Clinical practice guidelines

Clinical practice guidelines are resources* for Humana-contracted physicians and other Humana-contracted healthcare professionals. Humana has adopted the following guidelines:

Adult immunizations
Centers for Disease Control and Prevention
Recommended immunization schedule for adults aged 19 years or older, United States 2018, opens new window

Asthma care
Global Initiative for Asthma’s Global Strategy for Asthma Management and Prevention —Updated October 2018 ginasthma.org/wp-content/uploads/2018/04/wms-GINA-2018-report-V1.3-002.pdf
Guidelines for the diagnosis and management of asthma (EPR-3), opens new window

Atherosclerotic cardiovascular disease
2011 Update; Sidney C. Smith, Emelia J. Benjamin, Robert O. Bonow, Lynne T. Braun, Mark A. Creager, Barry A. Franklin, Raymond J. Gibbons, Scott M. Grundy, Loren F. Hiratzka, Daniel W. Jones, Donald M. Lloyd-Jones, Margo Minissian, Lori Mosca, Eric D. Peterson, Ralph L. Sacco, John Spertus, James H. Stein, Kathryn A. Taubert
AHA (American Heart Association)/ACCF (American College of Cardiology Foundation) Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 update, opens new window

Breast cancer screening
U.S. Preventive Services Task Force (January 2016)
Breast cancer: Screening, opens new window

Childhood immunizations
Centers for Disease Control and Prevention
Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2019, opens new window

Cholesterol treatment
2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults, opens new window

Chronic obstructive pulmonary disease (COPD)
Global Initiative for Chronic Obstructive Lung Disease (GOLD) – Global Strategy for The Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (COPD), 2019 Report
Guideline on diagnosis and management of stable COPD, opens new window

Depression
Institute for Clinical Systems Improvement (ICSI): Depression, Adult in Primary Care (March 2016)
Depression, Adult in Primary Care, opens new window

Diabetes
American Diabetes Association, Executive Summary: Standards of Medical Care in Diabetes – 2014
Executive summary: Standards of medical care in diabetes—2014, opens new window

Heart failure
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure; A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America; Clyde W. Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E. Casey Jr., Monica M. Colvin, Mark H. Drazner, Gerasimos S. Filippatos, Gregg C. Fonarow, Michael M. Givertz, Steven M. Hollenberg, JoAnn Lindenfeld, Frederick A. Masoudi, Patrick E. McBride, Pamela N. Peterson, Lynne Warner Stevenson and Cheryl Westlake
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure, opens new window

Heart risk calculator
Heart risk calculator, opens new window

Hypertension
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Paul K. Whelton, Robert M. Carey, Wilbert S. Aronow, Donald E. Casey Jr., Karen J. Collins, Cheryl Dennison Himmelfarb, Sondra M. DePalma, Samuel Gidding, Kenneth A. Jamerson, Daniel W. Jones, Eric J. MacLaughlin, Paul Muntner, Bruce Ovbiagele, Sidney C. Smith Jr., Crystal C. Spencer, Randall S. Stafford, Sandra J. Taler, Randal J. Thomas, Kim A. Williams Sr., Jeff D. Williamson and Jackson T. Wright Jr.
Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults, opens new window

Copyright notice: http://www.copyright.com/about/terms-conditions/, opens new window

Kidney disease
National Kidney Foundation Guidelines and Commentaries – Evidence-based clinical practice guidelines for all stages of chronic kidney disease
Guidelines and commentaries, opens new window

Obesity screening in adults
Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions, September 2018
Behavioral interventions, opens new window

Obesity screening in children
Obesity in Children and Adolescents — Screening: U.S. Preventive Services Task Force (USPSTF) June 2017
Final recommendation statement, opens new window

Perinatal guidelines
A compilation of pediatric guidelines in an eBook resulting from a joint effort by The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics (AAP)

Please note that clicking on the link below will take you to the Availity Portal. Once you log in, you will need to select Humana from the “Payer Spaces” dropdown menu. Then, select the “Resources” tab in the center of the page that loads to view the guidelines. You will see links to both the AAP Guidelines for Perinatal Care and the AAP eBook Collection.

If you do not have an Availity account, you may create one by clicking the “Register” button at the top of the Availity.com home page.
(AAP 2017 eBook collection) Guidelines for Perinatal Care, 8th edition, opens new window

Preventive care
Guide to Clinical Preventive Services, 2014
Recommendations of the U.S. Preventive Services Task Force, opens new window

Valvular heart disease
2014 AHA (American Heart Association)/ACC (American College of Cardiology) Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary; A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
AHA/ACC Guideline, opens new window

Well-woman routine care
ACOG (The American College of Obstetricians and Gynecologists)
Well-Woman recommendations, opens new window

Atrial fibrillation guidelines
2014 AHA /ACC/HRS (American Heart Association/American College of Cardiology/Heart Rhythm Society) Guideline for the Management of Patients With Atrial Fibrillation
http://www.onlinejacc.org/content/64/21/2246, opens new window

Copyright notice: http://www.copyright.com/about/terms-conditions/, opens new window

Clinical toolkit – atrial fibrillation
The Cardiosource^® site produced by the American College of Cardiology Foundation
http://www.acc.org/tools-and-practice-support/clinical-toolkits/atrial-fibrillation-afib, opens new window

Colorectal cancer screening guidelines
American Cancer Society guidelines for colorectal cancer early detection Updated 2018
https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html, opens new window

Primary prevention of cardiovascular disease and stroke
ACC (American College of Cardiology)/AHA (American Heart Association) Prevention Guideline: 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk – A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
http://circ.ahajournals.org/content/129/25_suppl_2/S49.short?rss=1&ssource=mfr, opens new window

Smoking cessation
Treating Tobacco Use and Dependence: 2008 Update – Clinical Practice Guideline
www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/update/index.html, opens new window

Humana periodically monitors compliance with nationally recognized clinical practice guidelines.

*Humana publishes medical guidelines from a number of well-respected national sources. These guidelines may have some differences in recommendations. Information contained in the guidelines is not a substitute for a physician’s or other healthcare professional's clinical judgment and is not always applicable to an individual. Therefore, the physician or healthcare professional and patient should work in partnership in the decision-making process regarding the patient's treatment. Furthermore, using this information will not guarantee a specific outcome for each patient. None of the information in the guidelines is intended to interfere with or prohibit clinical decisions made by a treating physician or other healthcare professional regarding medically available treatment options for patients.

Publication of these guidelines is not a promise or guarantee of coverage. Individuals should review their coverage to determine benefits.

Links to other websites are provided for your convenience only and do not constitute or imply endorsement by Humana of these sites, products or services described on these sites, or of any other material contained therein. Humana disclaims responsibility for their content and accuracy.