Clinical Guidelines

FEP—Accordant Rare Condition Management Clinical Guidelines

The Healthy Companion Program™ has reviewed and selected the following clinical guidelines for MPMC review and approval. These guidelines have been selected for their evidence-based guideline development, timeliness to today's practice and correlation with 2016 HEDIS measures. These guidelines also align with Blue KC's Patient Centered Medical Home (PCMH) quality of care initiatives.

These guidelines are recommended guidelines for physician practice in primary care. They are not requirements for care. If these guidelines are approved by MPMC for use by Blue KC, they will be placed on Blue KC's Physician Office Guide website as a reference tool. The Healthy Companion Program will communicate the availability of these guidelines to providers annually and whenever any changes are made.

These guidelines are also used as the basis for The Healthy Companion Program's preventive standards of care and disease management standards of care. Standards of care, preventive measures and acceptable laboratory values are routinely discussed with Blue KC members during care management calls.

Please review and approve the following clinical guidelines (hyperlinked). Questions can be directed to Lori Martin at ext. 2146 or lori.martin@bluekc.com.

Endocrine

Diabetes

Standards of Medical Care in Diabetes-2015
By the American Diabetes Association

Standards of Medical Care in Diabetes-2015 Executive Summary Update
By the American Diabetes Association

Metabolic Syndrome

AHA 2005 Diagnosis and Management of Metabolic Syndrome
By the American Heart Association and National Heart, Lung and Blood Institute

Cardiovascular

Hypertension

2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults (JNC8)
By the Eighth Joint National Committee Panel Members of the American Medical Association

Coronary Artery Disease

ACCF/AHA/AMA-PCPI 2011 Performance Measures for Adults with Coronary Artery Disease and Hypertension
By the American Heart Association

AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2011 Update
By the American Heart Association

Congestive Heart Failure

2013 ACCF/AHA Guideline for the Management of Heart Failure
By the American Heart Association

AHA/ACC Guidelines for Secondary Prevention for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2006 Update (Endorsed by NHLBI)
By the American Heart Association

Respiratory

COPD

GOLD Global Strategy for Diagnosis, Management, and Prevention of COPD (2015)
By the Global Initiative for Chronic Obstructive Lung Disease

ICSI: Diagnosis and Management of Chronic Obstructive Pulmonary Disease (January 2016, 10th ed.)
By the Institute for Clinical Systems Improvement

Asthma

NIH/NHLBI : Guidelines for the Diagnosis and Management of Asthma (EPR-3)
By the National Heart, Lung and Blood Institute

Adult Bronchitis

CDC Principles for Appropriate Antibiotic Use: Reviewed by CDC 2015
By the Centers for Disease Control and Prevention

Behavioral Health (Note: ICSI update expected after March 2016)

Depression

ICSI 2013 Adult Depression in Primary Care
By the Institute of Care Systems Improvement

ADHD

AAP 2011 ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention Deficit/Hyperactivity Disorder in Children and Adolescents
AAP 2001 Clinical Practice Guideline: Treatment of the School-Aged Child With Attention Deficit/Hyperactivity Disorder
By the American Academy of Pediatrics

Preventive Health Guidelines Across the Lifespan/Perinatal Care Guidelines/Cancer Screenings

Perinatal/Postnatal Care

ICSI 2012 Guideline for Routine Preventive Prenatal Care
By the Institute for Care Systems Improvement

Well-Child Visits and Immunizations

Summary of Recommendations for Immunizations Birth to18 Years
Summary of Recommendations for Immunizations for Adults
By Centers for Disease Control and Prevention

Cancer Screenings

ACS 2015 Breast Cancer Screening Guidelines
By the American Cancer Society

USPSTF 2012 Recommendations on Screening for Cervical Cancer (A recommendation only)
USPSTF 2008 Recommendations on Screening for Colorectal Cancer (A recommendation only)
By United States Preventive Services Task Force

FEP—Accordant Rare Condition Management Clinical Guidelines

At Blue Cross and Blue Shield of Kansas City (Blue KC) we care about the best level of service for our members. We rely on the high quality, proactive and timely care of our providers to assist in achieving these goals.

Blue KC's disease management (DM) program, Healthy Companion™, cares for the Federal Employee Plan (FEP) population in our area. Blue KC and FEP partner with Accordant Health for rare condition management. Accordant has developed the following clinical guidelines for rare condition management programs which telephonically support our FEP membership.

FEP and Accordant's goal is to encourage the best levels of health and to promote member activation in the physician-patient relationship with their provider. Blue KC's goal is to provide transparency to the clinical guidelines Accordant utilizes in the management of our FEP population.

The following is a complete list of guidelines available.