children's Defense Fund-Minnesota, problems are one of the highest-risk groups of young an estimated 140,000 youth aged 9 to 17 in Minnesota have people in the Twin Cities area,especially in our growing a diagnosable mental health disorder,and 69,000 of those ethnic communities,"said Deborah Saxhaug,executive suffer a functional impairment due to that disorder.These director of MACMH.`Because they often do not receive children face a tragic situation that involves far more than the appropriate school and mental health services,these just the routine challenges of growing up.For example, children are at high risk for school failure,family conflict, families dealing with a mental disorder must find ways to suicide and out-of-home placements?' cope with it at school and home,as well as face the social Saxhaug continued,"Investing in families through stigma outside the home.Part of these families'struggle is education,support and guidance gives them the tools they simply finding organizations in their area that can offer need to navigate the complex systems that serve children support,information and resources.This is one of the many with mental health disorders?'She added that such invest- reasons that a concerned group of parents formed the ments help family members become stronger advocates Minnesota Association for Children's Mental Health in 1989. on behalf of the children and the larger community. [ by John Bohman I illustration by Aimee Sicuro I photography by Joe Treleven I clearblue ii Breaking down barriers to care Parent-to-Parent centers serve the needs of many ethnic communities,including: Too often,the stigma associated with mental disorders • Somali community in Rochester presents major barriers to both children and their families, • Hispanic/Latino community in Willmar hindering access to proper treatment.Parents may blame themselves for their child's condition or deny the disorder • West African community in Brooklyn Center • African-American communities in St.Paul even exists.The child's disorder can be compounded by a i and Minneapolis society that—through misunderstanding and misinfor • an community in St.Paul mation—victimizes,isolates or punishes the child. MACMH programs empower families to get the knowledge "Before I found this program,I was really stressed out. and support needed to help overcome social isolation and I didn't know what to do or where to turn;'said single learn to successfully support and advocate for their child. mother Anna DelBosque."I was afraid of losing my child Children's poster contests,teacher lesson plans and group if I went for help as many other Hispanic parents sometimes li training sessions are just some of the ways MACMH fear.The total opposite is true.The family liaison and others works to address these concerns in schools statewide. involved in the Parent-to-Parent program really gave me the support and education I needed to handle my son's Building communication across cultures situation better" In addition to the"common"mental health barriers that many families face,Minnesota's growing ethnic populations "I WAS AFRAID OF LOSING MY CHILD encounter unique cultural issues.For example,many families IF I WENT FOR HELP AS MANY OTHER HISPANIC PARENTS that have immigrated to Minnesota are not familiar with mental health disorders in general.And even the most SOMETIMES FEAR. THE TOTAL OPPOSITE IS TRUE. knowledgeable families often don't know where to turn for THE FAMILY LIAISON AND OTHERS INVOLVED in help.Cross-cultural communication with families who IN THE PARENT-TO-PARENT PROGRAM REALLY GAVE ME don't speak English is another challenge for health care THE SUPPORT AND EDUCATION I NEEDED." providers and support organizations. "Many parents have said that they felt powerless when 101 they had no one they could communicate with,"said Saxhaug. Family liaison in Willmar and single mother Maria Florez "With Minnesota's increasingly diverse populations, said,"I've gone through the tough times trying to figure MACMH is committed to helping parents from different out what was wrong with my son,so now I am able to pass cultures give their children the best possible chance to on my knowledge and support to other parents?'She added, lead a healthy,happy life:'MACMH's board and staff "I invite parents to talk to me and get their concerns out 11111 agree that creating a broad network of parent-to-parent either one-to-one or at my monthly Hispanic/Latino parent illl programs is the best way to do this. group.It's also great that I am able to translate materials or discussions for those who don't speak English?' Introducing the Parent-to-Parent program Education and one-to-one mentoring is at the core of Looking to the future MACMH's innovative Parent-to-Parent program.This unique As programs like Parent-to-Parent continue to expand, program helps families of all backgrounds connect with children with mental health disorders and their parents other families across the state who have similar needs and will have greater access to the support and education they situations.With funding support from the Blue Cross and need."I think this program is great because I no longer Blue Shield of Minnesota Foundation,the Parent-to-Parent feel alone;'DelBosque said."This truly has changed our program currently operates five locations around the state, lives for the better:' where parents sit down together for group discussions, individual support and training. 12 clearblue 4„„, 7---,...„. ., ,,, , , - , - ,,, .. . . , .. - -.., ,,, -ti . ik.,:. 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From right to left: Parent-to-Parent family liaison Maria Florez, ,, Parent-to-Parent client Anna DelBosque and her children Juan Villarreal Jr.and Ricky DelBosque results from MACMH in 2003-04: MACMH mission: To enhance the quality of life for ,900 students learned more about mental health children with mental health disorders and their families +isorders through the Children's Mental Health Education and Intervention Program MACMH objectives: Educate the public to remove the stigma and barriers 'iM? ore than 15,000 parents and professionals received associated with children's mental health disorders hildren's mental health resources and materials at statewide and national conferences Inform and educate families and professionals about children's mental health 1,253 parents and professionals attended the 2004 Child and Adolescent Mental Health Conference Educate families about the multiple systems that serve children with mental health disorders and help them Trainers presented children's mental health-related navigate these complex systems workshops to more than 800 parents and professionals Provide programs and advocate for services that More than 5,500 MACMH publications in Spanish and meet the unique needs of parents from culturally English were distributed to parents and professionals specific communities clearblue 13 f .0. .0. .0. .0. .0 . ■ 0 . ■ 0 . ■ 0 . ■ 0 . ■ 0 . :0.. ■ 0 . ■ 0 . ■ 0 . ■ 0 . ■ 0 . ■ 0 . ■ 0 . ■ 0. .0. .0. .0 . .0 . . rk., , • !R fe, ; ' r r . .c R4s ..»alit 4 , ..► . .. , ,,, , se ,:, 6 f. ■ \ \ ■ ■ O ■ ;Y O.O , . • I . ■ 0 . 0 ■ ' 0 ■ O O.O V . •■ 0 ■ •0 ■ 0 ■ O■ o•O '0 . ■ 0 ■ • O.O •; 000 e�oh� O �ive�i o n c� . 2' la-C 6'�%o h ( -/ .a io-td/La ver, ■ ■ O • yaa o vv e2r ih a 1�a� ah o/m e. 134a4Im �u� �o 0 1E5' 2ha1,ge o ,, o 1ie�otvtee/wee ad a voli+4veeh a ...n� � �.z doufih `00 000 124 . . -4-41/2 ��yN rvK�Oic C2r2 lYa f lC a�fVa tl m Qi2 ei 1�i.�PhGPn2CC GfifCC O : 91' ita�t, Oho/ac cant`/t•✓Oa�G/C amt ra sy l✓N�h oc, Oa be h ; ' 7.--1 B 0 0 2iLa4Y O�eoLo � ua a meoeh �h�a�Y eune , to 0 rz 0 : : 0 : .keadee/- pace`m . a 65-•hock ' ��p .awl , 2 za eI •.o 00o• po2uh �.u.A .L .o�tun 7/ aol 1 e 7 �,,zeol.on 4-e-a (9,4 awl Y -r.,z ,.cap neiYeit•JieaiLOL.o y O / �c p,t�ti�vtO/tom. 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The ubiquitous cows,confusing traffic,absence of side- walks,constant blowing of horns,muddy potholes,abundant (2 Balraj is 9 years old.He is so bright.When he finishes poverty,and unfamiliar smells and tastes were overwhelming. school,he would like to be an engineer.His parents have However,my complete immersion into a new culture both died.His grandmother was taking care of him but is brought a life-changing awareness of how a majority of now no longer able. the world's population lives. Cg Kavitha is 7 years old.When she grows up,she would I learned that many of the people on this planet survive like to be a doctor.Her father has died,and her mother on a small percentage of the goods and services that most deserted her. Americans take for granted.I learned how a hot shower is Ea Kumar is 4 years old.Kumar's favorite food is rice,and one of the unknown luxuries never experienced by many. his favorite color is green.His sister,Punitha,is also at Maybe most striking of all—and what I have thought Dazzling Stone Orphanage.Their father is physically about the most since leaving India—was the absence of handicapped;he can walk only with his hands. any look of despair on the faces of the beautiful children I met in India. [Note:Dazzling Stone Orphanage was spared in Lourth Mary is 6 years old.She is currently studying the Dec.26 tsunami disaster.] upper kindergarten.Lourth Mary's parents come from a very remote village,where they are landless laborers.Due p pp to her poor family situation,her parents brought her to ay Ge mo�t�� t aI o�aGt— Dazzling Stone Orphanage,along with her brother, t-474.4 2A-a/ve a°9–kafQ'°''t-ge 4n.o Augustin Paul,and sister,Jesintha. <i 7i(e .,leati 7at.a4 —/wad 4,7Z„aided-pee -eige fea,e4fe 24,,.e . 