We recently posted the 2015-2016 Clinical Practice Guideline Summary, which replaces the previous version. The revised summary includes a listing of all Clinical Practice Guidelines adopted by AmeriHealth that are considered the accepted minimum standard of care in the medical profession. Adherence to these guidelines may lead to improved patient outcomes.

Guidelines are available for the following medical and behavioral health conditions: asthma, chronic obstructive pulmonary disease (COPD), coronary heart disease, diabetes, heart failure, obesity, renal disease, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, depression, and substance abuse disorders.

Changes in the 2015-2016 Clinical Practice Guideline Summary include updates to the current guidelines, as well as the addition of the following guidelines:

• Asthma. Global Initiative for Asthma (GINA) Pediatric Pocket Guide
• COPD. Global Initiative for Chronic Obstructive Lung Disease (GOLD) Diagnosis of Diseases of Chronic Airflow Limitation: Asthma COPD and Asthma - COPD Overlap Syndrome (ACOS)
• Coronary Heart Disease. AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes; and ACC/AHA/AACVPR/AAFP/ANA Concepts for Clinician-Patient Shared Accountability in Performance Measures
• Diabetes. Type 1 Diabetes Mellitus and Cardiovascular Disease A Scientific Statement from the American Heart Association and American Diabetes Association; and Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus
• Heart Failure. Transitions of Care in Heart Failure; and Decision Making in Advanced Heart Failure
• Obesity. Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches; and Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient – 2013 Update

Individual clinical decisions should be tailored to specific patient medical and psychosocial needs. As national guideline recommendations evolve, please update your practice accordingly. The summary provides the reference for each condition and links directly to the guidelines.

We update the guidelines annually based on changes made to nationally recognized sources. Changes are reviewed by internal and external consultants, as appropriate, and by the AmeriHealth Quality Committee, which is comprised of network physicians.

You can access the 2015-2016 Clinical Practice Guideline Summary on the AmeriHealth New Jersey website or the AmeriHealth Pennsylvania website. Paper copies of the summary can be ordered by submitting an online request or by calling the Provider Supply Line at 1-800-858-4728.