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Patrick O'Donnell, in Michigan, says his communication with other BCBS in-plants has been by chance. He often turns to the International Publishing Management Association's listserv for advice, and has seen other BCBS in-plants posting tips in the past.

"That's really a great service," he says.

Larson says that while she knows of no formal associations among the in-plants, she has attended several impromptu roundtables at a number of trade shows, especially Xplor.