For Medicare member Frank Pecora, making a call to Customer Care at Excellus BlueCross BlueShield meant finding medications he could afford.
Frank Pecora
The 75-year-old is one of thousands who call the number on the back of their membership card and benefit from the expertise offered by customer care advocates who answer questions on everything from medical claims to prescription refill costs.
Frank, who recently joined Excellus BCBS as a Medicare member, said he was learning the details of his coverage, including what to expect from the costs associated with his deductible and the prescription plan coverage he had for medications he used. That’s what prompted him to call Customer Care where he connected with Customer Care Advocate Stephanie Major.
“My number one goal when talking to Frank was to find him alternative, more cost-effective medications,” said Stephanie. “Taking the time to listen, educate our members, and find solutions provides them with a sense of relief. We want them to know we are here to help them access affordable care.”
Stephanie Major
With Stephanie’s help, Frank was able to provide his physician with several recommendations for medications that would be more affordable.
”My doctor agreed that the alternate medications would be fine, and I was able to get new medications that were actually less expensive than what I had been paying out of pocket,” Frank said. “Stephanie made me a happy camper. She took her time with me, answered all my questions, and took care of everything I needed. I couldn’t ask for anything more than that.”
Providing affordable care for our 1.5 million members across 39 counties in upstate New York is critical to our mission at Excellus BCBS. Stephanie says she isn’t surprised Frank was pleased with the outcome of his call.
“Whenever you give someone news about potentially saving money, they are a very happy person, especially for our Medicare members who may be on a fixed income,” Stephanie said. “In Customer Care we do all we can to assist all our members get what they need to get and stay healthy at an affordable price.”
(Member Video) Hear from Frank about his experience.
The ACCEL Clinic, a healthcare facility located at the Economic Opportunity Program in Elmira, NY, is providing affordable care to community members when they need it most.
They couldn’t afford their blood pressure checks
For Glenda and Woody Aikens, residents of West Elmira, the cost of weekly co-pays to have their blood pressure checked was simply not affordable. But thanks to the ACCEL Clinic they have been able to follow their primary care doctor’s orders at no cost. They learned about the clinic through a flyer provided with a food delivery from the Economic Opportunity Program. The Aikens said they were thrilled to discover that the clinic offered free services and easy access, allowing them to consistently monitor their health and interact with others in the community.
The ACCEL Clinic is a collaborative partnership between Excellus BCBS, Arnot Health, Chemung County Health Department, Lake Erie College of Osteopathic Medicine (LECOM), and the Economic Opportunity Program. The clinic provides free and accessible medical services to children and their families.
The ACCEL Clinic is supported by an Excellus BlueCross BlueShield Member and Community Health Improvement grant and the funding has enabled the clinic to enhance health outcomes and reduce health disparities in Chemung County. This has been achieved through the analysis of data collected and has enabled the clinic to provide targeted care and connect them with appropriate healthcare providers.
“The ACCEL Clinic helped us when we needed medical services but couldn’t pay for them,” said Glenda Aikens. “We enjoyed going there every week to check in and we feel important at the clinic. The ACCEL Clinic is great for our community and for people who don’t have much money.”
Surprised by her son’s high lead levels
Other services at the ACCEL Clinic include free lead screenings, an initiative that is in response to the historically high lead levels in Chemung County. The free screenings help the clinic identify and address lead poisoning in children, ensuring early intervention and appropriate treatment.
Tanisha Logan-Lattimore, a patient at the clinic, discovered that her son had high levels of lead through the clinic’s testing.
“I had my entire family tested, including myself. I was surprised when the results showed that my son had very high levels of lead in his body. I had no idea about this before, and it was fortunate that we found out because my son already has a weakened immune system. Sharing the test results with his doctors allowed them to consider the lead exposure when planning his treatment. It was truly a blessing in disguise,” Tanisha stated.
Since its opening in 2022, the clinic has successfully conducted over 400 lead screenings, contributing to the reduction of lead levels in Chemung County, according to Economic Opportunity Program Chief Executive Officer Andrea Ogunwumi.
Access to Affordable Care
Convenience and accessibility are key factors in the success of the ACCEL Clinic. Being in the same building as Head Start programs and after-school activities makes it easier for parents to bring their children in for screenings. This eliminates barriers such as transportation and time constraints, ensuring that healthcare services are readily available to those who need them said Ogunwumi.