7~74.2. dearblue 19 A devoted insurance agent,volunteer,wife,mother Riley, the insurance agent of two,stepmother of six,grandmother of two,and step- An grandmother of 15,Riley knows well the true meaning of insurance professional for more than 20 years,Riley 'unconditional giving?'In ways large and small,Riley gives launched her own agency in 2001.With her husband and of her time and talents daily,serving as an outstanding role business partner,Tom Riley,she specializes in the needs of model for her family,clients and community neighbors."This Minnesota's Hispanic insurance market.Offering bilingual country has given me the opportunity to earn a living and insurance sales and translation services primarily to indi- viduals,my services back to the community;'she said."Being viduals,employers and fellow insurance agencies,Riley is involved in volunteer activities is my way of life.I have taught helping to fill gaps within today's insurance industry."My my children and grandchildren this philosophy,as well?' major customers are usually small businesses that employ Hispanics.My partnership with the employers includes Riley, the volunteer the translation of human resources documents,safety programs,employee meeting materials,and one-to-one When she's not meeting the bicultural needs of her Hispanic communications(verbal and written),"she said. insurance clients or taking care of her growing family, Normally,it can take years to establish a successful Riley donates hours upon hours as an active volunteer. insurance practice,but Riley has made quite an impact in Organizations she has supported over the years include her niche-market area within a very short amount of time. the Multiple Sclerosis Society,Hospice of the Lakes, American Field Service Student Exchange Programs, Birthright,St.John's Funeral Committee,Wild Animal Rescue,Camp Ajawah Youth Camp for Girls,University WHAT'S THE SECRET TO HER SUCCESS? of Minnesota Children's Hospitals,American Heart "I FOCUS MY FULL INTEREST ON MY CLIENTS' AND Association,Minneapolis AquaJesters Club,and Support » THEIR EMPLOYEES' WELL-BEING, SHE REVEALED. for Women Owners of Small Businesses. "I TREAT THEM THE WAY I WANT I Whether she's mentoring foreign exchange students, TO BE TREATED — WITH RESPECT AND KINDNESS." serving as an event host,helping at fundraisers,crocheting blankets for the homeless,visiting the sick and elderly, baking cakes and cookies,rescuing animals,or supporting female business owners,Riley puts her heart to work for What's the secret to her success?"I focus my full interest on the greater good."I volunteer for many reasons but mostly my clients'and their employees'well-being,"she revealed. because I believe in a cause;'she explained."My volunteer "I treat them the way I want to be treated—with respect activities throughout my life reflect who I am as a person?' and kindness?'It also doesn't hurt that Riley is one of the Revealing her more light-hearted side,Riley admits best cake and cookie bakers around."It's true that I'm that her favorite volunteer activity is"clowning around." well-known for my baked goods;'she said."I think my As an official member of the Minneapolis AquaJesters Club clients love having me for an agent—sooner or later, who is known as"Cakee the Clown;'Riley said she loves they all get a treat straight from my kitchen." dressing up as a clown for parades and making children laugh. She added,"I also like to visit the University of To learn more about Riley's business philosophy,services Minnesota's Children's Hospital and the veterans'home as and Support for Women Owners of Small Businesses(her Cakee to spread some cheer.I firmly believe that laughter support group for female small-business owners),visit is powerful medicine?' www.rileyandassoc.com. 1 clearblue 21 I Community account manager Rob Blankenfeld works from a "virtual" home office in Bemidji, Minn., but he doesn't spend a lot of time there. A very mobile Blankenfeld averages about three days a week on the road, traveling to and from customer meetings and presentations across his 12-county territory, which covers about 11,000 square miles in northwestern Minnesota. For many of Blankenfeld's community accounts,which of public entities and have a lot of meetings before the work include a variety of public and private service groups that day or in the evenings,especially since I tend to deal with range from manufacturers to banks,he is the face of Blue committees that are reviewing and analyzing their group Cross and Blue Shield of Minnesota.And he is a main health care programs.I don't know that I've ever had two point of contact for groups and agents,whom he credits days that were exactly the same,and I like it that way." with being a very valuable part of the Blue Cross structure. "Agents are our front-line team,"said Blankenfeld,"and Meeting customers' needs it's important that we continue to provide them with the Blankenfeld addresses his clients'needs by working with support to help them address our clients'short-and them to identify the goals that they have for their group long-term health care goals?' health care programs."It's all about dealing with immediate According to Blankenfeld,helping customers identify needs,while laying the foundation for a more long-term their health insurance goals is just one of the many good approach.In the short term,it's about focusing on the reasons to have a representative located in the region. year ahead,"he said."But long-term planning really gives "By having someone focus on this part of the state,we're our customers the tools and resources they need to actively able to keep a continued pulse on the needs and requests manage their health care programs for their employees of all of our customers,"Blankenfeld explained."Plus,the and make the biggest difference?' community accounts staff working`outstate'can demonstrate Blankenfeld came to this role through another service the importance of this region to Blue Cross?' job with the Northwest Service Cooperative,which serves schools,cities,counties and other governmental agencies Making `road time' productive time in northern Minnesota.(The cooperative is one of his Blankenfeld"passes the miles"by listening to public radio clients today.)Though he comes from a service background, and planning out his many"to-dos:'He has even learned Blankenfeld has had an interesting range of jobs,including a few tricks to make his mobile workplace more efficient. work as a Navy corpsman and middle school math and "I have a tape recorder that I carry with me in the car,"he social studies teacher.It's his diverse background combined said."When I have ideas or need a reminder about something with a personal history in the region—Blankenfeld was that needs doing when I get back to the office,I record a born and raised in northwestern Minnesota—that makes message to myself.After all,I can't really take notes and this job a good fit for him."I've done one form of service remain a safe driver?' or another all of my working life,and I really enjoy it, Blankenfeld has been with Blue Cross for nearly six especially in this area of the state?' years,serving community clients that have Blue Cross as their claims administrator or primary insurer."I don't have your typical 8-to-5 job,"he said."I work with a number [ by Rebecca Lunna I photography by John Noltner clearblue 23 tjce c. ' 46/ile Aft graduatin from the University of Minnesota in 1972 with a degree in business administration, Denny Roy and his :. wife,Wendy,moved to Grand Rapids, Minn.There,he opened a Prudential insurance office in their home.Thirty-three years and three grown children later, Roy still works from the same home office. However,for the past 20 years,he's been working for Blue Cross and Blue Shield of Minnesota as a community account manager for his region of the state. Separating business from pleasur- Many more U.S.employees are opting to work from home full-or part-time.However,Roy could be considered a"virtual office" pioneer — he's had a home office for his entire career. Making the adjustment to a home/work environment can be a challenge,but Roy learned early on how to successfully live and work under the same roof."I've always started my workday at 8 a.m.,"he said,"and when I go into my office,I treat it no differently than if I was at Blue Cross' headquarters in Eagan." In fact,it's not staying on task that presents the bi gg est challenge for Roy.It's staying out of the office."Limiting myself to an eight- or 10-hour day can be tough,since it's easy to break away from dinner and go downstairs to`finish up a few things'—only to find myself there four hours later,"Roy confessed.Even though work/life time management can be difficult 4 for him some days,Roy would be the first to point out that he has a"convenient office commute"that makes up for it all. • • Making a healthy living vent dug e .oesn ave"o battle traffic jams every day,Roy does spend a good deal of time driving to meet with his clients.He services Itasca,Koochiching and St.Louis counties and averages about 25,000 to 30,000 business miles a year. Roy works primarily with large groups,including manufacturers and service cooperatives—such as cities,counties and school districts—as well as with independent agents."Most agents offer more than one health insurance provider,so it really helps that Blue Cross has representation in the agents'own backyards,"Roy explained."Our face-to-face relationships out in the field'give us a lot of credibility both with agents and with our large-group insurance clients:' • Wearing many hat • , - z„ pent informing groups about their health care options and keeping them abreast of the products and services that Blue Cross offers.It's a job that often has him serving a"hybrid role"of sales,service and even health educator, depending on the day.According to Roy,it's up to him to find a way to provide greater