Clinical Practice Guidelines
Clinical Guidelines
BMC HealthNet Plan (the Plan) adopts, develops and implements Clinical Practice Guidelines (CPGs) relevant to its membership for the provision of preventive and non-preventive acute and chronic clinical services and for both medical and behavioral health conditions. For example, the Plan adopted a CPG for asthma (as noted below) because of the high prevalence of asthmatics in our covered population and our desire to reduce the variation in the delivery of care across our network. The Plan adopts clinical practice guidelines from national sources or develops guidelines in collaboration with specialty organizations and/or regional collaborative groups. CPGs serve as a means of establishing standards among providers in medical and behavioral health to improve health outcomes and are not intended to replace clinical judgment.
For a complete list of medications covered by BMC HealthNet Plan, visit our online formulary. Click on the "Pharmacy" button at the top of this page.
Massachusetts Health Quality Partners
BMC HealthNet Plan has endorsed the evidence-based guidelines developed by the Massachusetts Health Quality Partners (MHQP). We encourage you to follow these guidelines to deliver quality care to all of your patients and our members.
You can access these guidelines on the MHQP Web site, www.mhqp.org, or by clicking any of the links below.
Pediatric Asthma
Asthma
BMC HealthNet Plan endorses the National Asthma Education and Prevention Panel Guidelines for Diagnosis and Management of Asthma.
Diabetes
BMC HealthNet Plan participated in updating the Massachusetts Guidelines for Adult Diabetes Care The 2011 Executive Summary of Revisions and Recommendations (2011 Executive Summary) is intended to serve as an amendment to the 2009 Massachusetts Guidelines for Adult Diabetes Care (2009 Guidelines), and is based on the Standards of Medical Care in Diabetes published by the American Diabetes Association (ADA). This guideline will assist in standardizing care to people with diabetes.
Anti Hyperglycemic Agents
HIV/AIDS Clinical Guidelines
HIV/AIDS guidelines are periodically updated by panels of HIV experts. For the most current clinical practice guidelines, BMC HealthNet Plan recommends this link.
Additional information and resources can be found at www.aidsinfo.nih.gov.
Additional Links and Resources
Pediatric Environmental Home Assessment (PEHA)
BMC HealthNet Plan endorses the importance of home environmental assessments to help members with their asthma management.
Massachusetts Lead Screening Prevention Program
Behavioral Health Clinical Guidelines
Major Depression in Adults in Primary Care
Treatment of substance abuse disorders
BMC HealthNet Plan endorses the APA Guideline for the treatment of patients with substance abuse disorders. In addition to the opiate programs listed in the guideline, certified suboxone prescriber offices are included as additional sites for suboxone care.
