Preventive Health Services Guidelines
LifeWise has adopted the United States Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services. The guideline is evidence-based, relying on current scientific studies. Vaccinations are part of USPSTF recommendations for Preventive
Health Services, and LifeWise recommends the Centers for Disease Control & Prevention (CDC) and Advisory Committee on Immunization Practices (ACIP) for an up-to-date vaccination schedule. USPSTF “A” and “B” grade services, in addition to content from
other recognized sources, have been selected and formatted in two quick reference guides for provider use.
Preventive Health – Guide to Clinical Preventive Services for Adults
Preventive Health – Guide to Clinical Preventive Services for Children/Adolescents
Clinical Practice Guidelines
LifeWise adopts clinical practice guidelines for the provision of non-preventive acute and chronic services relevant to its member population and for preventive and non-preventive behavioral health services. Evidence-based guidelines from recognized sources
are designed to guide practitioner and member decisions about appropriate healthcare for specific clinical circumstances. LifeWise adopts evidence-based national guidelines for treatment of conditions addressed by LifeWise disease management, quality
and pharmacy programs. Performance on key guidelines is measured and analyzed annually.
LifeWise’s adoption of the following guidelines does not guarantee benefit coverage for services and is not an authorization of payment for specific procedures.
Guidelines are reviewed and approved for adoption at least every two years by LifeWise’s Clinical Quality Improvement Committee. The committee’s composition reflects a variety of medical and behavioral health specialties, as well as geographic regions
served by LifeWise.
ADHD
Guideline:
Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents - October 2019
Source:
The American Academy of Pediatrics
Asthma (Adult and Pediatric)
Guideline:
2019 GINA Report, Global Strategy for Asthma
Management and Prevention
Source:
Global Initiative for Asthma (GINA)
Coronary Artery Disease CAD
Guideline:
2013 ACC/AHA Guideline on the Lifestyle
Management to Reduce Cardiovascular Risk
Source:
American Heart Association, American College of Cardiology
Guideline:
2013 ACC/AHA Guideline on the Assessment of
Cardiovascular Risk
Source:
American Heart Association, American College of Cardiology
Chronic Obstructive Pulmonary Disease COPD
Guideline:
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Updated January 2017
Source:
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
Depression
Guideline:
Practice Guideline for the Treatment of Patients with Major Depressive Disorder
Source:
American Psychiatric Association (APA)
Guideline:
Psychiatric Evaluation of Adults: A Quick Reference Guide
Source:
American Psychiatric Association (APA)
Diabetes
Guideline:
Standards of Medical Care in Diabetes - 2020
Source:
American Diabetes Association (ADA)
Heart Failure (HF)
Guideline:
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure
Source:
American College of Cardiology Foundation (ACCF), American Heart Association (AHA)
Oncology
Guideline:
Guidelines, Tools and Resources
Source:
American Society of Clinical Oncology (ASCO)
Guideline:
NCCN Guidelines and Clinical Resources
Source:
National Comprehensive Cancer Network (NCCN)
Guideline:
Clinical Guidelines and Recommendations
Source:
American College of Physicians (ACP)
Resources for Managing Chronic, Non-Cancer Pain
LifeWise recognizes the challenges many physicians encounter when treating patients who have chronic, non-cancer pain and who are taking controlled substances for pain management. Below are links to various resources and tools for providers to use in
managing these patients’ care.
Professional Resources:
National Resources: Federation of State Medical Boards
Washington State Department of Health: Prescription Monitoring Program
Provider/Patient Pain Management Agreement: Web MD Pain Management Agreement