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Clinical Practice Guidelines

Pediatric Preventive Guidelines:

Approved June 2022

Well-Child Visits in the First 30 Months of Life (W30) HEDIS®

The percentage of members who had the following number of well-child visits with a PCP during the last 15 months. The two rates are reported:

  • Well-Child Visits in the First 15 Months. Children who turned 15 months old during the measurement year: Six or more well-child visits.
  • Well-Child Visits for Age 15 Months–30 Months. Children who turned 30 months old during the measurement year: Two or more well-child visits.

Child and Adolescent Well-Care Visits (WCV) HEDIS®

The percentage of members 3–21 years of age who had at least one comprehensive well-care visit with a PCP or an ob-gyn practitioner during the measurement year.

Nationally Recognized Sources

Committee on Practice and Ambulatory Medicine, Bright Futures Periodicity Schedule Workgroup. 2022
Recommendations for preventive pediatric health care. Pediatrics. 2022

Copyright 2021 by the American Academy of Pediatrics, updated March 2021.

AAP Periodicity Schedule (aap.org)

Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2017

2022 Recommendations for Preventive Pediatric Health Care – American Academy of Pediatrics (aap.org)

ADHD:

Approved June 2022

Clinical Practice Guideline for the Diagnosis, Evaluation and Treatment of Attention-Deficit Disorder in Children and Adolescents in the Primary Care Setting

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan via HEDIS)

Follow-Up Care for Children Prescribed ADHD Medication (ADD) HEDIS®

The percentage of children newly prescribed attention-deficit/hyperactivity disorder medication (ADHD) who had at least three follow-up visits within a 10-month period, one of which was within 30 days of when the first ADHD medication was dispensed. Two rates reported:

  • Initiation Phase: The percentage of members 6-12 years of age with an ambulatory prescription dispensed for ADHD medication, who had one follow-up visit with a practitioner with prescribing authority during the 30-day Initiation Phase.
  • Continuation and Maintenance Phase: The percentage of members 6-12 years of age with an ambulatory prescription dispensed for ADHD medication, who remained on the medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.

Nationally Recognized Sources

ADHD: Clinical Practice Guidelines for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Clinical Practice Guideline from the American Academy of Pediatrics

CDC ADHD Treatment Recommendations ADHD in Children and Adolescents (aafp.org)

Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (aappublications.org)

Wolraich ML, Hagan JF, Allan C, et al; Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactive Disorder. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4):e20192528 (aappublications.org)

Anxiety:

Approved June 2022

Treatment of Adults (18 years old and older) with General Anxiety Disorder (GAD) in the Primary Care Setting

Nationally Recognized Source

American Academy of Family Physicians: Anxiety Disorders

AAFP – Anxiety Disorders View Guidelines Generalized Anxiety Disorder (fpnotebook.com) Generalized Anxiety Disorder – StatPearls – NCBI Bookshelf (nih.gov)

Anxiety:

Approved June 2022

Treatment of Children and Adolescents with Anxiety Disorders

Nationally Recognized Source

Journal of the American Academy of Child & Adolescent Psychiatry

Journal of the American Academy of Child & Adolescent Psychiatry Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders

Depression:

Approved June 2022

Managing Adults with Depression in the Primary Care Setting

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan via HEDIS)

Antidepressant Medication Management (AMM) HEDIS®

The percentage of members 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression and who remained on an antidepressant medication treatment. Two rates reported:

  • Effective Acute Phase Treatment: The percentage of members who remained on an antidepressant medication for at least 84 days (12 weeks)
  • Effective Continuation Phase Treatment: The percentage of members who remained on an antidepressant medication for at least 180 days (6 months)

Nationally Recognized Sources

Nonpharmacologic Versus Pharmacologic Treatment of Adult Patients with Major Depressive Disorder: A Clinical Practice Guideline from the American College of Physicians

American College of Physicians Clinical Practice Guideline for Adult Patients with Major Depressive Disorder

Managing depression in primary care – PVC (nih.gov)

Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts (apa.org)

Depression:

Approved June 2022

Managing Depression in Children and Adolescents less than 18 years old in Primary Care Setting

Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) HEDIS®

The percentage of members 12 years of age and older who were screened for clinical depression using a standardize instrument and, if screened positive, received follow-up care.

  • Depression Screening. The percentage of members who were screened for clinical depression using a standardized instrument.
  • Follow-Up on Positive Screen. The percentage of members who received follow -up care within 30 days of a positive depression screen finding.

