It is the policy of ABS to promote nationally recognized clinical practice guidelines (CPGs) that promote cost-effective quality health care to members. The clinical guideline development process is a laborious and rigorous process designed to produce concise evidence-based recommendations that will improve the quality of care delivered. In most cases the National Guideline Clearinghouse (NGC) is utilized for CPGs. NGC is an initiative of the Agency for Healthcare Research and Quality (AHRQ) and the U.S. Department of Health and Human Services. NGC was originally created by AHRQ in partnership with the American Medical Association and the American Association of Health Plans (now America’s Health Insurance Plans [AHIP]). The NGC mission is to provide physicians and other health professionals, health care providers, health plans, integrated delivery systems, purchasers, and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation, and use.
Other acceptable CPGs are The Michigan Quality Improvement Consortium guidelines. The Michigan Quality Improvement Consortium establishes and implements clinical practice guidelines and performance measures with a focus on improvement for effecting positive health outcomes for residents of the state of Michigan. MQIC guidelines are updated every two years. In additional ABS supports the use of recommendations from US Preventive Services Task Force (USPSTF).
If you would like to review or discuss the appropriate clinical practice guideline, please contact Barbara Kelly, RN, BS, CCM the ABS Manager of Care Management by phone: 586.693.1216 or via email at bkelly@abs-tpa.com.
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