benefits and value to all of his clients. And he does that by specializing in products that go beyond traditional health insurance,including life and short-and long- term disability insurance,flexible spending accounts and dental coverage.Roy also helps groups understand the benefits of • value-added products like Blue Cross'care management programs and services,which are all designed to help people achieve a better state of health. "At Blue Cross,we've gotten increasingly involved with our members and their health;"Roy said."Good health:That's really what it's all about.I give Blue Cross a lot of credit for how well we've kept that in focus all these years." [ by Rebecca Lunna I photography by John Noltner] 24 clearblue [ the clearblue interview ] Crossing continents, cultures AN INTERVIEW WITH FRED DICKSON, CHIEF INFORMATION OFFICER THE LEAP FROM SUB-SAHARAN AFRICA TO FROSTY MINNESOTA IS BOUND TO PROVIDE ONE WITH A BIT OF CULTURE SHOCK, NOT TO MENTION A SERIOUS CASE OF "THERMAL SHOCK." JUST ASK FRED DICKSON, CHIEF INFORMATION OFFICER AND VICE PRESIDENT, WHO MOVED HERE FROM GHANA, WEST AFRICA, AT THE AGE OF 19. ickson,nowa A move to the Twin Cities naturalized U.S.citizen, first came to the United States After about three years in Morris,Dickson moved to as a college student at the University of Minnesota-Morris. Minneapolis,where he completed his studies at the There,he immersed himself in the wonders of mathematics University of Minnesota-Twin Cities campus.To kick-start his career in insurance and technology,Dickson attended and computer science,as well as the regional oddities well known to the rest of us as snow,sub zero temperatures classes at night and worked during the day for Prudential and four unique seasons."When you come from where I Insurance as a programmer/programming analyst. did,you have no concept of what minus 20 degrees really From Prudential,Dickson was recruited by The Pillsbury means,"said Dickson."It just doesn't register until you feel Company,where he spent 13 years managing various it for the first time,and then you never forget.My most technology areas.Then in 1999,Blue Cross and Blue memorable moment from back then is when I awoke one Shield of Minnesota offered Dickson the opportunity to very sunny day in March and thought to myself,`It must lead its"new technologies group?'And after serving in be warm out today:I left the house with no jacket or winter various vice president roles within the Blue Cross infor clothes on.Was I ever in for a surprise when that cold bit mation systems(IS)division,Dickson was promoted to the role of chief information officer in 2004. into me:' [ by Teresa Novacek I photography by Joe Treleven I clearblue 27 s u \ \ _ a,,,,,, ..♦l 4li'.FA IRSYLL • - , ,,••m•• Djib..Y �'^ pra.0 �) !� b L. «• ♦ ' AM..Bw.p • II h rH10PiA F_\TRAP 1FRIC 4\ RFPI RI.R ' Plow 14q.I, 'SOMALIA '07 ..._r ate....-. .....«....��. i - '..... .k In his current capacity,Dickson is responsible for leading We are currently piloting smart cards with Target the entire IS division,which includes application systems, Corporation members,who are now able to pay their infrastructure,support services,risk management and copays with their smart cards(linked to their medical controls.Some of his other duties include defining and spending accounts),as well as provide their doctors with executing Blue Cross'technology strategy to support the instant eligibility and benefits information. 'I company's overall business objectives.In addition,Dickson Blue Cross first offered health savings accounts in early serves as Blue Cross'IS liaison to the Blue Cross board of 2004.Partnering with Schwab and Devenir,financial trustees,the Blue Cross and Blue Shield Association,and industry leaders,we provide our members with the best local and national business and regulatory organizations. investment opportunities available.Now our members can invest the money in their health savings accounts, ClearBlue:Why is technology important to a company creating maximum value over time. like Blue Cross? We strengthened our Web"portals"for consumers, Dickson:In todays world,technology can help a company members,providers,corporate clients and agents.We have like ours compete successfully in the marketplace.My had a strong Web presence for quite some time.But we belief has always been that technology is powerful,but it added functionality so that many new,enhanced services are now available online 24 hours a day,seven days a week. can be more powerful when it is used to solve problems and add value for an organization.But there's more to it ClearBlue:What are some major initiatives coming out than just technology.You need talented people and good of your area this year? processes,as well. Dickson:We are currently strengthening Blue Cross' ClearBlue:How many employees work in the IS division? analytics and business intelligence capabilities,which will Dickson:We rely on the talents of about 550 employees. allow us to provide valuable information to our customers in new ways so that we can better work together to manage ClearBlue:What are some major projects that you and health care costs and improve our members'health outcomes. your group have recently completed? We are also investing in our core technology infrastructure Dickson: We have completed a number of key projects by improving the redundancy and high-availability of our within the last few years,including the technology foun- "mission-critical"systems.And we will begin modernizing dations for Options Blue,fitness center discounts,smart our older core-transaction processing systems,as well as cards,health savings accounts,our various Web portals continuing to invest in our customer-facing systems and a host of other projects. (Web portals). For Options Blue,we enhanced www.bluecrossmn.com ClearBlue:How have Blue Cross'investments in technology to give those members a powerful tool to manage this made the company more efficient? cutting-edge consumer-directed health plan.Options Blue members can use the site to monitor their medical spending Dickson:A good example is our Web based portals,which accounts and manage their health plan.And it's not limited have increased our ability to serve our various customers, to Options Blue—all Blue Cross members can use the providing immediate,efficient and secure self-service www.bluecrossmn.com site to view explanations of benefits, features.Members can view their explanations of benefits claims and much more. and claims on www.bluecrossmn.com without having to make a call to customer service.Members can also go The Blue Cross fitness center discount program took the market by storm last year.Our technology infrastructure online to request new ID cards,view provider quality and enabled us to support the most comprehensive fitness comparison information,and e-mail questions to customer discount network nationwide. service.Our agents and providers have similar features that they can use to conduct their business with us quickly and easily,as well. 28 dearblue 1 ' ' I .awaA e S U D A N 1.1'11' } QR/EA Br 4 M q� le I,uw.}1 "• }hn n} Orab. 1.4.10.121V Elf Zat 1=:IHIOPIA it sEMw.Y u SR 'SOM;V.1X one f fIn our claims area,we have used technology to reduce Dickson: By putting meaningful information in the hands . the time it takes for claims to move through our systems. of members,we can help them make good decisions,which 0 By better editing our incoming claims,we are able to can make a healthy difference in their lives.That's why we p increase the"pass rate"of claims,which leads to cost savings. have worked hard to provide online tools and information, • . And in our customer service area,we continue to enhance such as those found at www healthcarefacts.org, our tools to provide service representatives with better wwwbluecrossmn.com and wwwblueprintforhealthmn.corn access to the information they need to answer customer At all three of these sites,our members can access a wealth inquiries via phone,Web,e-mail,etc. of important information that can aid them in better These improvements,as well as many other system health care decision-making and healthier living. improvements,have helped the company become more 1 efficient and effective.Unlike a for-profit health care company that is accountable to stockholders,we are accountable to BY PUTTING MEANINGFUL INFORMATION P our members and the community.And when we save IN THE HANDS OF MEMBERS, WE CAN HELP money,we return that to our members in the form of THEM MAKE GOOD DECISIONS, WHICH CAN MAKE enhanced services,new health improvement programs A HEALTHY DIFFERENCE I N THEIR LIVES. P l. and competitive premiums. ClearBlue:How is our technology structured to support I. our company and its customers? ClearBlue:What is the culture like in our IS shop? Dickson: Overall,the company's technology framework Dickson:We have a rich array of experience in our IS includes three major areas: Q Transactions:These help run the business and include division.We have employees with significant tenure,and we also have a number of newer employees.The result is a transactions to define benefits,contract with providers, diverse collection of people with creative ideas and various enroll members,process claims,etc. technical skills.Our division's mission is to be recognized as a high-performing,best-in-class IS shop that adds value Q Interactions:These allow the company to do business to the company and the customers it serves. with various customers through communications channels,such as phone,Web,e-mail,etc. ClearBlue: What would you tell potential job applicants about Blue Cross as an employer? Q Analytics:These activities allow us to better understand the business by transforming all the data we have into Dickson:As a leader in