Depression Remission or Response for Adolescent and Adults (DRR-E) HEDIS®

The percentage of members 12 years of age and older with a diagnosis of depression and an elevated PHQ-9 score, who had evidence of response or remission within 4-8 months of the elevated score

  • Follow-up PHQ-9. The percentage of members who have a follow-up PHQ-0 score documented within 4-8 months after the initial elevated PHQ-0 score.
  • Depression remission. The percentage of members who achieved remission within 4-8 months after the initial elevated PHQ-9 score.
  • Depression response. The percentage of members who showed response within 4-8 month after the initial elevated PHQ-9 score.

Nationally Recognized Source

American Academy of Pediatrics

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part 1

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management (aap.org)

Depression in children and adolescents in primary care – Cheung – Pediatric Medicine (amegroups.com)

Opioid Use:

Approved June 2022

Adult Opioid Prescription Management

Quality Performance Indicators
(Clinical Indicators Measured by UPMC Health Plan via HEDIS®)

Use of Opioids at High Dosage (HDO) HEDIS®

Members 18 years old and older who received prescription opioids at a high dosage (average morphine milligram equivalent dose (MME) ≥ 90) for ≥ 15 days during the measurement year.

Use of Opioids from Multiple Providers (UOP) HEDIS®

Members 18 years old and older, receiving prescription opioids for ≥15 days during the measurement year who receive opioids from multiple providers. Three rates are reported:

  • Multiple prescribers: The proportion of members receiving prescriptions for opioids from four or more different prescribers during the measurement year
  • Multiple pharmacies: The proportion of members receiving prescriptions for opioids from four or more different pharmacies during the measurement year
  • Multiple prescribers and multiple pharmacies The proportion of members receiving prescriptions for opioids from four or more different prescribers and four or more different pharmacies during the measurement year

Risk of Continued Opioid Use (COU) HEDIS®

Members 18 years old and older who have a new episode of opioid use that puts them at risk for continued opioid use. Two rates are reported:

  • The percentage of members with at least 15 days of prescription opioids in a 30-day period
  • The percentage of members with at least 31 days of prescription opioids in a 62-day period

Nationally Recognized Sources

CDC Guideline for Prescribing Opioids for Chronic Pain (Updated 8/28/2019)
CDC Opioid Prescribing Guideline

PA Opioid Prescribing Guidelines
PA Department of Health Opioid Prescribing Guidelines

Pain Management Best Practices Inter-Agency Task Force Report
Pain Management Best Practices Inter-Agency Task Force Report (HHS.gov)

Substance Abuse:

Approved June 2022

Treatment of Adults (18 years old and older) with Substance Abuse Disorders in the Primary Care Setting

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan via HEDIS)

Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET) HEDIS®

The percentage of new substance use disorder (SUD) episodes that result in treatment initiation and engagement

  • Initiation of SUD treatment. The percentage of new SUD episodes that result in treatment initiation through an inpatient SUD admission, outpatient visit, intensive outpatient encounter, partial hospitalization, telehealth or medication treatment within 14 days
  • Engagement of SUD treatment. The percentage of new SUD episodes that have evidence of treatment engagement within 34 days of the initiation

Nationally Recognized Sources

Unhealthy Alcohol and Drug Use: Adult, Primary Care, Clinical Practice Guideline
Unhealthy Alcohol and Drug Use: Adult, Primary Care, Clinical Practice Guideline

Journal of Addiction Medicine

Prescribe to Prevent: Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists

NIH: National Institute on Drug Abuse

Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) Screening for Substance Use in the Family Medicine/Obstetrics Setting

Adult Cholesterol Management:

Approved June 2022

Statin Therapy for Patients with Cardiovascular Disease (SPC) HEDIS®

The percentage of males ages 21-75 and females ages 40-75 who were identified as having clinical atherosclerotic cardiovascular disease (ASCVD) and met the following criteria. Two rates are reported:

  • Received Statin Therapy. Members who were dispensed at least one high-intensity or moderate-intensity statin medication during the measurement year.
  • Statin Adherence 80%. Members who remained on a high-intensity or moderate-intensity statin medication of any intensity for at least 80% of the treatment period.