The clinic is staffed by LECOM medical students who not only assist with screenings but also ensure that individuals receive necessary primary care follow-up. This includes appointments with primary care physicians and lab screening services provided by Arnot Health. This comprehensive approach to healthcare ensures that individuals receive the necessary care and support to manage their health effectively.
The ACCEL Clinic also collaborates with SNAP-Ed’s Fruit & Vegetable Prescription Program to provide nutritional education services.
“The ACCEL Clinic is a valuable resource in the community, providing cost-free and accessible healthcare services to those in need,” said Dr. Richard R. Terry, LECOM – Elmira Associate Dean of Academic Affair. “A collaborative approach, uniting healthcare organizations, community programs, and funders, is key to improving health outcomes and effectively controlling rising health costs. By working together, these stakeholders can leverage their unique strengths and resources, creating a powerful synergy that fosters innovation, efficiency, and sustainability in healthcare delivery. Through collective efforts, they not only enhance the quality of care but also address the root causes of health disparities, ultimately paving the way for healthier communities and a more cost-effective healthcare system.”
As part of Melissa Klinko’s professional development, she was able to enroll in an online Harvard business course, fully sponsored by Excellus BlueCross BlueShield, that specifically focused on addressing and reducing health care disparities. Little did she know that this experience would open her eyes to the underlying causes of these disparities and provide her with real-world examples and case studies.
Melissa Klinko is a corporate communications manager for Excellus BlueCross BlueShield
My New Perspective
During the course, Melissa gained a new perspective on healthcare and realized the impact of unconscious biases. It was a moment of self-reflection when she recognized that she had assumed the doctor she was seeing was Asian based solely on her last name. However, upon meeting her, she discovered her assumption was incorrect. This incident made her acutely aware of the unconscious biases we all carry and the importance of addressing them to provide equitable care to all individuals.
Melissa’s awareness of disparities in healthcare was further heightened by her brother’s experience. As an adoptee from Korea, he often faces the expectation that he should be able to speak Korean. This expectation becomes frustrating, especially in certain situations. Language barriers are one of the biggest obstacles in healthcare, leading to a lack of care and confusion regarding medications and next steps in treatment. This realization solidified her belief that health equity is crucial in bridging these disparities.
Recognizing and Educating
By recognizing and addressing systemic racism and biases, we can ensure that everyone receives the care they deserve. It is through educational opportunities like the Harvard Business course, that we can contribute to closing the gaps in healthcare.
Melissa shared that one of the most intriguing aspects of the course was learning about the Kotter method, which helps identify organizational gaps and needs. This method helps to create a vision for change and implement an executable strategy to reduce disparities. Additionally, the course emphasized the importance of collecting and analyzing data unique to underserved populations. By utilizing this data, we can effectively inform and drive meaningful change.
“I am grateful to work for a company that values health equity and actively supports its employees in recognizing disparities in healthcare and education. By providing resources and fostering awareness, our company ensures that we are aware of how situations are perceived and how we can contribute to making a positive difference.”
We Care About Health Equity
Melissa’s experience sheds light on how Excellus BCBS goes above and beyond in fostering a culture of continuous learning and support for their employees.
Are you interested in joining the Excellus BCBS team?
We have the right fit for you. Positions are available in many departments including Customer Care, Operational Excellence, Marketing and Sales, Information Technology, and more. Check us out at careers.excellusbcbs.com. Get to know our people and our values, and grow your relationship with us. For more information, reach out to Director of Talent Acquisition Jason Helsdon at Jason.Helsdon@excellus.com.
Did you know that Excellus BlueCross BlueShield is supported by a team of local Medical Directors? That’s right, a team of 27 doctors who live and work right here in our communities serve as Medical Directors for the health plan. This diverse group includes medical, dental and behavioral health specialists. Their work ensures that every one of our members is receiving equitable, high-quality care that’s as affordable as possible. It’s not only a love of science and medicine that drew them into the profession, but an innate need to help, heal, and serve others.
Working with community doctors
A strong relationship with community providers is essential to providing quality care to our members. As board certified physicians with years of experience caring for patients in hospitals and outpatient settings, our Medical Directors work together with our local providers to improve quality and control costs by identifying opportunities to close gaps in care, and better controlling chronic health conditions. An example of this is our value-based payment arrangements where we reimburse doctors based on the quality of care they deliver and not just the number of services they perform. Providers can receive higher reimbursement when they meet goals around quality, experience and affordability. This is one of the ways we work with doctors to improve care while controlling costs.
