Clinical Practice Guidelines
Meridian encourages the use of evidence-based Clinical Practice Guidelines (CPGs) by our providers. Our Quality Improvement Committee approves and adopts CPGs for prevention, diagnosis and management of medical and behavioral health conditions. These guidelines are developed by the nationally-recognized National Committee for Quality Assurance (NCQA), MQIC or other CPG developers to develop clinical strategies to monitor and evaluate the quality of care provided to Medicare beneficiaries.
NCQA guidelines are reviewed and updated quarterly, or more frequently if necessary. Once approved by NCQA Medical Directors, CPGs are sent to the National Guideline Clearinghouse (NGC) for inclusion on the US Department of Health and Human Services Agency for Healthcare Research and Quality. NGC prepares structured abstracts for consistency of guidelines on their website.
Meridian promotes implementation of these CPGs via dissemination among practitioners and uses numerous performance measures to provide feedback to achieve consistent and high quality health outcomes for our members.
The CPGs are reviewed at least every two years and updated as necessary by the Meridian Health Plan Physician Advisory Committee (PAC), and approved by Meridian's Quality Improvement Committee and Board of Directors.
Please click below to view the guidelines in electronic format. They are also available in hard copy upon request by contacting the Medicare Quality Improvement department at 1-855-898-1470.
NCQA guidelines are now available through a free mobile app. Search "NCQA" in the App Store or Google Play and all guidelines can be downloaded right to your phone or tablet.
Recently Updated Clinical Practice Guidelines
- Diagnosis and Management of Adults with Chronic Kidney Disease (PDF)
- Quality Palliative Care
- Management of Uncomplicated Acute Bronchitis in Adults (PDF)
- Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance (PDF)
- Bipolar Disorder: Assessment and Management
Medical
- Acute Myocardial Infarction in Women (PDF)
- Adults with Heart Failure with Reduced Ejection Fraction (PDF)
- Adult Preventive Services (Ages 50 and older) (PDF)
- Advance Care Planning (PDF)
- Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care
- Asthma, Diagnosis and Management (PDF)
- Breast Cancer Screening
- Care Transitions (PDF)
- Cervical Cancer Screening
- Clinical Practice Guideline for the Management of Chronic Obstructive Pulmonary Disease (PDF)
- Colorectal Cancer Screening
- Comprehensive Diabetes Care (PDF)
- Diagnosis and Management of Adults with Chronic Kidney Disease (PDF)
- Diagnosis and Treatment of Low Back Pain (PDF)
- Disease Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis (PDF)
- Healthy Eating for the Prevention and Treatment of Metabolic and Endocrine Diseases in Adults (PDF)
- Heart Failure (PDF)
- Hypertension, Medical Management of Adults (PDF)
- In Office Use of Sedation (PDF)
- Interventions for patients with ST-Elevation Myocardial Infarction
- Lipid Screening and Management (PDF)
- Management and Prevention of Osteoporosis (PDF)
- Management of Acute Low Back Pain (PDF)
- Management of Diabetes (PDF)
- Management of Overweight and Obesity in the Adult (PDF)
- Management of Uncomplicated Acute Bronchitis in Adults (PDF)
- Managing Medicines for adults receiving social care in the community
- Physical Activity in Older Adults
- Potentially Harmful Drug-Disease Interactions in the Elderly (PDF)
- Prescribing Opioids for Chronic Pain (PDF)
- Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults
- Screening, Diagnosis and Referral for Substance Use Disorders (PDF)
Behavioral Health
- Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance (PDF)
- Bipolar Disorder: Assessment and Management
- Borderline Personality Disorder: Recognition and Management (PDF)
- Challenging Behavior and Learning Disabilities: Prevention and Interventions for People with Learning Disabilities Whose Behavior Challenges (PDF)
- Clinical Practice Guideline for the Management of Borderline Personality Disorder: National Health and Medical Research Council
- Clinical Practice Guideline for the Management of Substance Use Disorder (PDF)
- Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders, Advanced Sleep-Wake Phase Disorder (PDF)
- Core Elements in Responding to Mental Health Crises (PDF)
- Delirium: Prevention, Diagnosis and Management
- Depression in Adults: Recognition and Management
- Depression in Adults: Screening
- Eating Disorders: Recognition and Treatment (PDF)
- Guidelines on the Diagnosis and Management of Disorders Associated with Dementia
- Guideline Watch: Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder (PDF)
- Guideline Watch: Practice Guidelines for the Treatment of Patients with Bipolar Disorder, 2nd Edition (PDF)
- Guideline Watch: Practice Guidelines for the Treatment of Patients with Delirium (PDF)
- Guideline Watch: Practice Guideline for the Treatment of Patients with Eating Disorders, 3rd Edition (PDF)
- Guideline Watch: Practice Guidelines for the Treatment of Patients with Obsessive-Compulsive Disorder (PDF)
- Management of Depression in Patients with Cancer (PDF)
- Mental Health Problems in People with Learning Disabilities: Prevention, Assessment and Management (PDF)
- National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use (PDF)
- Parkinson's Disease in Adults
- Post-Traumatic Stress Disorder: Management (PDF)
- Post-Traumatic Stress Disorder and Acute Stress Reduction (PDF)
- Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder (PDF)
- Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder (PDF)
- Practice Guidelines for the Treatment of Patients with Alzheimer's Disease and Other Dementias, 2nd Edition (PDF)
- Practice Guideline for the Treatment of Patients with Eating Disorders, 3rd Edition (PDF)
- Practice Guidelines for the Treatment of Patients with Major Depressive Disorder (PDF)
- Psychiatric Evaluation of Adults, 3rd Edition
- Psychosis and Schizophrenia in Adults: Prevention and Management (PDF)
- Psychosomatic Medicine Practice Guidelines for Psychiatric Consultation (PDF)
- Schizophrenia Practice Guidelines (PDF)
- Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults with Cancer: An American Society of Clinical Oncology Guideline Adaptation
- Self-Harm in Over 8s: Long Term Management (PDF)
- Self-Harm in Over 8s: Short-Term Management and Prevention of Recurrence (PDF)
- The Management of Major Depressive Disorder (PDF)
- Treating Pregnant and Parenting Women with Opioid Use Disorder and their Infants
- Treatment of Patients with Delirium (PDF)
- Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia (PDF)
- Use of High Risk Medications in the Elderly (PDF)