Guidelines adopted by Humana

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

Adult immunizations
Centers for Disease Control and Prevention (CDC)
Recommended immunization schedule for adults aged 19 years or older, United States 2021, opens new window

Asthma care
Global Initiative for Asthma (GINA)
2021 GINA Report: Global Strategy for Asthma Management and Prevention , opens new window

Atrial fibrillation guidelines
AHA/ACC/Heart Rhythm Society
2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society, opens new window

Back pain
Institute for Clinical Systems Improvement
Health Care Guideline: Adult Acute and Subacute Low Back Pain 16th Edition (March 2018), 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, 2021, opens new window

Cholesterol treatment
2018 AHA/ACC/American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR)/ American Academy of Physician Assistants (AAPA) /Association of Black Cardiologists (ABC) /American College of Preventive Medicine (ACPM) / American Diabetes Association (ADA) / American Geriatric Society (AGS) / American Pharmacist Association (APpA) / American Society of Preventive Cardiology (ASPC) / National Lipid Association (NLA) / Preventive Cardiovascular Nurses Association (PCNA)
Cholesterol Clinical Practice Guidelines 2018 Guideline on the Management of Blood Cholesterol, 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), 2021 Report, PDF opens new window

Covid-19 (New August 2020)
National Institute of Health (NIH) Covid-19 Treatment Guidelines
(The NIH updates this guideline continually, as it obtains new information about managing Covid-19). The guideline is approved in its most current format.
Guideline for the Management of Covid-19, opens new window

Depression
Institute for Clinical Systems Improvement
Depression, Adult in Primary Care, 17th edition (March 2016), opens new window

Diabetes
American Diabetes Association
Standards of Medical Care in Diabetes – 2021, opens new window

Heart failure
2017 ACC/AHA/Heart Failure Society of America (HFSA) Task Force on Clinical Guidelines
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure, opens new window

Heart risk calculator
American College of Cardiology Foundation
Heart risk calculator, opens new window

Hypertension
ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA
2017 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., opens new window

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

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

Opioid Guidelines
ICSI
Pain: Assessment, Non-Opioid Treatment Approaches and Opioid Management 8th Edition, August 2017: Version 2 , opens new window

Health and Human Services (HHS)
HSS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics, 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)
(AAP 2017 eBook collection) Guidelines for Perinatal Care, 8th edition (e-book collection) , opens new window

Please note that clicking on this link will take you to Availity Portal. After logging in, 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. The link from Availity is https://ebooks.aappublications.org/content/guidelines-for-perinatal-care-8th-edition, opens new window.

If you do not have an Availity account, you can create one by clicking the “Register” button at the top of the Availity.com homepage

Preventive care
U.S. Preventive Services Task Force
There are more than 100 guidelines on the USPSTF site. Humana recommends the following guidelines*:

  • BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing – women with a personal or family history
  • Breast Cancer
  • Cervical Cancer
  • Colorectal Cancer: Screening – Adults aged 50 to 75 years
  • Interventions for Tobacco Smoking Cessation
  • Obesity in Children and Adolescents: Screening
  • Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions

*Some of these guidelines have multiple entries. Where that occurs, Humana recommends entries that USPSTF has graded A (high certainty that the net benefit is substantial) or B (high certainty that the net benefit is moderate or moderate certainty that the net benefit is moderate or substantial). Information about the USPSTF grading system can be found at https://www.uspreventiveservicestaskforce.org/apps/gradedef.jsp?_sm_au_=iVVrKq3HF11t1ZcDWTW4vK0p3MfC0, opens new window

Primary Prevention of Cardiovascular Disease and Stroke
ACC/AHA Task Force on Clinical Practice Guidelines
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, opens new window

Sickle cell anemia
NIH
Evidence-Based Management of Sickle Cell Disease: Expert Panel Report 2014 , opens new window

Valvular heart disease
AHA/ACC Task Force on Clinical Practice Guidelines
2017 Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease , opens new window

Well-woman routine care
The American College of Obstetricians and Gynecologists (ACOG)
Recommendations for Well-Woman Care 2021, 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.