Western Health Advantage Clinical Practice Guidelines
The goal of WHA's plan-approved clinical practice guidelines is to improve patient health outcomes. WHA's guidelines are reviewed annually and meet the following criteria:
- Are evidence-based and adopted from recognized professional organizations.
- Relevant to WHA's population.
- Adopted in consultation with network health care professionals who treat populations with illnesses or diseases covered in the guidelines.
When established guidelines are not available, WHA will develop evidence-based guidelines with the professional recommendations of board-certified network practitioners.
- Appropriate board-certified practitioners and members of WHA's Quality Improvement Committee (QIC) will make recommendations for guidelines pertaining to their specialty area.
- Utilization management, member education, interpretation of covered benefits and practitioner feedback related to the guidelines will be considered as part of the development and review process.
The guidelines are presented to WHA's Quality Improvement Committee (QIC) for approval every two years or when new updates are made available prior to distributing to our providers.
WHA encourages our healthcare providers to use these guidelines to support clinical practices consistent with nationally recognized standards of care. Although clinical practice guidelines are considered the accepted minimum standard of care, they are not intended to replace clinical judgment. When applying these guidelines, the member's individual medical and psychosocial needs should be considered.
Behavioral Health Guidelines
Clinical Practice Guidelines