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Clinical Guidelines

  • FamilyCare recognizes the use of clinical guidelines to help direct providers to the most current, evidence-based standards in healthcare. While FamilyCare strives to cover guideline recommended treatments for covered conditions, coverage is dependent on benefits as established by OHP, the prioritized list and/or FamilyCare policy or formulary. Guidelines are put forth by many organizations, and FamilyCare acknowledges there may be multiple valid guidelines for conditions. The endorsement of the following guidelines does not imply unique authority of the listed guidelines, rather they are listed as a starting point for providers wishing to review current recommendations. An excellent resource for clinical guidelines is the National Guideline Clearinghouse provided by AHRQ. Its location is www.guideline.gov.

Depression Screening: FamilyCare recommends the guidelines issued by the MacArthur Initiative on Depression & Primary Care. Click here to download the Scoring Guide and Patient Health Questionnaire-9 (PHQ-9), a nine-question tool for helping you to screen for and identify cases of depression. For your convenience, this link includes both the PHQ-9 and the Guide to Making a Tentative Diagnosis. To access the MacArthur Initiative website, go to www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9

Diabetes: FamilyCare recommends the guideline issued by the American Diabetic Association (currently the 2010 Clinical Practice Recommendations) at the American Diabetic website under “For Professionals”. It is located at http://care.diabetesjournals.org/content/33/Supplement_1

Asthma guideline:  FamilyCare recommends the following comprehensive asthma guideline found at www.nhlbi.nih.gov/guidelines/asthma

Preventive Services for Adults:  FamilyCare recommends the following guideline at http://www.uspreventiveservicestaskforce.org/adultrec.htm

Preventive Services for Children and Adolescents:  FamilyCare recommends the following guideline at http://www.uspreventiveservicestaskforce.org/tfchildcat.htm

 

Mental Health Guidelines

Schizophrenia Guideline: FamilyCare recommends the following guideline for schizophrenia: www.guideline.gov/summary/summary.aspx?ss=15&doc_id=5217&string=schizophrenia

Depression Guideline: FamilyCare recommends the following guideline for depression: www.guideline.gov/content.aspx?id=15521&search=depression#Section420. Alternatively, we recommend the practice guideline for the treatment of patients with major depressive disorder, third edition, published by the American Psychiatric Association

 

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10/03/2012
H3818_WEB_00248 CMS Approved