Blue Cross and Blue Shield of Oklahoma (BCBSOK) uses evidence-based clinical guidelines from nationally recognized sources to guide our quality and health management programs. Guidelines are designed to support the decision-making processes in patient care. Recommendations from other national entities may vary.
Clinical Practice Guidelines (CPGs) and Preventive Care Guidelines are adopted by BCBSOK and are the foundation for selected Condition Management Programs. These guidelines are based on established evidence-based standards of care, publicized by specialty societies and national clinical organizations. These guidelines are updated at least every 2 years and when new significant findings or major advancements in evidence-based practices and standards of care are established.
You may request a hard copy of a CPG by calling 866-670-6681. If you would like to comment on the CPGs adopted by BCBSOK, please email OKQADepartment@bcbsok.com.
The Clinical Practice Guidelines (CPGs) are meant to serve as general guidelines and are not intended to substitute for clinical judgment in individual cases. At this time, HCSC endorses the AAFP and ACP criteria for defining high blood pressure, which varies from the values provided in other guidelines. Providers are encouraged to make decisions based on their own judgement and most current evidence-based information available. The links below provide information about the CPGs:
- Asthma – Management and Prevention
- Cardiovascular Disease Guidelines
- Chronic Kidney Disease Guidelines
- COPD & Diagnosis Management and Prevention
- Diabetes Mellitus- Standards of Care
- Heart Failure Guidelines
- HIV Clinical Practice Guidelines
- Hypertension Guidelines
- Management of Overweight and Obesity in Adults
- Metabolic Syndrome Guidelines
- Sleep Apnea Guidelines
- Tobacco Cessation Guidelines
Shared Decision-Making Aids
Shared decision-making is a communications process. It’s a way for providers and patients to make informed health care decisions that align with what matters most to patients. Below are resources to help you involve your patients in shared decision-making.
These evidence-based aids provide information about treatment options, lifestyle changes and outcomes. They don’t replace your guidance but can help your conversations with patients.
Why it’s important: When patients help make decisions about their health care, it can lead to improved patient experience, better outcomes, and quality of life.
- Mayo Clinic Knowledge and Evaluation Research Unit Care That Fits Tools
- Acute Myocardial Infarction Choice
- Anticoagulation Choice
- Cardiovascular Primary Prevention Choice
- Chest Pain Choice
- Depression Medication Choice
- Diabetes Medication Choice
- Graves’ Disease Treatment Choice
- Head CT Choice
- Osteoporosis Choice
- Percutaneous Coronary Intervention Choice
- Rheumatoid Arthritis Choice
- Smoking Cessation Around the Time of Surgery
- Statin Choice