the market,Blue Cross is an meaningful information,knowledge and insights. innovative company with an impressive history,spanning Armed with this information,we can work with our more than 70 years.Blue Cross'purpose is to make a customers to better manage costs and health outcomes. healthy difference in people's lives,and everyone in the company works hard to deliver that vision.Blue Cross These key areas are critical to our company's success.Our provides an inclusive environment where you can work challenge in IS is to ensure that all these areas work together with talented individuals and grow professionally and seamlessly to support our operations and customers now personally.We are also well-known for our compensation and into the future. and benefits program,as well as our dedication to work/life balance. ClearBlue:How do our investments in technology affect Of importance to information technology applicants, the health of our members? Blue Cross is a company that believes in the value that technology brings and invests in technology accordingly. clearblue 31 si,• �I e A lesson • • r i. 1046 Imagine what it would be like to develop a mysterious fever, weight loss, dehydration, and malabsorption of disease that short-circuits your body's immune system, vital nutrients, among other complications. attacking your digestive system as if it were a virus. Imagine what it might be like to make frequent visits Imagine what it would be like to have this disease to the hospital, undergoing regular IV infusions of come on with unrelenting force and without warning, potent anti-inflammatory medications or, in the worst leaving you weakened and ill. case, any number of surgeries to address more severe Imagine what it would be like to never know exactly effects of the disease. what foods, situations or combination of the two trig- Imagine no more. This is reality for people who suffer gered the disease or when you might be stricken with from more extreme forms of Crohn's disease. In the its debilitating symptoms, including uncontrollable United States, seven in ioo,000 people have this disease, diarrhea, intestinal bleeding, severe abdominal pain, which can vary in severity and complexity. I [ by Teresa Novacek I photography by David Ellis] 32 clearblue i 'II Tamar Green,a vibrant 19-year-old student at Barnard time.In addition,Tamar had to have an emergency College in New York City,learned about Crohn's disease colostomy in sixth grade,which was later reversed,requiring for the first time after a family trip to Mexico at age 7. her to wear an ostomy pouch every day from the age of 12 �+ Three months upon her return,Tamar developed severe through 14—a time when puberty alone is challenging intestinal pain and diarrhea.At about the same time,her enough for a young girl. father,Joel Green,developed ulcerative colitis,which is a As one might guess,Tamar said some of her greatest condition that also affects the digestive system.While challenges were the perceptions of other children."Most family history and genetics are significant factors with of the time,though,everyone was very supportive of me �I these diseases,Joel and Tamar suspect that some bacteria at school.But there was one time that a boy in my class or virus in the foreign food or water may have triggered said something really hurtful just after I had to go on their conditions. steroids because my body was literally starving itself;'she said."My classmate told me that my face was so round like 't r Turning a disease into a `gift' a balloon that he could pop it with a pin.Those were the Throughout her young life,Tamar has been told by various days when I felt very alone with my disease?' experts that she has one of the more severe cases of Crohn's Tamar,however,would like to point out that dealing disease and is not"the norm"for the condition.Even so, with her disease at such a young age was actually more of a blessing than a curse for her."I feel I was lucky to be she would be the first to tell you that her disease"has actually been a gift?'She explained,"Crohn's has taught diagnosed at age 7,instead of as an adult;'she said."It has me that I can still fulfill my dreams.This disease does not just become a way of life for me.Hospitalization is a way define my life.My life is still my life.I remind myself that of life.Infusions are a way of life.I have adjusted,and I it's okay to feel the fear and anger sometimes.But I don't have learned to not let it stop me:' lose hope.Never.I always remember that this,too,shall pass?' With the difficult formative years behind her,Tamar has fulfilled her dreams in spite of her disease,graduating from high school right on time and attending her favorite "CROHN'S HAS TAUGHT ME THAT I CAN college.She also transformed herself into an avid world STILL FULFILL MY DREAMS. THIS DISEASE DOES NOT traveler,studying at length in Israel twice in the past two DEFINE MY LIFE. MY LIFE IS STILL MY LIFE. years.And she has become an eloquent advocate,presenting I REMIND MYSELF THAT IT'S OKAY TO FEEL THE FEAR on behalf of the local chapter of the Crohn's and Colitis AND ANGER SOMETIMES. Foundation of America(CCFA).Her next goal is to launch a youth mentorship program through the national BUT I DON'T LOSE HOPE. NEVER. CCFA organization,headquartered in New York. I ALWAYS REMEMBER THAT THIS, TOO, SHALL PASS." Understanding the mystery of Crohn's disease That's an amazing realization,given that,since age 7, Medical experts can't predict when or how Crohn's will Tamar has been hospitalized 21 times,spending significant strike a person,but they do agree that the likelihood of portions of her school years in the hospital for flare-ups and occurrence is highest when a sibling or parent already has bowel obstructions or in recovery at home.She repeatedly the disease.Family history of other intestinal diseases,such missed her SAT and ACT exams due to Crohn's-related as colon cancer and ulcerative colitis,is also a potential complications.There were also the corticosteroids she had risk factor. to take in grade school,which added nearly 50 pounds of Unaffected by the trip to Mexico when he was a child, water weight to her frail 39-pound frame in a few months' Tamar's 16-year-old brother,Elan,didn't develop symptoms 34 clearblue I .o> of Crohn's disease until the fall of 2003.Fortunately,his I I I condition seems to be far less severe than his sister's case. Managing a chronic illness abroad Tamar and Elan's mother,Rani Halpern,has not developed symptoms of Crohn's or any other digestive disorder.And Traveling overseas requires careful planning for all agree that she is the stabilizing force within the family. even the healthiest traveler.In Tamar Green's case, "Mom is there for all of us,and I know it hasn't always been she needed to ensure that she would have access to easy for her,"said Tamar."She is an amazing person and a network of Blue Cross providers who could provide has done everything she can to help us fulfill our dreams." her with her regular medical infusions and emergency Rani and Joel's goal has always been to teach their children care,when needed,while she was away from her that the world is open to them and that they can do anything home and family. within it."We just need to plan everything more carefully Tamar's parents,Rani Halpern and Joel Green, than other people,"said Rani."As parents of children with worked closely with Laura Abramson,Blue Cross a chronic illness,we wanted first to take care of them and case manager,to line up a list of qualified Israeli then teach them how they can take care of themselves by providers,pharmacies and hospitals within the understanding their bodies and conditions.Only by helping comprehensive B1ueCard®*network,which includes our children learn to take care of themselves can we truly more than 50,000 providers around the globe. help them explore their world as individuals:' Fortunately,Tamar's two recent trips to Israel were incident-free for the most part."Israel was wonderful. It was a great learning opportunity for me,"said "ONLY BY HELPING OUR CHILDREN Tamar."There were some bumps while I was there, but we had all the right medicine and care lined up, LEARN TO TAKE CARE OF THEMSELVES and everything worked out just fine." CAN WE TRULY HELP THEM EXPLORE THEIR WORLD Rani and Joel also worked with Abramson to AS INDIVIDUALS." arrange for all of Tamar's medicine and medical care in New York while she is at school.The proactive coordination of care has given everyone peace of Tamar today mind."We know she will be taken care of while she's there,"said Rani."And we know this is what ,t Now in her freshman year of college,Tamar has proven she really wants to do.Joel and I will do whatever again and again to her family,friends and professors that we can to help her,as well as her brother.In fact, she has unstoppable will and conviction to not just suc- Elan is now preparing for his first trip to Israel this ceed but excel in her life,even when her disease attempts summer,and we are working with Laura to arrange to stand in her way."I am a firm believer in living in the the same treatment and precautions for him:' moment and doing all that I can to learn,grow and see the world right now because tomorrow I might not feel well *The BlueCard Worldwide Program supports members enough,"said Tamar.That statement sums up Tamar's life g ' p of Blue Cross and/or Blue Shield licensees who may f Y philosophy."If I am feeling well,"she said,"I make the travel or live outside the United States.BlueCard most of it.I value every second that I feel healthy?'