Quality

Nothing matters more to Arise Health Plan than providing quality service to members. Our guiding principle is to provide services that are safe, timely, effective, efficient, equitable, and member-centered. We’re dedicated to maintaining an active quality improvement program that includes both clinical and service quality initiatives.

Clinical Practice Guidelines

Clinical practice guidelines offer providers consistent and appropriate guidance for prevention, diagnosis, and treatment of specific conditions or diseases. Clinical guidelines are evidence-based, reflect the current literature and research about treatment protocols, and reflect best practices. The clinical guidelines below present an opportunity to significantly reduce variation in the clinical setting and provide part of a framework necessary for measuring and improving the quality of care.

We view all caregivers as active participants in the monitoring and feedback of the effectiveness of these guidelines and welcome provider feedback and suggestions.

Clinical Practice Guidelines

 

Topic Guideline Source

Preventive Care For All Ages  

Includes: 
children up to 24 months; 
children 2-19; 
adults 20-64; 
adults 65 and older) and perinatal care  guidelines

Summary of Recommendations for Clinical Preventive Services
American Academy of Family Practice (AAFP)
 

U.S Preventive Services Task Force (USPSTF) A and B recommendations- all ages

CDC Immunization Schedules:
Children 0-18 years

Catch up schedule for infants and children

Adults

CDC Vaccine Information Statements (VIS)  site

AAFP

 

USPSTF

 

CDC

Adult Depression In Primary Care

Major Depression in Adults in Primary Care

Common Mental Health Disorders: Identification and Pathways to Care

Institute for Clinical Systems Improvement Health Care Guideline (ICSI)

NICE Clinical Guideline CG123

Asthma 

Diagnosis and Management of Asthma

Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (Landmark Report)

ICSI

NHLBI/NIH

ADHD – Pediatric

Diagnosis, Evaluation, and Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents

And  Supplement:
Implementing the Key Action Statements: An Algorithm and Explanation for Process of Care for the Evaluation, Diagnosis, Treatment, and Monitoring of ADHD in Children and Adolescents

AAP (ICSI Endorsed Guideline)

 

Chronic Heart Failure in Adults  

Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults

Heart Failure in Adults Guideline

ACC/AHA

COPD

Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease

Diagnosis and Management of Chronic Obstructive Pulmonary Disease- includes clinical algorithm

ACP

ICSI Endorsed VA/DoD Clinical Practice Guidelines

Controlling Blood Pressure 

2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults :  Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)

NIHLB/NIH (ICSI Endorsed JNC 8)

Coronary and Other Atherosclerotic Vascular Disease (CAD)

Secondary Prevention for Patients with Coronary and Other Atherosclerotic Vascular Disease

ACC/AHA (ICSI Endorsed JNC 8

Diabetes

Standards of Medical Care in Diabetes

American Diabetes Assoc.

Diagnosis & Treatment  of Low Back Pain

Diagnosis and Treatment of Low Back Pain (Landmark Guideline)

ACP & American Pain Society

Prenatal Care American Academy of Family Practice Update on Prenatal Care 2014

AAFP