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Clinical Care Guidelines

The Health Partners Plans Quality Management department is responsible for developing and monitoring systems that support our commitment to providing quality care and services to our members. This includes evaluating our performance based on clinical standards. We encourage our participating providers to take an active role in the ongoing management of member care, particularly members with chronic conditions. We also seek to ensure the coordination of care across specialties and care settings. 

 

Condition

Reference

Clinical Evidence

ADHD

Centers for Disease Control and Prevention

ADHD Diagnosis of Attention Deficit Hyperactivity Disorder in Primary Care for School Age Children and Adolescents (2014)

Asthma

National Heart, Lung and Blood Institute

Guidelines for the Diagnosis and Management of Asthma (Expert Panel Report 3 / EPR3)

Chronic Obstructive Pulmonary Disease
(1 of 3)

U.S. Preventative Services Task Force

Chronic Obstructive Pulmonary Disease: Screening

Chronic Obstructive Pulmonary Disease
(2 of 3)

American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society

Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease

 

Chronic Obstructive Pulmonary Disease
(3 of 3)

GOLD 2017 Global Strategy for the Diagnosis, Management and Prevention of COPD

Global Initiative for Chronic Obstructive Lung Disease

Diabetes

American Diabetes Association

Standards of Medical Care in Diabetes 2017

Elevated Blood Lead Levels in Children
(1 of 2)

Centers for Disease Control and Prevention

New Blood Lead Information

Elevated Blood Lead Levels in Children
(2 of 2)

Centers for Disease Control and Prevention

 

Summary of Recommendations for Follow-up and Case Management of Children Based on Confirmed* Blood Lead Levels

Heart Failure

American College of Cardiology/American Heart Association

2017 ACC/AHA/HFSA Focused Update Guideline for the Management of Heart Failure

Hepatitis C

Agency for Healthcare Research and Quality

Hepatitis C- Management and Treatment

High Blood Cholesterol in Adults

American College of Cardiology/American Heart Association

2013 ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults (2013)

HIV

National Institutes of Health

AIDS Infor-NIH-Guidelines for the Use ofAntiretroviral Agents in HIV-1-Infected Adults and Adolescents (2017)

Hypertension in Adults
(1 of 2)

ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA

2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

Hypertension in Adults
(2 of 2)

American College of Cardiology/American Heart Association/Heart Failure Society of America

Update Guideline for the Management of Heart Failure-2017 Hypertension

Hypertension Child/Adolescent

American Academy of Pediatrics

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

Obesity-Children and Adolescents

Institute for Clinical Systems Improvement

Prevention and Management of Obesity for Children and Adolescents (2013)

Obesity-Adults

Institute for Clinical Systems Improvement

Prevention and Management of Obesity for Adults (2013)

Opioid use Disorder
(1 of 2)

Centers for Disease Control and Prevention

Guideline for Prescribing Opioids for Chronic Pain

Opioid Use Disorder
(2 of 2)

Philadelphia Department of Public Health/ Department of Behavioral Health and Intellectual disABILITY Services

Opioid Prescribing

Prenatal Care
(1 of 3)

Agency for Healthcare Research and Quality

Routine Prenatal Care (2012)

Prenatal Care
(2 of 3)

American Congress of Obstetricians and Gynecologists

Method for Estimating Due Date (2014)

Prenatal Care
(3 of 3)

National Institute of Health

Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States (2017)

Sexually Transmitted Diseases
(1 of 2)

Centers for Disease Control and Prevention

STD Treatment Guidelines (2015)

Sexually Transmitted Diseases
(2 of 2)

U.S. Preventative Services Task Force

Other Supporting Document for Sexually Transmitted Infections: Behavioral Counseling

Smoking Cessation
(1 of 3)

Agency for Healthcare Research and Quality

Treating Tobacco Use and Dependence (2008)

Smoking Cessation
(2 of 3)

American Diabetes Association

Foundations of Care: Education, Nutrition, Physical Activity, Smoking Cessation, Psychosocial Care, and Immunization (2015)

Smoking Cessation
(3 of 3)

U.S. Preventive Services Task Force

Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions (2015)

Zika Virus
(1 of 2)

Centers for Disease Control and Prevention (CDC)

Healthcare Providers Caring for Pregnant Women

Zika Virus
(2 of 2)

PA Department of Health

Diagnosis and Testing Zika Virus

These guidelines are reviewed at least annually, and are approved by our Quality Management Committee. To request printed copies of any guidelines, please call our Provider Services Helpline at 888-991-9023 or 215-991-4350. 

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