This team actively collaborates with our provider partners, seeking their input and feedback in areas such as medical policy, quality improvement and medical management. This collaboration leads to improved member care and healthier communities.
Improving member wellbeing
Our Medical Directors seek out innovative opportunities to engage our members in enhancing their health and wellbeing. This dedicated group of physicians serves as advisors and leaders for dozens of initiatives. For example, in 2024 we introduced a new virtual physical therapy option to help our members manage musculoskeletal disorders from the comfort and convenience of a virtual environment. And we have partnered with a kidney care management program to help members with stage 4-5 chronic kidney disease navigate medical care services and follow their physician’s treatment plan.
Our code of ethics
They tackle big issues such as health care disparities, rising costs, and a changing health care landscape while following a code of ethics rooted in trust. This code embraces quality and patient safety in clinical decision-making. Our Medical Directors define quality care as safe, effective, patient-centered, timely, efficient, and equitable. Their decisions are guided by evidence-based standards of care and the expertise of community providers.
Proud to live in the local area
Our Medical Director team is proud to call the upstate New York area home. You might see them out in your neighborhood enjoying time with their family, running errands, or participating in community events. Get to know our Medical Directors by visiting our website to learn more.
Common Ground Health is one of Excellus BlueCross BlueShield’s 2023 Health Equity Innovation Award recipients. Funds are used for their Get It Done program to support African American and Latino barbers and beauticians who serve as community health educators (CHEs) and peer leaders to increase health knowledge, community outreach, and increase health/mental health workshops. Support will also be provided for referrals to health care and health/social service resources.
More than 30 barber shops and beauty salons in all four quadrants of the city of Rochester take part in the Get It Done events.
Jackie Dozier, Director of Community Health and Wellbeing at Common Ground Health
“We’ve found that when people come in to get their hair done or cut, they have conversations with their stylist about whatever issues they are going through personally and professionally,” says Jackie Dozier, Director of Community Health and Wellbeing at Common Ground Health. “This is a great opportunity for stylists to educate and share health care resources and information with clients in the black and brown communities who live in the neighborhoods they serve.”
(Video) Learn more about the impact of these Get It Done events below from a salon owner and student at the University of Rochester School of Medicine and Dentistry.
The Monroe County Family Coalition is one of Excellus BlueCross BlueShield’s 2023 Health Equity Innovation Award recipients. Funds will be used to provide more mental health wellness, support and education to youth and families, develop a peace garden to address food deserts and nutrition shortages in underserved communities, and enhance financial literacy and crisis support resources.
“We want to meet people where they are and make sure that no one is left behind,” says Dina Johnson, president and CEO of Monroe County Family Coalition. “Addressing inequities and health disparities in our community is vital to the success of our youth and families and we couldn’t do it without partnerships like the one we have with Excellus BlueCross BlueShield.”
Dina Johnson, president and CEO of Monroe County Family Coalition and Kimberly McKinsey-Mabry, Excellus BCBS community investments and partnerships manager.
Hear from two women who share very different experiences of how The Monroe County Family Coalition has impacted their lives.
As an active community member and local senior center volunteer, Richard doesn’t like to sit still. However, sciatic nerve pain can slow him down.
“I wish I had changed health plans earlier. I am saving money on doctor visit copays and two prescriptions that I take,” says Richard. “I have much better coverage, the service I receive is awesome, and I have a friend in Helen.”
Richard and Helen at the local senior center
Helen Pleszewicz, Medicare Consultant, met Richard for the first time in their apartment complex parking lot.
“I would be out walking my dog and see Richard outside and we would just start talking. We were neighbors and we got to know each other,” says Helen. “We talked about health insurance coverage, what he liked, what he didn’t like, and I mentioned when it comes time, let’s see what the plans are, and we can sit down and compare.”
So that’s what they did. Richard was particularly interested in his dental coverage, having paid extra for it on his previous plan. He quickly learned it was part of our Medicare benefits.
“There was no pressure. I felt so relaxed and informed. Medicare can be complicated, but Helen took the time and explained everything to me, so I was aware of my coverage, and I decided to make the change. I’m so glad I did,” says Richard.
“It’s personal to me. I’m working with people who are part of my community, they are like family and it’s important to show people we are local. You never know the impact you could have on someone just by having a conversation,” says Helen.
There’s no slowing Richard down. He’s joined a senior exercise class and says eating right, and being around family and friends, is what keeps him motivated, happy, and as healthy as he can be.
