Preventive Care Guidelines
HPP's 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. HPP encourages providers to discuss preventive care with their patients. The below grid demonstrates examples of evidence based guidelines.
Preventive Care Resources
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Social Determinants of Health: Immunizations: |
Depression: U.S. Preventive Services Task Force: Other Resources: |
Update to Colorectal Cancer Screening GuidelinesNCQA recently updated the Measurement Year (MY) 2023 HEDIS guidelines and lowered the recommended age range for screening to ages 45-75. HPP plans to implement this change for the Medicare QCP program in Measurement Year 2023. More details to follow. |
Preventive Care Guidelines
| Condition | Reference | Clinical Evidence |
| ADHD | Agency for Healthcare Research and Quality (AHRQ) | Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents |
| Adult Well Care | U.S. Preventive Services Task Force (USPSTF) | Adult Preventive Health Care Schedule |
| Breast Cancer Screening | ||
| American Cancer Society (ACS) | Breast Cancer Screening for Women at Average Risk | |
| American College of Radiology (ACR) | Breast Cancer Screening in Women at Higher-Than-Average Risk: Recommendations From the ACR | |
| Cervical Cancer Screening | Centers for Disease Control and Prevention (CDC) | Cervical Cancer Screening Guidelines |
| National Institute of Health: National Institute of Cancer | ACS’s Updated Cervical Cancer Screening Guidelines | |
| Child and Adolescent Well Care | Bright Futures/American Academy of Pediatrics (AAP) | Bright Futures/AAP Periodicity Grid |
| Colorectal Cancer Screening | ||
| American Cancer Society (ACS) | ACS Guidelines for Colorectal Cancer Screening | |
| U.S. Preventative Services Task Force | Final Recommendation Statement: Colorectal Cancer Screening | |
| Depression Screening, Adults | U.S. Preventative Services Task Force | Depression in Adults Screening |
| Depression Screening, Children and Adolescents | Agency for Healthcare Research and Quality | Depression in Children and Adolescents Screening |
| Developmental Screenings | Centers for Disease Control and Prevention (CDC) | Developmental Monitoring and Screening for Health Professionals |
| American Academy of Pediatrics (AAP) | Development Surveillance and Screening | |
| Obesity Screening, Adults | U.S. Preventative Services Task Force | Screening for and Management of Obesity in Adults |
| Obesity Screening, Children and Adolescents | Agency for Healthcare Research and Quality | Obesity in Children and Adolescents: Screening |
| Pediatric Oral Health | Various Sources | Pediatric Oral Health Resources |
| Prostate Cancer Screening | U.S. Preventative Services Task Force | Prostate Cancer: Screening |
| Sexually Transmitted Infections (STI) Counseling, Adolescents and Adults | Agency for Healthcare Research and Quality | Sexually Transmitted Infections: Behavioral Counseling |
| STI/Chlamydia Screening | U.S. Preventive Services Task Force | Chlamydia and Gonorrhea: Screening |
| Suicide Screening, Adolescents, Adults and Older Adults | U.S. Preventive Services Task Force | Suicide Risk Screening |
| Upper Respiratory Infections, Adults and Children | Centers for Disease Control and Prevention | Adult Treatment Recommendations |
| Centers for Disease Control and Prevention | Pediatric Treatment Recommendations | |
| Well Elderly | American Academy of Family Physicians | Geriatric Assessment: An Office-Based Approach |
These guidelines are reviewed at least annually, and are approved by our Utilization Management Committee. To request printed copies of any guidelines, please call our Provider Services Helpline at 1-888-991-9023.