Health Care Links

Clinical Practice Guidelines

CareSource approves and adopts evidence-based nationally accepted standards and clinical practice guidelines to help inform and guide the provision of clinical care to members.  CPGs are identified through member review of member population demographics and state/national priorities. Review occurs every two years by our Provider Advisory Committee and CPGs are updated as necessary. 

The use of these guidelines allows CareSource to measure their impact on member health outcomes. Review and approval of the guidelines are completed by the Market CareSource Provider Advisory Committee (PAC) and the CareSource Enterprise PAC. The Quality Enterprise Committee (QEC) are notified of guideline approval. CareSource identifies guideline topics through analysis of member population demographics and national or state priorities. Guidelines may include, but are not limited to:

  • Behavioral health (e.g., depression)
  • Adult health (e.g., hypertension and diabetes)
  • Population health (e.g., obesity and tobacco cessation)

Guidelines may be promoted to providers through one or more of the following: newsletters, our website, direct mailings, provider manual, and through focused meetings with CareSource Provider Engagement Specialists. A broad range of wellness, preventive health and chronic disease management tools are also available on the CareSource member website, newsletters or upon request.

If you would like more information on CareSource quality improvement, please call Provider Services.

Clinical Practice Guidelines

Health ConditionClinical Guideline
Asthma

2020 Focused Updates to the Asthma Management Guidelines:  A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. 

At-A Glance Guide-Asthma Management Guidelines (2020 Focused Updates)

National Heart, Lung and Blood Institute, National Institutes of Health

Blood Cholesterol2018 Guideline on the Management of Blood Cholesterol: Executive Summary

The American Heart Association, American College of Cardiology, American Association of Cardiovascular & Pulmonary Rehabilitation, American Academy of Physician Assistants, Association of Black Cardiologists, American College of Preventive Medicine, et al.

The American Heart Association is a national voluntary health agency to help reduce disability and death from cardiovascular diseases and stroke.

Chronic Obstructive Pulmonary Disease (COPD)Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease, 2023 Report

Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD)

Coronary Artery Disease2019 ACC/AHA Guideline on Primary Prevention of Cardiovascular Disease: Executive Summary

American College of Cardiology and American Heart Association Task Force on Clinical Practice Guidelines

The American Heart Association is a national voluntary health agency to help reduce disability and death from cardiovascular diseases and stroke.

Dental HealthADA® Center for Evidence-Based Dentistry™ Clinical Practice Guidelines

The American Dental Association (ADA)

ADA is a registered trademark of the American Dental Association and ADA.org is a service mark of the American Dental Association. Links may be made to ADA.org provided the links do not use trademarks or service marks of the American Dental Association or its affiliated entities.

Diabetes

Standards of Medical Care in Diabetes – 2023

American Diabetes Association

Diabetes Care 2023 Jan; 46 (Supplement 1)

Geriatric Medicine

Geriatric Medicine Clinical Recommendations & Guidelines

American Academy of Family Physicians (AAFP)

Heart Failure

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

HIV/AIDSHIV Guidelines and Recommendations

Centers for Disease Control and Prevention

CDC.gov is your online source for credible health information and is the official web site of the Centers for Disease Control and Prevention (CDC)

Hepatitis C VirusNavigate Hepatitis C Virus Infection Care Pathway

A Report from the American Gastroenterological Association Institute HCV Care Pathway Work Group

Hypertension2020 International Society of Hypertension Global Hypertension Practice Guidelines

American Heart Association

The American Heart Association is a national voluntary health agency to help reduce disability and death from cardiovascular diseases and stroke.

Navigate Hypertension Clinical Practice Guideline

Infant MortalityInfant Mortality: What is CDC Doing?

Centers for Disease Control & Prevention

Kidney DiseaseNavigate 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease

Kidney Disease Outcomes Quality Initiative (KDOQI)

Navigate U.S. Commentary on the 2012 Kidney Disease: Improving Global Initiatives (KDIGO) Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD)
The National Kidney Foundation

Lead ToxicityPrevention of Childhood Lead Toxicity

The American Academy of Pediatrics, Council on Environmental Health

The mission of the American Academy of Pediatrics is to attain optimal physical, mental and social health and well-being for all infants, children, adolescents and young adults.

Interpregnancy CareNavigate Obstetric Care Consensus, Interpregnancy Care

The American College of Obstetricians and Gynecologists

The American College of Obstetricians and Gynecologists is a membership organization dedicated to the advancement of women’s health care through continuing medical education, research and practice.

