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. Revised 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, July 2018
(Adopted June 2003. Revised September 2018.)

Asthma Action Plan
(Adopted June 2003. Revised June 2011.)

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease
UPHP Treatment Guideline for Chronic Obstructive Pulmonary Disease
(Adopted March 2009. Revised March 2017.)

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, June 2018
(Adopted March 2009. Reviewed September 2018.)

Heart Failure

Adults with Heart Failure
Michigan Quality Improvement Consortium, January 2017
(Adopted June 2007. Revised March 2017.)

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

UPHP Medical Management of Adults with Hypertension
(Adopted September 2015. Reviewed September 2017)

Kidney Disease

Diagnosis and Management of Adults with Chronic Kidney Disease
Michigan Quality Improvement Consortium, November 2016
(Adopted September 2010. Reviewed March 2017.)

Low Back Pain

Management of Acute Low Back Pain
Michigan Quality Improvement Consortium, March 2018
(Adopted September 2009. Revised 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.)

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
(Revised September 2018.)

Treatment of Childhood Overweight and Obesity
Michigan Quality Improvement Consortium, June 2018
(Adopted March 2009. Revised 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 2017
(Adopted September 2009. Reviewed March 2017.)

Prenatal and Postpartum Care

Routine Prenatal and Postnatal Care 
Michigan Quality Improvement Consortium, June 2018
(Adopted September 2008. Revised September 2018.)

Prevention of Falls in Older Persons

The American Geriatrics Society Recommendations

Prevention of Falls in Older Persons Summary Guide
The American Geriatrics Society and British Geriatrics Society, 2010
(Adopted December 2010. Reviewed December 2016.)

Prevention of Falls in Older Persons Algorithm
The American Geriatric Society, 2009
(Adopted December 2010. Reviewed December 2016.)

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 2016
(Adopted December 2010. Reviewed December 2016.)

 


Page Last Updated: 12/12/2018