The Blue Cross and Blue Shield Association: Creating a Healthier America, One Community at a Time

February 12, 2013

The Blue Cross and Blue Shield Association: Creating a Healthier America, One Community at a Time

By, Dr. Allan Korn, Senior Vice President and Chief Medical Officer (Ret), Blue Cross and Blue Shield Association


The Blue Cross and Blue Shield System is made up of the Blue Cross and Blue Shield Association (BCBSA) and 38 independent Blue Cross and Blue Shield (BCBS) companies that provide health insurance coverage to more than 100 million people–one in three Americans.

For more than eight decades, The Blues® have viewed their responsibility and commitment to the communities that they serve as reaching far beyond insurance coverage.

As community leaders with a presence in every zip code, Blue Cross and Blue Shield companies are positioned to offer an array of programs and services that address both the national and local health concerns of American families. Because Blue Cross and Blue Shield companies are locally operated, they have an ability to create programs that meet each community’s specific needs. Yet this nationwide network also enables the Blues to take the best of what works at the local level and replicate or adapt it to work in other communities across the country.

Blue Cross and Blue Shield companies are using their resources, including hundreds of employee volunteers, to promote wellness and the prevention of disease, with many of these programs focused on increasing physical activity and promoting healthier nutrition choices. These activities can help reduce obesity, which leads to heart disease, diabetes and other chronic illnesses that take a terrible toll on patients and their families and lead to higher healthcare costs for everyone.

Programs are tailored to meet the needs of rural and urban communities, as well as the particular needs of diverse ethnic and cultural communities where access to care and prevention information often is lacking. Successful programs are expanded statewide and in some cases, nationwide. They are already showing concrete results:

Individual Cities

In 2011, Blue Cross and Blue Shield of Nebraska partnered with Live Well Omaha, a long-term collaborative partner for improving the overall health of area residents and positioning Omaha as a thriving community, and Community Bike Project Omaha, which works to improve access to bicycles for everyone. Together they launched Omaha B-cycle, the first large-scale municipal bike sharing system in Omaha. The goal of Omaha B-cycle is to provide a cost-effective, environmentally friendly, and healthy way for riders to make quick trips or enjoy the city’s riding trails. B-cycle riders also help keep pounds of pollutants out of the air, conserve fuel, and burn calories.

To use B-cycle, participants select a bike, swipe a membership card or credit card, ride the bike and then return it to one of the five stations located throughout the city. Since its start, 850+ members burned an estimated 606,972 calories during an impressive 2,389 trips on B-cycle bikes.

Diverse Racial and Ethnic Communities

Blue Cross and Blue Shield companies are working to address healthcare disparities in low-income and ethnically diverse communities by tailoring approaches for the local communities they serve. In Western Pennsylvania, Highmark Inc. became the first Blue Cross and Blue Shield company to receive a Distinction in Multicultural Health Care by the National Committee for Quality Assurance (NCQA). The award specifically recognizes Highmark’s commercial HMO and Medicare Advantage HMO products offered under the Keystone Health Plan West subsidiary. Clinical interventions targeting minority patients have improved hypertension medication adherence, blood pressure control, colorectal cancer screening rates and diabetes care.

Statewide Initiatives

North Carolina

Blue Cross and Blue Shield of North Carolina’s Nourishing North Carolina is a statewide community gardening program that makes locally grown, healthy food more accessible to communities across the state. The program, which began in 2011, provides resources to create or enhance community gardens in each of North Carolina’s 100 counties. This innovative program involves collaboration between the community, the local public school system, health department and parks and recreation departments.

Community residents and elementary school students volunteer weekly to maintain the garden, sharing both in the work and rewards that come from home grown food. Gardens located in food deserts or areas that will be providing fresh produce to underserved/at-risk-populations are given higher consideration over other applicants. A food desert is any area where healthy, affordable food is difficult to obtain.

Last year, Nourishing North Carolina supported 25 community gardens across 19 counties. More than two tons of produce from these gardens was donated to food shelter and rescue organizations.

To date, Nourishing North Carolina supports a total of 55 community gardens across 41 counties. In addition, the gardens have also offered hundreds of hours of physical activity to community volunteers. Blue Cross and Blue Shield of North Carolina also established its own community garden, maintained by employees, on its office campus. All of the garden’s produce is donated to a local organization that provides food to the needy.


Iowa ranks as the 16th healthiest state in the nation and in August 2011, Iowa Governor Terry Branstad issued a statewide challenge to make Iowa the Healthiest State in the nation by 2016 as measured by the Gallup Healthways Well-Being Index®. Wellmark Blue Cross and Blue Shield of Iowa is playing a major

role toward achieving this goal through their support of the Blue Zones Project™. “Blue Zones” is a phrase coined by Dan Buettner, National Geographic author and researcher, and refers to areas in the world where people are not only living longer, but are also living healthier and happier. The research

has been used to develop tools and programs that are being applied through a community-by-community movement to improve the well-being of all Iowans. By encouraging systematic environmental change that optimizes the places where we live, work and play, the healthy choice will become the easy choice.

Four Iowa communities — Mason City, Waterloo, Cedar Falls and Spencer — were selected as the initial demonstration sites in May of 2012. Six additional Iowa communities with populations of more than 10,000 will be announced in January 2013, for a total of 10 Blue Zones Project demonstration sites of this size. Additional demonstration sites with populations of less than 10,000 citizens will be selected and the first round of those will be announced in October 2012.

Multi-State Initiatives

Last year, Health Care Service Corporation (HCSC) launched the Healthy Kids, Healthy Families initiative with the goal of improving the health and wellness of at least one million children over three years across its health plans at Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas. Healthy Kids, Healthy Families focuses its efforts in four areas: nutrition education, physical activity, managing and preventing disease, and supporting safe environments.

Key 2011 partners included: OrganWise Guys, a school-based program that encourages children to take charge of their health; KaBOOM!, which builds safe, new playgrounds to encourage physical activity; and the Care Van program, which provides preventive care to the uninsured and medically underserved. In 2011, the Healthy Kids, Healthy Families initiative provided funding in 49 schools, helping to improve nutrition education for approximately 24,500 students. It also helped build nine new playgrounds that served more than 23,000 children and provided more than 145,000 immunizations to kids in need.

National Programming

In addition to the Blues’® projects in local communities, BCBSA also has national programming and sponsorships that encourage healthier living for all Americans. For example, BCBSA recently joined with the First Lady’s Partnership for a Healthier America (PHA) to sponsor 40 new Play Streets — roads closed to traffic and open to the community to encourage physical activity. Cities and towns across the U.S. are invited to apply for funding that will create at least four Play Streets per locality. Ten cities

are to be chosen based on their on-going commitment to increasing physical activity among kids; health education and programming; sustainability of the program concept; and community development. They will receive funds and support from PHA and BCBSA for the events in their city or town.

Cities that already have begun participating have seen an immediate impact. In New York City, 64 percent of the kids using Play Streets reported that, if not for the local Play Street, they would have been engaged in a sedentary activity. Seventy-one percent reported that they walked to their Play Street, an added benefit.

The same survey also underscored the promise that Play Streets holds for local economic development: Area businesses reported that foot traffic around the Play Streets increased greatly. BCBSA is committed to maintaining and expanding these initiatives and others like them to help people live healthier lives.

This effort will also help transform our nation’s healthcare system from one that focuses on treating chronic, preventable disease at great expense to one that helps prevent illnesses and thus helps to curb costs.

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