Maternal CareNavigate Obstetric Care Consensus, Levels of Maternal Care

The American College of Obstetricians and Gynecologists

Maternal HealthNavigate Avoidance of Nonmedically Indicated Early-Term Deliveries and Associated Neonatal Morbidities

The American College of Obstetricians and Gynecologists, ACOG Committee Opinion

Postpartum CareNavigate ACOG Committee Opinion, Optimizing Postpartum Care

The American College of Obstetrics and Gynecologists

Postpartum Care Resources

The American College of Obstetrics and Gynecologists

Sickle Cell DiseaseEvidence-Based Management of Sickle Cell Disease, Expert Panel Report, 2014

National Heart, Lung and Blood Institute (NHLBI)

Sickle Cell Disease: PediatricManagement of Children with Sickle Cell Disease: A Comprehensive Review of the Literature

American Academy of Pediatrics

Preventive Health Guidelines

Health ConditionClinical Guideline
0-18 Years of Age Immunization ScheduleRecommended Child & Adolescent Immunization Schedule for Ages 18 Years or Younger

Centers for Disease Control and Prevention

≥ 19 Years of Age Immunization ScheduleRecommended Adult Immunization Schedule for Ages 19 or Older, United States

Centers for Disease Control and Prevention

Periodicity ScheduleBright Futures Periodicity Schedule

American Academy of Pediatrics

Recommendations for Preventive Pediatric Care: 0-21 Years of Age2022 Recommendations for Preventive Pediatric Care

American Academy of Pediatrics

USPSTF: A & B RecommendationsU.S. Preventive Services Task Force Recommendations

U.S. Preventive Services Task Force

Vision Screening (Adult)Navigate Comprehensive Adult Eye & Vision Examination

American Optometric Association

Vision Screening (Pediatric)Navigate Comprehensive Pediatric Eye and Vision Examination

American Optometric Association

Other Health Resources

Health ConditionClinical Guideline
ADHD: PediatricsTreatment of ADHD

Centers for Disease Control and Prevention

Cancer Care

National Comprehensive Cancer Network Guidelines

Cardiovascular Health and Risk Reduction in Children & AdolescentsIntegrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, published October 2012

National Heart, Lung & Blood Institute

Contraceptive Use: U.S. Medical Eligibility CriteriaUS Medical Eligibility Criteria (US MEC) for Contraceptive Use 2016-Present

Centers for Disease Control and Prevention

DiabetesPro®

American Diabetes Association, Professional Education Portal

Domestic ViolenceIntimate Partner Violence

Centers for Disease Control & Prevention

Infant MortalityInfant Mortality Rates by State

National Center for Health Statistics

LactMed® Drugs & Lactation DatabaseDrugs and Lactation Database, National Library of Medicine, 2006-(Present)

National Library of Medicine

Maternal MortalityReproductive Health, Maternal Mortality

Centers for Disease Control and Prevention

MedlinePlus®

U.S. National Library of Medicine site

U.S. National Library of Medicine

MedlinePlus directs you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. MedlinePlus also contains extensive information about drugs and supplements, an illustrated medical encyclopedia, the latest health news, and surgery videos.

Preconception & Prenatal CarePre-Pregnancy Care and Prenatal Care Resources, Resources for Researchers and Health Care Providers

Eunice Kennedy Shriver National Institute of Child & Human Development

Pregnancy: Safer Medication UseTreating for Two: Medicine and Pregnancy

Centers for Disease Control and Prevention

Behavioral Health Guidelines

Health ConditionClinical Guideline
ADHDClinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

American Academy of Pediatrics

Navigate ADHD Clinical Practice Guidelines Flier

DementiaDementia Care Practice Recommendations & Dementia Care Practice Recommendations, 2018

Alzheimer’s Association

The Alzheimer’s Association is not responsible for information or advice provided by others, including information or advice provided by others, including information on websites that link to Association sites and on third party sites to which the Association links. Please direct any questions to weblink@alz.org

Depression

Management of Major Depressive Disorder (MMD) (2022)

Veteran’s Affairs/Department of Defense Clinical Practice Guidelines

Depression Clinical Practice Guidelines Flier

Depression Adolescent

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management (March 2018)

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management

Opioid Use DisorderThe ASAM National Practice Guideline for the Treatment of Opioid Use Disorder, 2020 Focused Update

The American Society of Addiction Medicine

Behavioral Health Resources

Health ConditionClinical Guideline
Depression Screening Tool: PHQ-9Patient Health Questionnaire-9
Depression Screening Tool: PHQ-9 (Spanish)Cuestionario Sobre La Salud Del Paciente – 9
Depression Screening Tool: Pregnancy/PostpartumNavigate Edinburgh Postnatal Depression Scale

The 10-question Edinburgh Postnatal Depression Scale (EPDS) is a valuable and efficient way of identifying patients at risk for “perinatal” depression.

Mental Health and Substance Use Disorders Practitioner Training

SourcePractitioner Training Description
SAMHSA – Substance Abuse and Mental Health Services AdministrationPractitioner Training: SAMHSA’s practitioner training offers tools, training, and technical assistance to practitioners in the fields of mental health and substance use disorders.
MHFA – Mental Health First Aidhttps://www.mentalhealthfirstaid.org/