© provides eligible members with access to medical services from more than 50,000 health care providers worldwide. Coverage provided through the BlueCard program is as seamless as coverage provided for services obtained by members in the United States. (o), II' It .1 Ui 36 clearblue [ investment in prevention ] Supporting community health workers, 1 l ' promoting culturally competent care v 1 a � I �l . 1/ WITH EACH PASSING YEAR, MINNESOTA IS BECOMING EVER MORE DIVERSE. CHILDREN OF COLOR NOW ., ACCOUNT FOR AT LEAST ONE OUT OF EVERY FIVE CHILDREN IN BELTRAMI, CASS, HENNEPIN, MAHNOMEN, NOBLES, RAMSEY AND WATONWAN . COUNTIES. WHETHER IMMIGRANT, REFUGEE OR BORN AND RAISED IN THIS STATE, 11.5 PERCENT OF MINNESOTANS BELONG TO ONE OR MORE IDENTIFIED MINORITY GROUPS, AND 8.5 PERCENT SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. [ by Joan Cleary and Monika Strom I photography by John Noltner] Good health is not shared by all Innovative training on the way While our state consistently ranks as one of the healthiest, Thanks to a unique partnership between the Blue Cross I not everyone who lives here shares in that good health— and Blue Shield of Minnesota Foundation and the Health particularly American Indians,people of color,foreign- Education-Industry Partnership(HEIP),new training born Minnesotans,and people with low incomes. opportunities will increase the number of CHWs in According to the Institute of Medicine,these health Minnesota,their employment opportunities and their disparities are the result of many different factors,including impact in our diverse communities.With a major grant vi lack of insurance coverage,unequal treatment,language from the Blue Cross Foundation,HEIP—a program of barriers,lack of familiarity with our health care system, Minnesota State Colleges and Universities—has developed cultural expectations about health care and health care a standardized CHW curriculum. providers,and spiritual beliefs about illness and health. More than three dozen students are now enrolled in a "Populations change far more rapidly than the mainstream pilot CHW training and certificate program through HEIP, culture that has built the health care system.People want which is now offered at Minneapolis Community and to be healthy,but they need to learn how to use the health Technical College and Southwest Community Technical care system to do that;"said Jeanne Nelson,R.N.,M.S.N., College in Mankato.Once the pilot effort is complete,the director of the former PathFinder pilot program,which program will expand throughout the Minnesota State helped Latino,Cambodian and Somali immigrants with Colleges and Universities system. health care access in Olmsted County. First-of-its-kind accredited training The HEIP program offers standardized,accredited CHW "POPULATIONS CHANGE FAR MORE RAPIDLY training that—in addition to improving health and health care—aims to increase the diversity of the health care THAN THE MAINSTREAM CULTURE THAT HAS BUILT workforce in an increasingly diverse Minnesota.This is y � I THE HEALTH CARE SYSTEM. PEOPLE WANT TO BE the first training program of its kind in our state. IAII HEALTHY, BUT THEY NEED TO LEARN HOW TO USE "The students love it;"said Anne Willaert,project director THE HEALTH CARE SYSTEM TO DO THAT." with HEIP.Student Gloria Contreras believes the program will enable her to combine her interests,further her CHW career and help other Latinos."I like to support community education and empowerment.I wanted to be involved in Community health workers are key tradition and culture,'said Contreras. I Enter community health workers(CHWs)to bridge the gaps between cultures and health care—gaps that con- tribute to health disparities.CHWs help people with unique cultural needs to navigate our complex health system. I LIKE T O SUPPORT COMMUNITY EDUCATION • These employees of clinics,hospitals and other organizations AND EMPOWERMENT. I WANTED T O BE INVOLVED offer diverse communities tailored health information, I N TRADITION AND CULTURE." assistance and guidance.They also help Minnesota's health care system and community organizations increase their cultural competence,improve access to care and expand health education.But many more CHWs are needed to meet Minnesota's growing need. 40 clearblue j 0 r� I 'mss • Surveys and experience confirm a difference;'Glass-Kelly remarked."It's been interesting to the importance of CHWs pull all these people together who've done this kind of work, develop a curriculum and get some training and credentials." Long an important frontline role in health care in other The idea for the CHW training program arose in 2001 parts of the country and world,CHWs are a tried-and-true with a Blue Cross Foundation survey on the use of CHWs strategy for promoting health education and improving in our state.This survey was an important step toward health care access in a more personal way."When people improving health care cultural competence in Minnesota walk through the door and they look like you and talk like under the foundation's Growing Up Healthy in Minnesota you,you're more willing to let them know what you really funding initiative. need;'said Teretha Glass-Kelly of her 25 year experience The Blue Cross Foundation survey also found that CHWs as a CHW in the Twin Cities. "This is what I've wanted to do since I was 15 years old, are important and highly valued.Demand for them is strong and will increase.But there is a shortage of qualified and it's all I've ever done.I know I have the power to make clearblue 41 V .0, • 4 h tf I s'4 You recognized the future of health care is here now. You gave employees new tools to manage their health. You brought back summer hours. 'ouru - It's the fast-growing, consumer-directed ppp health plan that will help keep your employees happy and your BlueCross BlueShield yi bottom line healthy. Call your Blue Cross agent or visit yourule.info. of Minnesota CHWs.Employers have said that standardized training Making a difference would mean a better-prepared workforce and an increased pool of qualified CHWs.In turn,many CHWs The new CHW training program has really hit home for the many students.Contreras explained how CHWs can see training as an important means to validate their work and help them gain greater recognition and respect from make a difference,"A lot of people don't have insurance, health care professionals,according to Wilder Research or they have problems scheduling appointments,or there Center and Blue Cross Foundation findings. are language problems.We can reach communities in their own language and culture to connect them with medical Linking diverse communities services and to identify systemic barriers to health access." and the health care system "CHWs are critical links between diverse communities ",q LOT OF PEOPLE DON'T HAVE INSURANCE, and the health care system,so when the Blue Cross OR THEY HAVE PROBLEMS SCHEDULING F Foundation saw this opportunity to reach out and truly make a healthy difference in our state,we went for it," APPOINTMENTS, OR THERE ARE LANGUAGE PROBLEMS. said Kaying Hang,foundation program officer. WE CAN REACH COMMUNITIES The foundation approached HEIP with the results of IN THEIR OWN LANGUAGE AND CULTURE TO its survey.Since then,the two groups have worked collab- CONNECT THEM WITH MEDICAL SERVICES AND TO oratively with a dedicated consortium of more than 20 IDENTIFY SYSTEMIC BARRIERS TO HEALTH ACCESS." other organizations to develop the standardized CHW curriculum from the ground up.The program was developed with input from practicing CHWs like Glass-Kelly and A look to the future CHW program directors like Nelson,who now teaches in } With a successful nomination by the Blue Cross Foundation, the HEIP program at Minneapolis Community and E ' Technical College. HEIP has secured a Robert Wood Johnson Foundation P With fine-tuning from faculty at Minnesota State Local Initiatives Funding Partners Grant to further develop the CHW training program.HEIP plans to expand the University,Mankato,the program's host institution,an 11-credit program emerged to combine classroom learning program throughout the Minnesota State Colleges and with fieldwork and internships."It's been like running a Universities system in 46 communities across the state,as race—it's very exciting.People really put their soul into well as other community and technical colleges. this,"Willaert said. For more information about the Blue Cross Foundation, its funding priorities,recent grants,and the application process, ITS BEEN LIKE RUNNING A RACE — visit www.bluecrossmn.com/foundation.