Clinical Practice Guidelines

Actively practicing in-plan practitioners are involved in the development and adoption of clinical practice guidelines.  These guidelines are reviewed and approved by the Upper Peninsula Health Plan Clinical Advisory Committee at least biennially or as new scientific evidence or national standards are published.  Guidelines will be consistent with member education and utilization management criteria.  Practitioner performance will be measured against at least two important aspects of four guidelines annually.  These measures will be either practitioner based or population based.  The guidelines can be obtained from Customer Service by calling 1-877-349-9324.

Advance Care Planning

Advance Care Planning
Michigan Quality Improvement Consortium Guideline, January 2018
Adopted March 2014, Reviewed March 2018

Attention-Deficit/Hyperactivity Disorder (ADHD)

Diagnosis of ADHD for Children and Adolescents
Michigan Quality Improvement Consortium Guidelines, March 2017
Adopted June 2015, Reviewed June 2017

Treatment of ADHD for Children and Adolescents
Michigan Quality Improvement Consortium Guidelines, March 2017
Adopted June 2015, Reviewed June 2017

Asthma

General Principles for the Diagnosis and Management of Asthma
Michigan Quality Improvement Consortium Guidelines, September 2018
Adopted June 2003, Reviewed December 2018

Asthma Action Plan
Adopted June 2003, Reviewed December 2018

Depression

UPHP Primary Care Diagnosis and Management of Adults with Depression
Adopted March 2016, Reviewed June 2018

Diabetes

Management of Diabetes Mellitus
Michigan Quality Improvement Consortium, November 2018
Adopted March 2009, Reviewed March 2019

Heart Failure

Adults with Heart Failure
Michigan Quality Improvement Consortium, January 2019
Adopted June 2007, Reviewed March 2019

Lipid Screening and Management

Lipid Screening and Management
Michigan Quality Improvement Consortium, August 2017
Adopted December 2017

Framingham Risk Assessment Tool
(Calculates Estimated 10-Year Risk)

Hypertension

Medical Management of Adults with Hypertension
Michigan Quality Improvement Consortium, November 2018
Adopted March 2019

Kidney Disease

Diagnosis and Management of Adults with Chronic Kidney Disease
Michigan Quality Improvement Consortium, November 2018
Adopted September 2010, Reviewed March 2019

Low Back Pain

Management of Acute Low Back Pain
Michigan Quality Improvement Consortium, March 2018
Adopted September 2009, Reviewed June 2018

Opioid Therapy in Adults Excluding Palliative and End-of-Life Care

Opioid Prescribing in Adults Excluding Palliative and End-of-Life Care
Michigan Quality Improvement Consortium, November 2018
Adopted March 2018, Reviewed March 2019

Osteoarthritis

UPHP Management and Prevention of Osteoarthritis
Adopted December 2015, Reviewed December 2017

Osteoporosis

Management and Prevention of Osteoporosis
Michigan Quality Improvement Consortium, January 2018
Adopted September 2010, Reviewed March 2018

Overweight Persons and Obesity

Prevention and Identification of Childhood Overweight and Obesity
Michigan Quality Improvement Consortium, June 2018
Reviewed September 2018

Treatment of Childhood Overweight and Obesity
Michigan Quality Improvement Consortium, June 2018
Adopted March 2009, Reviewed September 2018

UPHP Management of Overweight and Obesity in the Adult
Adopted June 2013,  Reviewed June 2017

Pharyngitis

Acute Pharyngitis in Children
Michigan Quality Improvement Consortium, January 2019
Adopted September 2009, Reviewed March 2019

Prenatal and Postpartum Care

Routine Prenatal and Postnatal Care 
Michigan Quality Improvement Consortium, June 2018
Adopted September 2008, Reviewed September 2018

Prevention of Falls in Older Persons

US Preventive Services Task Force
Adopted December 2018

Preventive Services for Adults 

Adult Preventive Services (Ages 18-49)
Adopted June 2015, Reviewed June 2017

Adult Preventive Services (Ages 50-65+)
Adopted September 2010, Reviewed June 2017

Preventive Services for Children 

Routine Preventive Services for Infants and Children (Birth—24 Months)
Michigan Quality Improvement Consortium, May 2017
Adopted December 2012, Revised June 2017

Routine Preventive Services for Children and Adolescents (Ages 2—21) 
Michigan Quality Improvement Consortium, May 2017
Adopted December 2012, Revised June 2017

Respiratory Tract Infections

Management of Uncomplicated Acute Bronchitis in Adults
Michigan Quality Improvement Consortium, May 2018
Adopted March 2014, Reviewed June 2018

Pediatric Treatment Recommendations
Adopted June 2016, Reviewed June 2018

The Diagnosis and Management of Acute Otitis Media

Self Management

Chronic Care: Self Management
Guideline for Self Management of Chronic Care
Adopted June 2013, Reviewed September 2017

Substance Use Disorder
Screening, Diagnosis, and Referral for Substance Use Disorders
Michigan Quality Improvement Consortium, August 2017
Adopted December 2017

Tobacco Cessation 

Tobacco Control
Michigan Quality Improvement Consortium, September 2017
Adopted December 2012, Reviewed December 2017

Urinary Incontinence in Adults

Assessment and Management of Urinary Incontinence in Adults
Upper Peninsula Health Plan, December 2018
Adopted December 2010, Reviewed December 2018


Page Last Updated: 04/17/2019