Practice guidelines

Aetna Better Health’s Clinical Practice Guidelines (CPG’s) and Preventive Health Guidelines (PHG’s) are based on nationally recognized recommendations and peer reviewed medical literature.

 

Aetna Better Health adopts evidence-based clinical practice guidelines (CPGs) from nationally-recognized sources. CPGs are tools that help practitioners make decisions about appropriate health care for specific clinical circumstances.  The Aetna National Guideline Committee reviews CPGs every two years or more frequently if national guidelines change within the two-year period.

CPGs are provided for informational purposes only and are not meant to direct individual treatment decisions. All patient care and related decisions are the sole responsibility of providers.  These guidelines do not dictate or control a provider’s clinical judgement regarding the appropriate treatment of a patient in any given case.

Formally adopted CPGs can be accessed using the following link:

Clinical Practice Guidelines

Aetna Better Health adopts nationally accepted evidence-based preventive services guidelines from the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention. When there is lack of sufficient evidence to recommend for or against a service by these sources, or conflicting interpretation of evidence, we may adopt recommendations from other nationally recognized sources. The guidelines are adopted to facilitate improved health care and to reduce unnecessary variation in care. They are not intended to direct coverage or benefits determinations, or treatment decision.

Guidelines

 

 Recognized Source

 Preventive Service Guidelines

 

 U.S. Preventive Services Task Force (USPSTF)

 Immunization schedules

 

 CDC

 

Preventive Health Services:

These documents are updated on an annual basis. Caution is advised as recommendations often change.  The online summaries of recommendations do not represent benefits; not all recommended services are necessarily covered by a member’s health plan.  Therefore, members must refer to their plan documents, contact their employer’s benefits department or contact Member Services directly for coverage information.

Formally adopted preventive health guidelines can be accessed through the link below:

Preventive Service Recommendations

The following links provide the immunization schedules:

Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger

Recommended Immunization Schedule for Adults Aged 19 Years or Older