Brent Bish, Senior Vice President and Chief Actuary for Actuarial Services at Excellus BCBS, volunteers for the American Diabetes Association (ADA) in honor of his son, Graeme.
“My family’s life changed when my son was diagnosed with Type 1 diabetes at 3 years old,” explains Brent. “Out of those challenges came an opportunity to raise awareness by volunteering for the ADA.”
Brent poses with son and wife at the annual golf event
From fundraising to advocacy, Brent supports the ADA in their journey for research and, ultimately, a cure. This year, he joined the Leadership Board, and although he appreciates the opportunity to give back, the most rewarding part of his involvement with the ADA is setting an example for his son by giving back to an organization that means so much to their family.
“My dream is that one day Graeme will grab a cup of coffee and a donut without worrying about his blood sugar,” says Brent.
To help his son reach that dream, Brent realized much needed funds are required for research, clinical trials and programming, so in 2019 Brent started the ADA golf tournament. The first year $2,000 was raised by 38 participants. Two years later, there were 127 participants and $12,300 was raised. This year, the 2023 event will direct funds to Camp Aspire – a week-long summer camp for children with diabetes between the ages of 8 and 17.
Finding a cause and volunteering with them is encouraged in our Lifetime Way Culture, and with so many not-for-profits in our regions, there is sure to be an organization you can align with.
“It’s simple – find something you’re passionate about and reach out to a related organization to see how you can get involved,” explains Brent. “For me and my family, it’s diabetes, but there is no shortage of causes that need support. Most importantly, volunteer for the right reasons. Be genuine and helpful. Your time will not be wasted.”
How a recent change may impact upstate New Yorkers with Medicaid, Essential Plan or Child Health Plus.
If you or a family member are one of the more than 1.3 million* upstate New Yorkers with Medicaid, Essential Plan or Child Health Plus, you may have questions about a renewal that could impact your health insurance coverage.
We want to help everyone continue to access affordable health care. BJ Adigun of Excellus BlueCross BlueShield answers questions on what you can do to remain insured. Adigun is director of Safety Net Community Partnerships and Engagement.
Q. Tell me more about this change to Medicaid, Essential Plan and Child Health Plus
If you have Medicaid, Essential Plan or Child Health Plus, you may have to renew your coverage for the first time since early 2020. New rules required states to restart these renewals in the Spring of 2023.
When the state renews your plan, they’ll check to see if you’re still eligible for coverage. Whether or not you qualify for these free or low-cost plans is based on your income, household size, and other criteria.
Q. What happens if I’m no longer eligible for my current health insurance coverage?
If your income has changed, for example, and you’re no longer eligible for your current health insurance coverage, you may qualify for other coverage options. Information on how to get help to find new coverage is listed below.
Q. What are my options if I’m no longer eligible for my current coverage?
If you find out you no longer qualify for Medicaid, Essential Plan or Child Health Plus, there are coverage options that may meet your needs:
Coverage through your employer, if applicable
Medicare coverage, if you meet certain qualifications, such as being age 65 or older
Other types of free or low-cost plans available directly from a health insurer or from NY State of Health, the state’s health insurance marketplace.
Q. What will my renewal look like?
When it’s time for you to renew your plan, you’ll receive a notice from the state telling you what to do. Follow the steps to renew. The renewal letters are being sent on a rolling monthly basis and started in April.
Q: How do I prepare for the renewal of my coverage?
Watch for a renewal letter from NY State of Healthor the county. Check if NY State of Health and/or your local county Medicaid office has your current mailing address and contact information.
Q. I need help. What are my options?
Our main priority is to make sure you keep health insurance coverage, either by staying in your current plan or by moving to another plan that meets your needs. Please know that help is available, if needed:
*More than 1.3 million individuals in the 39 counties of upstate New York have Medicaid, Essential Plan or Child Health Plus, according to 2022 year-end data from the New York State Department of Health
We invite you to join Excellus BlueCross BlueShield in recognizing Maternal Mental Health Month. Mental and behavioral health issues affect millions of Americans, and the challenge can be even greater for those impacted by mental illness during pregnancy and postpartum. One in eight mothers experience symptoms of maternal depression. Developing a strong support system and finding treatment for symptoms can help both mother and baby thrive.