© IT'S VERY EXCITING. PEOPLE REALLY PUT THEIR SOUL INTO THIS." As an exciting feature,program credits can be applied to training programs for other health occupations,creating a career ladder for those CHWs who want to move into other health-related fields.Through this added flexibility, the training program contributes to a more diverse health workforce and addresses the overall shortage of health care workers in Minnesota. clearblue 43 • • • • • • • • • �J✓ �J7�YL 'VIJi oieia,Qi • • • Blue Cross employee has dedicated • her career to exceptional customer service • • • • Joanne Young, senior customer service • representative, has been carrying a thank-you • note and a baby picture around with her for • nearly 20 years. And it isn't a picture of a • grandchild, niece or other family member. • • • • • • • • • • • • • • • • • he baby picture and thank-you note came Young,with 38 years in customer service at Blue Cross, • from a woman whom Young helped through a high-risk has a passion that shines through to the Blue Cross members. • • pregnancy years ago in her role as a customer service she speaks with daily over the phone."When you are talking • representative."If it wasn't for you,my son wouldn't be here with someone,that person is not just talking to the insurance • today;'said the woman in her note to Young.These words company,"Young said."That person is calling for a reason, • still inspire her today.For Young,the picture and note and you must take the time to listen.Health insurance is • symbolize how she approaches her work and her life—with overwhelming to people.You must relate to that person • a dedication to excellence and making a healthy difference. beyond what he or she is calling about." • • • [ by Karl W. Oestreich I photography by Michael Hendrickson ] • • • I kia ka , y • '1 • •S • 1 1 itill•• ti r + d S O t. 0 3 -3 c • d 0 a . , 1 c I. „ 4014 a 4 • O • a 4, Ade ,„6:10, .,.. ove ahead. Healthy employees help you better manage health care costs. How? Well, they're absent less and that can lead to greater productivity and a more efficient use of health care resources. So when employees are taking a walk during lunch, they're actually taking steps to improve your bottom line. We can help get your workforce excited about good health. Learn more at www.bluecrossmn.com/moveahead. V BlueCross BlueShield(7/9 of Minnesota And that's the key,according to Young:relating to people. Customer service positions aren't for everyone,but they can provide a great career for people who have a desire to Key attributes of a successful Blue Cross help people."You must have your heart in it?'Young said. customer service representative "You have to enjoy working with people." ` 0 Conscientiousness:Takes pride in work and Young first began her Blue Cross customer service claims ownership for completing assignments career by assisting seniors with their Medicare coverage. and making timely decisions,even when obsta- She went on to work in service training,and then she des arise.Is devoted to raising the standard of switched gears and served Blue Cross medical providers quality and excellence in all areas of service. for 17 years.Now,Young meets the customer service needs of companies that have 100 employees or fewer. 0 Service orientation:Desires to serve external "She always has a positive attitude,"said Alan Klimisch, and internal customers and considers customer her former supervisor in provider service."She really cares impact in decision making.Willingly puts the for people.It's not just a job for her.She shows her enthusiasm t% needs of others first and pitches in to help. in everything she does."Her current supervisor echoed those thoughts."Her positive attitude helps other people," © Communication effectiveness:Relates well to said Stacey Lehman,community accounts supervisor."She ■ all kinds of people,verbally and in writing— is a good role model for young people who are entering both formally and informally—to groups and customer service positions.She demonstrates her commit individuals,inside and outside the organization. ment and passion through her everyday work:' Defuses high tension situations comfortably. Can accurately and patiently restate opinions of others,even when he or she disagrees. "She really cares for people. It's not just a job for her. She shows her 0 Self-assurance:Shows confidence in own abilities enthusiasm in everything she does." but knows limitations and when to ask for help. Understands needs and takes action to develop new skills to meet changing expectations. And does she have any plans to retire?"What's the point Learns from and doesn't repeat mistakes.Shows of retiring?"Young asked."I like the people.And I like the confidence when interacting with others. •job,the tools and all the technology I can use to help people. The job varies every day,with different personalities and 0 Compassion:Genuinely cares about people as different situations.There is nothing about it that makes individuals.Recognizes expressed and unexpressed me want to leave." needs.Acknowledges others'feelings. Young is a problem solver,counselor and customer service representative extraordinaire."You need to ask `Why,why and why?'when you're solving problems for customers,"Young said."I am determined and stubborn when it comes to helping our customers?' And what would Young do if she woke up on a Monday morning and could do anything besides come to work? "That's easy,"she said."I would babysit my two great nephews." Serving Blue Cross customers,family members and friends:That's what Young would say she was born to do. clearbtue 47 Get up and get moving [Test drive a neighbor's dog.] [do phone squats.] [Don't let the machines win. Take the stairs.] If you live around the Twin Cities or Duluth, you have probably seen these and other do ads popping up on billboards, worksite signs, buses and even light-rail trains. The do promotions all have the same tag line: "Groove your body for io minutes 3 times a day." II Why do? "It seemed time for a fresh approach,so we decided to combine several recommended strategies into one multi- When people learn that Blue Cross and Blue Shield of media community-wide campaign,"said Michael Huber, Minnesota and the American Heart Association created director of cardiovascular health at Blue Cross'Center for this innovative campaign,they often ask,"Why?" Tobacco Reduction and Health Improvement.The goal? "The simple,powerful answer,"said Sanne Magnan, "To ditch the traditional`get enough exercise'message. M.D.,Ph.D.,medical director of Blue Cross'Center for do reframes that advice into a more user-friendly invitation Tobacco Reduction and Health Improvement,"is to save to`build three 10 minute activity bursts into every day lives,save money and improve health." and have fun doing it, 'he explained. Surveys show that fewer than half of Minnesotans Smith added,"do is built on the insights that activity regularly accumulate 30 minutes of moderate activity on doesn't need to be`exercise'and doesn't have to happen most days of the week."That's the minimum needed for for 30 minutes straight:' basic heart health and body health;'explained Magnan. Introducing a fresh, fun approach Reaching out to anti exercisers to physical activity The best part of do is that no spandex,no gym membership and no big blocks of time are required.The do team's Physical inactivity and poor nutrition combined are the suggestions include walking around the block,taking the second leading cause of preventable death and disease across stairs,dancing in your living room,mowing the lawn the country. The low-activity,drive-everywhere lifestyle and playing with your dog(or even someone else's,as one costs us dearly—in illness,in lives lost and in money. billboard ad suggests).The simple truth is that physical "It shouldn't take a heart attack,stroke or other life- activity is within everyone's reach and can easily be incor- threatening illness to make people understand the importance porated into a daily routine. of being physically active,"said Joseph Smith,M.D.,Ph.D, do deliberately reaches out to people who are turned president of the American Heart Association's Twin Cities off by the idea of"exercise;'the folks who regard exercise Metro Board and senior vice president/chief medical officer as"not for me"for whatever reason."We especially wanted at Guidant Corporation. [ by Mary Hunter and Katherine Bass I photography by Jonathan Chapman ] 48 clearblue r r • to appeal to adults who are inactive,"said Amy Lyons- Try do, too Sayers,who manages the do campaign for Blue Cross."do Watch for the roving do van,check out the •► encourages them to start simply.So the campaign aims to www do-groove.com Web site and try a new activity or two. • empower those people ... and motivate everyone else Making daily activity the norm instead of the exception can along the way;'she added. yield big rewards for individuals,worksites and communities. So what are you waiting for?Get out and do. do @ work In addition to community events and mass media,do has been appearing at workplaces across the state.Interested <o. i employers have been customizing the do campaign to fit their worksites'unique needs. Modest physical activity makes • For example,in Brooklyn Center,Medtronic marked P Y Y off a do"walking lane"in its hallways to encourage a huge difference* employees to walk on their breaks.And in Duluth, If Minnesotans were more physically active,there could be: Minnesota Power and Light/Allete placed do signs with an arrow and the words"free stairmaster"by the elevator, O 30 percent fewer cases of heart disease,stroke,colon cancer and osteoporosis pointing employees toward the stairwell.Medtronic's Gen Barron,manager of health,wellness and work life,said, O 18 percent fewer cases of type 2 diabetes and high "do is a great fit with our overall corporate initiative to blood pressure support employee health and wellness.We jumped at the p 17 percent fewer injuries from falls in the elderly chance to roll out do to our employees in the Twin Cities." 