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Preventive Healthcare 'Wellness' Guidelines by Age and Sex
Apollo Managed Care Consultants, Feb 2009, Pages: 90
Prevention embodies all activities that identify, promote, preserve and restore health and wellness.
Mission:
The mission of the preventive health risk assessment, wellness and preventive care program is to collaboratively advocate and institute appropriate and relevant interventions that lead to improved mental and physical health and well-being.
Vision:
We will provide our members and those in our community the information necessary for disease prevention or early disease detection. Recognizing that prevention starts with the individual, we will focus on providing preventive health care, safety, nutritional and other educational information to our members to promote self-awareness and responsibility. The program will account for cultural diversity to ensure that the information is received and understood by all members.
Core values:
To eliminate barriers to the delivery of proven and effective prevention and wellness services to our members or patients.
Policy:
1. The Health Plan/Medical Group will inform individual members and providers about health promotion and preventive health services available to them and encourage members to seek appropriate services.
2. The Health Plan/Medical Group will distribute preventive health guidelines to members and providers annually. All new providers will receive a copy of the guidelines in the Health Plan Provider Manual.
3. The Quality Improvement Program Medical Director will review the preventive health care screening guidelines annually. The guidelines will be updated or modified based on objective scientific-based evidence. The guidelines will then be reviewed and approved, following additional modifications, if any, annually by the Medical Policy Committee and the Quality Management Committee.
4. The Health Plan Quality Improvement Program will assess the use of preventive health services annually following NCQA HEDIS criteria or other objective evidence-based national standards.
Criteria for the Selection of Screening Measures
1. The condition must affect the quality of life or longevity.
2. Recognized methods of treatment must be available.
3. The condition must have a relatively or absolute asymptomatic interval, and if detected during this period of time, treatment will reduce mortality or
morbidity.
4. Early treatment is advantageous as compared to delayed treatment that is initiated only following the onset of symptoms.
5. Accurate and reliable tests must be available to detect the condition while asymptomatic.
6. The incidence of the condition must be sufficient to justify the costs of screening.
7. The patient should understand the pros and cons of screening for a given condition, including the likelihood of false-positive test results and subsequent additional testing, possibly invasive and associated with potential complications, that would not otherwise occur.
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