According to the Centers for Disease Control and Prevention (CDC), mental health is an important part of overall health and wellbeing. It includes our emotional, psychological, and social wellbeing. It affects how we think, feel, and act. Mental illnesses are among the most common health conditions in the United States. With more than half of all Americans expected to be diagnosed with a mental illness or disorder at some point in their lifetime, almost everyone is impacted by mental illness in some way.
Pregnancy and motherhood come with many challenges from lifestyle to hormonal changes. Each woman’s experience is different. Some adapt to these changes easily, while others may struggle physically and mentally. Maternal mental health disorders typically occur during pregnancy and within the first year after birth.
Identifying the signs and symptoms is an important first step to getting help. According to the Centers for Disease Control and Prevention, symptoms of postpartum depression can include intense sadness, anxiety, and hopelessness, loss of interest in activities, withdrawing from family and friends, or thoughts of hurting yourself of baby.
If you are struggling, you’re not alone and support is available. The National Maternal Mental Health Hotline provides free, confidential support, resources, and referrals from professional counselors to pregnant and postpartum individuals facing mental health challenges 24 hours a day, 7 days a week. Counselors offer support in English and Spanish and interpreter services are available in 60 additional languages. Call 833-943-5746.
The Maternal Mental Health Hotline is not intended as an emergency response line and individuals in behavioral health crisis should contact the 988 Suicide and Crisis Lifeline by calling or texting 988 or chat 988lifeline.org.
Share your story
Sharing stories can be a powerful way to raise awareness about this very important issue. Hear from two courageous mothers and Excellus BCBS employees who are proud to share their stories and encourage others to seek support.
Michelle and her daughter – a thriving college student.
“To say I’m not OK and I need help, shows just how strong you are, because if you’re not here, imagine the light that’s being taken away from those around you,” says Michelle Mack-Hayward, Excellus BCBS Affordability Program Development Specialist. Michelle experienced the devastating loss of her twin boys at 19 weeks pregnant, followed by a difficult pregnancy with her daughter that included 10 weeks on bed rest in the hospital. “Having the joy of this beautiful little girl and grieving the loss of my two sons was hard. It took me saying I’m not OK and admitting I need help,” says Michelle. “If my story can help someone get through a rough time, it doesn’t have to be fetal loss, it can just be the hardships of giving birth, motherhood and it’s challenges, and reach out to say I need help, then I will tell it a million times.” Listen to Michelle’s full story here.
Melinda and her 3-year-old son.
Melinda Coleman, Excellus BCBS Health Care Quality Improvement Manager, knew she just didn’t feel right after giving birth to her son, so she decided to reach out for help. “I felt robbed. I was angry, tired of being in pain all the time and I lost all my confidence,” says Melinda after being pregnant at the height of the pandemic and experiencing a traumatic delivery that left her with nerve damage. “I like to share my story because it may help other mothers to know that things may not go as planned and how to prepare for it,” says Melinda. “If something doesn’t feel right, speak up, talk, you are not alone, and there are resources available to help.” Read Melinda’s full story.
Supporting maternal mental health in our communities
With a goal of reducing racial disparities in maternal health by 50% over the next five years, Excellus BCBS continues to invest in the community, partnering with organizations that are working to improve maternal health outcomes throughout the Health Plan’s footprint.
Multi-year funding has been provided for the following programs:
Mount Hope Family Center located in Rochester, NY provides home-based interventions for teen moms to address maternal mental health, parenting and child development, and trauma.
Integrated Community Alternatives Network in Utica, NY provides comprehensive prenatal and postpartum care, transitional housing, and a supportive peer community for young homeless women who are pregnant and/or parenting.
Oneida Health located in Oneida, NY, began a Women’s Health Behavioral Navigation program designed to bridge the gap between providers, patients, and behavioral health services through a care-coordinated model. The program provides services to address mental health, substance abuse, or age-specific women’s behavioral health conditions of Oneida Health patients receiving care at its Women’s Health office, Lullaby Center, or Emergency Department (ED).
Mothers & Babies Perinatal Network located in Binghamton, NY provides home/virtual visits to support new parents with breastfeeding, safe sleep, medical appointments and transportation, insurance & food insecurity through the first year of life.
Gerard Place in Buffalo, NY provides education, advocacy, mentoring & clinical tracking of low-income moms by nurse educators.
Keep the conversation going
Excellus BCBS encourages you to keep the conversion about maternal health and maternal mental health going. If you know someone who is pregnant or has recently given birth, offer to listen. Visit the CDC’s Hear Her page for helpful resources.