12 percent fewer cases of depression and anxiety a o Employer interest in do's accessible message is high.More than 150 businesses sent representatives to two workshops O 5 percent fewer cases of breast cancer that Blue Cross sponsored earlier this year.The workshops explained how to implement the do campaign at work. Physical activity/inactivity by the numbers ► The popular employer section of the do Web site,found at $495 million—Estimated dollars s p ent in 2000 treatin g www.do-groove.com/order,lets companies order do diseases and conditions that could be avoided if all posters,signs and do-branded items for employee incentives. Minnesotans were physically active 75—Percent of all short trips(less than one mile) Will do make a difference? that are made by car Before-and-after data will show whether or not do moved 4.7—Estimated percent reduction in health care costs the physical activity needle for adult Minnesotans aged 18 if sedentary people were active for 30 minutes just one to 64,the campaign's target audience.All involved with day per week the program agree that's an ambitious goal.However, awareness of the campaign is already quite high,so staff *Sources: Minnesota Department of Health,U.S.Centers for think that do is off to a great start. Disease Control and Prevention,Journal of the American "Before people behave differently,they need to think Medical Association,American Heart Association,U.S. Department of Transportation. differently;"said Lyons-Sayers."That's where do is starting. We want people to realize that being active doesn't require going to a special place at a special time and wearing special clothes.Opportunities to be active are all around us." clearblue 51 jII .1 „, _, .,tlJ ., Making do a healthy wa y of life [ One Medtronic employP-'� r}r,.. ' 1 1 1 1 II Il1 1 1 ord has it that do took Medtronic heart disease.However,for many people,the term"exercise" employees by storm shortly after the company launched stops them cold."Exercise is not a happy thought,"McFadzen the pilot program in 2004."When the do program came explained."Exercise to me means putting on a workout outfit, along,it was just perfect for me,"said Karen McFadzen,a my tennis shoes and going to do something I don't want to � self-proclaimed"anti-exerciser"and Medtronic senior do.I tried joining clubs and just couldn't do those things.' supervisor."All employees got pedometers when the pilot started, she said."And right away,we started checking g Y g with one another to see who put in the most steps." do: A real life-changer Never a fan of exercise,McFadzen suffered a heart For McFadzen,the do program has made a difference on a attack at age 36.Shortly after the attack,she learned that very personal level,helping her improve her overall state she had a hereditary form of heart disease."I thought there of health and keep off the 40 pounds she lost.Through wasn't much that could be done,"she said of her initial do,McFadzen was able to accomplish something she ' response to the diagnosis."My first reaction was to take it wouldn't have been able to achieve through a fitness cen- easy,but before too long,I joined a weight loss program ter,a place she vows that you will never find her."Because and started taking short walks with my dogs." of do;'said McFadzen,"I set a goal for myself:to walk Doctors often recommend exercise as one way to manage 10,000 steps a day.But I don't call it exercise?' [ by Katherine Johnson I photography by Jonathan Chapman ] 52 clearblue Designing stairways to health ,. , .6 , , €t . , .... , c �° �� I AREA PRA ..--v, ..; re���' <�iest are e�' �. To make a Arai, al e • and one bee t R t. nspired by the do public health awareness campaign, During any given half-hour period,an estimated 25 Blue Cross and Blue Shield of Minnesota has taken its Blue Cross employees are taking the stairs and enjoying own stairways to new heights. the new scenery.One frequent stairwell user said,"The To encourage employees to take the stairs instead of stairway is so much more colorful and inviting that I elevators and escalators,Blue Cross'internal health and hardly ever take the elevator anymore.And thanks to wellness group,Blue Balance,initiated a stairwell beautifi- using the stairwell daily,I'm no longer out of breath when cation project in one of Blue Cross'eight Eagan buildings. I reach the top:' To enhance the appeal of the stairwell,it was painted,wired "The poetry stairwell allows walkers to take a break with nature sounds and wrapped with inspirational poetry. from their linear left brain and switch over to their creative Senior designer Laurie Phillips said,"Changing the right brain,"Phillips added."I wonder how many innovative environment of the stairwell was about promoting solutions to business problems have been found while employee health.Because our corporate purpose is to climbing from the first floor to the fourth floor?" make a healthy difference in people's lives,this stairwell "Blue Balance encourages employees to take actions was a great way for us to literally`walk our talk:" that will improve their health and well-being,"said Diane With the help of more than 25 employee volunteers, Pozdolski,Blue Balance co-chair."Taking the stairs is exercise the redesigned stairwell opened last summer,complete and fits easily into our busy lives here at work.Sometimes, with"re-directional"signage posted near elevators."We the small choices we make every day can have a big effect had tremendous support and interest for this stairwell on our health:' project all along the way;'said health improvement project The first stairway redesign went over so well with manager Fred Holmly."Now more people use the stairs Blue Cross employees that two other stairwell projects instead of the elevator.I think it's a big success?' are now in the works. [ by John Bohman I photography by Peter Kowler] clearblue 55 UNIMMIIMEM IN MIMI MI NNW 41.11111.111111MM 41.11M11111111.1/11I 1.11111.111.1=11110.11 YY 1fhIUY•0+ .40.1 � �I � • . d t Blue Cross volunteers help connect families during troubling times } w Communicating with family and friends during an impor- Led by several volunteer coordinators throughout tant life event—such as critical medical treatment,child- Blue Cross,many employee teams have formed to help birth,rehabilitation or end-of-life-care—is never an easy CaringBridge on a weekly basis.From mailing letters to task.However,reaching loved ones during those challenging monitoring the many personal Web pages,Blue Cross times is now just a mouse click away for many people. volunteers are making a valuable difference to this organi- An innovative new Web site called www.CaringBridge.org zation and the families it supports.Out of approximately enables families to stay in touch and informed by offering 250 volunteers who help CaringBridge thrive,at least 60 a free personalized Web page for care updates and status of them are Blue Cross employees. reports.CaringBridge is a nonprofit organization and Since Blue Cross employees started to volunteer their depends on the generosity of volunteers and donors.And time to CaringBridge one year ago: a number of Blue Cross and Blue Shield of Minnesota 320 volunteer hours have been recorded employees are rolling up their sleeves to help out. 4,000 personal Web pages have been reviewed "A key value of CaringBridge is to provide this free w service to those who need it,and the only way we can and monitored do that is through volunteer help,"said Sona Mehring, 12,000 letters have been stuffed,sealed and delivered •1i CaringBridge founder and executive director."The Blue 23,000 brochure packets have been prepared \ Cross volunteers truly enable CaringBridge to expand and touch people's lives." [ by John Bohman I illustration by Curtis Parker] 56 dearblue 4o► CaringBridge is a nonprofit service organization based in Eagan,Minn.,but it spans the globe to serve family and More about CaringBridge friends worldwide."We help bring people's worlds together when they need it most;'said Mehring."It is fantastic to use CaringBridge is a free,easy-to-use Internet service developed to keep loved ones informed during technology in a way that can so personally and positively affect so many people:' important life events. Individuals can quickly and easily create a secure Employee reflections about CaringBridge: CaringBridge Web page to post journal entries and photographs for their family and friends.Visitors "CaringBridge was a big help when my family was going to the Web page can read updates and post their through difficult times dealing with my husband's cancer," own messages of support and encouragement.The said Marie Fischer,senior information systems project service allows the family to focus their energies on manager."It made it easier for me to communicate the loved one who requires healing. and keep everyone informed,and it gave me more P Y $ The inspiration for CaringBridge comes from a time to spend with my family.We received a lot of real-life experience when a baby named Brighid comfort and support from the many messages.It was was born prematurely after her mother developed amazing to see how many people were really touched a life-threatening condition.To keep family and by our experiences:' friends connected and informed,a Web page was created.Although Brighid died after a nine-day struggle,the response to her Web page was incredible. r "CA R I N G B R I D G E WAS A BIG HELP WHEN MY FAMILY The impact of Brighid's story inspired a remarkable WAS GOING THROUGH DIFFICULT TIMES... grassroots effort that has extended love,encourage- ,- IT MADE IT EASIER FOR ME TO COMMUNICATE ment and hope around the world.From this,the AND KEEP EVERYONE INFORMED, AND IT GAVE ME CaringBridge legacy was born. MORE TIME TO SPEND WITH MY FAMILY." Since baby Brighid's passing,CaringBridge has made the following possible: c 200 million visits to more than 27,000 "It's a wonderful feeling to volunteer for an organiza- personalized Web pages tion that helps people stay connected at a time when they really need support and encouragement from 900 new families using CaringBridge friends and family,"said Barbara Rock,financial every month underwriting manager. * 30 new Web pages developed every day 4,-;, "Posting pictures,messages and prayers brought comfort to my friend's family at a very difficult time,and I will For more information,visit www.CaringBridge.org. always remember that,"said Tracy Renstrom,major lo) accounts membership specialist III."It's a joy to volunteer for such a helpful organization." Health improvement coordinator Alisha Ellwood said, "CaringBridge touches and supports more and more lives every day.To be able to play a small role in keeping them going is so rewarding:' clearblue 59 [ engage ] . Il • I • • • • 1 * 1 • • I r lil *II ilil ___,-. i- trire/ - 4 v.. Volunteering helps keep my life in