Clinical Practice Guidelines

In recent years, the process of developing clinical practice guidelines has undergone significant re-evaluation by national professional organizations including the American Medical Association and the Institute of Medicine. With an eye toward increasing rigor and improving transparency, these organizations have articulated principles that form the foundation for new standards of guideline development. The American Psychiatric Association (APA) and the American Academy of Child and Adolescent Psychiatry (AACAP) have both published statements on their websites in support of these new standards.

Historically Beacon Health Options, Inc. (Beacon) and its legacy companies adopted clinical practice guidelines published by the APA, AACAP and other professional organizations. This was based on their reputation as primary contributors and developers of guidelines representing acceptable standards of care at the time of origination.

Related to the continued evolution of clinical practice guideline development calling for higher standards of evidence, the industry currently has maintained or produced a limited number of guidelines that meet the new standards for guideline rigor and transparency. Accordingly, Beacon has reviewed and adopted the following guidelines that meet those standards:

Clinical practice guidelines that were developed prior to the implementation of the revised guideline development standards and previously adopted by Beacon are provided below. Although not meeting the highest evidentiary formulation standards, these guidelines still contain information that continues to be clinically relevant. For example, some of the guidelines may recommend specific treatment interventions without adequately addressing the sufficiency of the evidence to support the recommendation. Continued use of the guidelines is warranted because resultant positive clinical contribution outweighs the fact that the summaries of the supporting research may have lacked adequate transparency related to the process of ranking the studies necessary to meet today’s standards of guideline development. Practices represented in these guidelines often are validated as the community standard of care but the rigorous scientific research confirmation is still in process.

In sum, we find the CPGs being utilized represent the best clinical information we have at this time. Until such time that updated information is developed, the CPGs are appropriate for use where applicable.

Anxiety Disorders

Assessment of Suicide Risk

Attention-Deficit Disorder

Autism Spectrum Disorders (ASD)

Eating Disorders

Mood Disorders

Psychotic Disorders

Substance Use Disorders (SUD)

Special Topic Guidelines

Screening Instruments

The Beacon Health Options Scientific Review Committee (SRC) reviews and/or updates each guideline at least every two years. In addition, if the original source of the guideline publishes an update or makes a change, the SRC will initiate additional review of the guideline prior to the two-year review cycle. Updates/changes are then presented to the Beacon Health Options Corporate Medical Management Committee for final approval. Please note that the SRC completes literature reviews as part of this process and at times will adopt/re-adopt a guideline that is more than five years old if it is determined that it remains a best practice and an industry standard of care.