perspective and reminds me of all the 1 �� Illik blessings I have," Prinsen said. "We ���� � ^ - s_ -- all have talents. It's just a matter of 1 lot finding a need that your talents can ,1' -, -$. , t help to fill." ,4 / . fi Lt., '4 /de f 'n+— P s /i 7 r Some people volunteer,and some people are volunteers. for premature infants,and burial garments and keepsakes For Mary Jo Prinsen,Blue Cross senior financial analyst and for families who have suffered a birth loss.In 2004 alone, president of Bundles of Love,volunteering is a way of life. Bundles of Love helped 4,000 families,produced more "Volunteering helps keep my life in perspective and than 45,000 items,and contributed 40,000 volunteer hours. reminds me of all the blessings I have,"Prinsen said."We "We're not only helping babies and families who receive all have talents.It's just a matter of finding a need that your the donated items,but we're also helping volunteers talents can help to fill:' contribute to their communities;'Prinsen said. , Prinsen has spent decades volunteering through church, Since she joined Blue Cross in 2002,Prinsen said the .1 youth organizations and other community activities.But company's support of Bundles of Love has been tremendous. I what really turned out to be her"true calling"is Bundles "I really appreciate working for a company like Blue Cross i. of Love,an all-volunteer nonprofit organization she started that so obviously values volunteerism,"Prinsen said. more than five years ago."Starting up Bundles of Love "There are a lot of good hearts here." was really a perfect fit and true joy for me;'said Prinsen. For more information or to volunteer,visit This organization provides clothing and bedding for www.bundlesoflove.org. newborns and families in need,correctly sized clothing [ by John Bohman I photography by Peter Kowler] 6o clearblue FROM THE PRESIDENT AND CEO: Ours is a Minnesota-grown success story built upon sincere commitment,honest determination and informed business decisions.During our 71 years of innovation,we have grown in our local and national account markets while remaining true to our purpose to make a healthy difference in people's lives. With more than 2.6 million members counting on us every day,we take our purpose to heart.And we strive to make a difference through the jobs we create,the health improvement and prevention programs we implement,and through the work of the Blue Cross and Blue Shield of Minnesota Foundation and • our award-winning Center for Tobacco Reduction and Health Improvement. Blue Cross and Blue Shield of Minnesota is a nonprofit health plan.Because of our unique corporate status,we view our work differently than a publicly traded company would.One major difference is that we focus on a positive operating margin to support our mandatory financial reserves and not on profits to fund shareholder returns.Because of this difference in focus,we can develop longer-term solutions designed to improve health and quality of life over many years.For example,in 2004,we invested$102 • million in health improvement and cost-containment programs.And our BluePrint for Health®care • support program enabled 203,000 members to better manage their chronic medical conditions. Last year,Blue Cross also continued to make its mark in the national health care arena,providing coverage and insurance services to 14 of the 19 Fortune 500 companies located in Minnesota and six of the 11 Minnesota-based companies on the Forbes list of America's Largest Private Companies. Membership increases outside Minnesota and the growing popularity of our consumer-directed product, N • ( Options Blue,were key contributors to our enrollment growth in 2004. • Blue Cross and its affiliates ended 2004 on a positive note,achieving a net income of$66 million. And last year,we held our general administrative expenses to 7.6 percent.Our measures of success also focused on operating efficiency,customer satisfaction,service excellence and health care outcomes.To us,a healthy report card with all these criteria is just as important as a healthy balance sheet.And that is why we are proud of our"Excellent"rating from the National Committee for Quality Assurance (NCQA),which measures the quality of care we provide,as well as our"A rating"from A.M.Best, • which measures Blue Cross'and Blue Plus'financial strength as a business. Minnesotans,our members,employer groups,medical providers and legislators look to us to lead the way for better health in our state and beyond.True to our purpose,we will work hard to create new solutions to the health care issues we will all face in the years ahead. Sincerely, • • • Mark W.Banks,M.l ). President and CEO • clearblue 61 I1 *AWARE INTEGRATED, INC. IIIIIN (BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND ITS FAMILY OF COMPANIES) • FIVE-YEAR SUMMARY OF SELECTED FINANCIAL DATA (in thousands) 2004 2003 2002 2001 2000 • Total Revenue 6,568,289 • 5,983,905 5,009,926 49052,262 Claims Incurred 3,444,446 5,864,926 5,269,o2i 49421,938 39548,930 3,020,140 Assessments, Surcharges and Broker Fees 149,290 107,233 95,667 89,621 85,337 Administrative • Expenses 514,736 • 477,520 413,559 355,180 320,785 Net Investment Income and Realized Gains on Sales of Investments 60,084 40,424 (1,18 5) 12,468 46,859 Tobacco Program Income/(Expense) (11,967) (21,990) 5,686 (36,052) 22,001 Net Other Income (Expense) (7,725) (2,479) (20,723) Income Tax 38,949 (2,811) Expense (Benefits) Net Income 13,890 (3,800) 23,842 8,939 12,396 65,839 149,886 3g�69g 6 4,957 71,837 At December 31 ITotal Assets (GAAP Basis) Total 2,260,900 2,069,236 1,808,403 1,831,380 III 1,637,285 Liabilities (GAAP Basis) 1,208, 443 1,098,408 1,024,182 1,074,117 941,404 62 clearblue • • Free Reserves 2004 2003 2002 2001 2000 (Statutory Basis) Blue Cross 691,771 608,412 494,833 403,466 421,079 • Blue Plus 130,312 96,250 77,147 66,197 55,946 Months in Reserve Blue Cross 4.24 4.33 3.96 3.56 4.10 • • Blue Plus 2.88 1.86 1.64 1.78 1.79 Membership Blue Cross 2,135,554 2,073,799 1,920,030 1,690,388 1,633,514 • Blue Plus 168,039 186,071 199,339 190,269 179,128 • All Other 329,206 324,598 299,807 305,965 230,672 • • *Aware Integrated,Inc.includes Blue Cross and Blue Shield of Minnesota,Blue Plus, First Plan of Minnesota,Care Delivery Management,Inc.,and our subsidiaries: Atrium Health Plan;MII Life,Inc.;Comprehensive Care Services,Inc.;Pharmacy Gold, Inc.;Comprehensive Managed Care,Inc.;and Capital Asset Care,Inc. • Blue Plus is a health maintenance organization that offers health plans and care • networks throughout Minnesota to individuals and groups,conducts research and promotes quality improvement. The complete Aware Integrated,Inc.,financial statements are available by calling Tim Schultz,vice president of finance,at(651) 662-1668. • • clearblue 63 BLUE CROSS AND BLUE SHIELD OF MINNESOTA 2005 Board Members 2005 Company Officers • MARK W. BANKS, M.D. CHRISTOPHER L.AASLAND KATHLEEN A. MOCK President and CEO, Blue Cross VP, Blue Cross and Blue Shield VP, Policy and Legislative Affairs 1 and Blue Shield of Minnesota of Minnesota; President, MII Life MICHAEL J. MORROW EMMETT D. CARSON, PH.D. MARK W. BANKS, M.D. Senior VP, Business Development President and CEO, President and CEO and Network Management; The Minneapolis Foundation CEO, Blue Plus J. STEPHEN BJORUM • SUSAN S. ENGELEITER VP, Blue Cross and Blue Shield of NANCY F. NELSON • President and COO, Minnesota; VP and Chief Actuary Data Recognition Corporation President and CEO, First Plan of Minnesota RICHARD P. NEUNER BENJAMIN R. FIELD (RETIRED) Senior VP and Senior Financial Advisor, LAURIE A. CLARK Chief Marketing Officer Bemis Company, Inc. VP, Core Application Systems and IT PMO RICHARD M. NIEMIEC JOEL R. HAUGEN, M.D. Senior VP, Corporate Affairs • Managed Care Medical Director, REGENIA DAVID Dakota Clinic, Ltd. VP, Customer Relations Management SHAWN E. PATTERSON and Analytics Systems VP, Marketing and Communications SHIRLEY J. HUGHES (RETIRED) Senior Vice President, FRED A. DICKSON TIMOTHY M. PETERSON Human Resources, VP and Chief Information Officer Senior VP and Ceridian Corporation Chief Financial Officer KATHY A. DUNMIRE BOBBIN S. JOHNSON VP, Major Accounts DAVID W. PLOCHER, M.D. • • Senior Vice President, Senior VP, Business Intelligence Director of Corporate Affairs, SUSAN G. FLYGARE and Informatics Cargill Incorporated VP, Commercial Sales COLLEEN F. REITAN and Account Management JONATHON E. KILLMER (RETIRED) Executive VP, Operations Partner, PricewaterhouseCoopers, LLP JENNIFER L. GILLESPIE STEVEN W. RICHARDS, M.D. VP and Actuary, Underwriting JOHN H. KLEINMAN, M.D. VP, Health Care Improvement • Vice President of Clinical Affairs, WILLIAM R. GOLD, M.D. • VHA Upper Midwest VP, Health Management, TIMOTHY A. SCHULTZ pp and Chief Medical Officer VP, Finance JOHN W. LETTMANN ROGER W. KLEPPE SANDERS R. SHAPIRO President and CEO, VP, Community Accounts Malt-O-Meal Company VP, Human Resources and Facilities Services MARK A. SHAW PETE H. MCNERNEY VP, Network Finance and Operations General Partner, Thomas, DANA G. LIEN • McNerney & Partners, LLC VP, Enterprise Transactions DAVID E. SPALDING • JOHN M. MURPHY JR. JAN L. LYSEN VP, Business Development Managing Partner, Somerset VP, Network Management Lois J. STEVENS Asset Management, LLC DEBORAH B. MADSON VP, Blue Cross and Blue Shield VANCE K. OPPERMAN, ESQ. VP, Government Programs of Minnesota; President, CCStpa President and CEO, DENISE M. MCKENNA MARYANN STUMP, R.N. • Key Investment, Inc. VP, Enterprise Service VP, Strategic and Consumer • Innovation; President, CDMI e. PAMELA A. WHEELOCK MICHAEL E. MCKURAS Executive VP and Chief Financial VP, Technology Infrastructure Services Officer, Minnesota Sports and Entertainment ROBERT J. MILLS VP, General Counsel II 64 clearblue I II