Nationally Recognized Source

Report of the American College of Cardiology/American Heart Association Task Force: 2018 Guideline on the Management of Blood Cholesterol

Guidelines Made Simple Tool – 2018 Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers

Adult Diabetes:

Approved June 2022

Adult Diabetes Management

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan via HEDIS)

Hemoglobin A1C Control for Patients with Diabetes (HBD) HEDIS®

Members 18-75 years of age with diabetes (types 1 and 2) whose hemoglobin A1C was at the following levels:

  • HbA1c control (<8.0%)
  • HbA1c poor control (>9.0%)

Blood Pressure Control for Patients with Diabetes (BPD) HEDIS®

Members 18-75 years of age with diabetes (types 1 and 2) whose blood pressure was adequately controlled (<140/90 mm Hg)

Eye Exam for Patients with Diabetes (EED) HEDIS®

Members 18-75 years of age with diabetes (types 1 and 2) who had a retinal eye exam

Kidney Health Evaluation for Patients with Diabetes (KED) HEDIS®

Members 18-75 years of age with diabetes (types 1 and 2) who received a kidney health evaluation, defined by an estimated glomerular filtration rate (eGFR) and a urine albumin-creatine ratio (uACR)

Nationally Recognized Sources

American Diabetes Association Guideline for the Diagnosis and Management of Diabetes

Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers Summary of Revisions: Standards of Medical Care in Diabetes—2020

Asthma:

Approved June 2022

Management of all members with asthma

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan HEDIS®)

Asthma Medication Ratio (AMR) HEDIS®

The percentage of members 5-64 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater

Nationally Recognized Source

2022 GINA Report, Global Strategy for Asthma Management and Prevention
*Please refer to pages 14-15 of the report for the “What’s new Summary”

GINA Main Report 2022

Cardiovascular Risk Factors and Coronary Artery Disease:

Approved June 2022

Recommendations for all adult members without known Coronary Heart Disease (CHD) whose symptoms suggest chronic stable angina, members with known stable angina, asymptomatic members with evidence suggesting CHD on previous testing or with risk factors that predispose them to CHD and those who have had a past MI or coronary artery revascularization procedure

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan via HEDIS)

Statin Therapy for Patients with Cardiovascular Disease (SPC) HEDIS®

The percentage of males 21-75 years of age and females 40-75 years of age who were identified as having clinical atherosclerotic cardiovascular disease (ASCVD) and met the following criteria:

  • Received Statin Therapy: Members who were dispensed at least one high or moderate-intensity statin medication
  • Statin Adherence 80%: Members who remained on a high or moderate-intensity statin medication for at least 80% of the treatment period

Persistence of Beta-Blocker Treatment After a Heart Attack (PBH) HEDIS®

The percentage of members 18 years of age and older who were hospitalized and discharged with a diagnosis of Acute Myocardial Infarction (AMI) who received persistent beta-blocker treatment for six months after discharge.

Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia (SMC) HEDIS®

The percentage of members 18-64 years of age with schizophrenia and cardiovascular disease, who had an LDL-C test.

Nationally Recognized Sources

AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2011 Update A Guideline from the American Heart Association and American College of Cardiology Foundation
AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update (ahajournals.org)

2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk
2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk (ahajournals.org)

2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk (ahajournals.org)

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (ahajournals.org)

COPD:

Approved June 2022

Management of adult members with stable COPD and acute exacerbations of COPD

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan via HEDIS)

Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR) HEDIS®

The percentage of members 40 years of age and older with a new diagnosis of COPD or newly active COPD who received appropriate spirometry testing to confirm the diagnosis

Pharmacotherapy Management of COPD Exacerbation (PCE) HEDIS®

The percentage of COPD exacerbations for members 40 years of age and older who had an acute inpatient discharge or ED visit during the measurement year and who were dispensed appropriate medications. Two rates reported:

  • Dispensed a systemic corticosteroid (or there was evidence of an active prescription) within 14 days of the event
  • Dispensed a bronchodilator (or there was evidence of an active prescription) within 30 days of the event

Nationally Recognized Source

The Global Initiative for Chronic Obstructive Lung Disease (GOLD)
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease

AAFP COPD: Clinical Guidance and Practice Resources
COPD: Clinical Guidance and Practice Resources

COPD Toolkit

UPMC Health Plan is pleased to provide you with this COPD Toolkit. It contains a variety of patient education materials as well as information on best practices for the diagnosis and treatment of chronic obstructive pulmonary disease. We’ve developed the below toolkit to support you and your practice in caring for your COPD population.

Provider Materials:

  • COPD tip sheet—Features a recently published COPD treatment algorithm from JAMA, the COPD Assessment Test (CAT™), and a description of the HEDIS® quality measures on COPD
  • Certified Tobacco Cessation counselor tip sheet—How to become a Tobacco Cessation Program (TCP) provider complete with billing and payment information for tobacco cessation counseling services
  • E-cigarettes tip sheet—Details the risks of vaping and e-cigarettes
  • UPMC Prescription for Wellness quick reference guide—Explains the health and wellness resources available to members and how providers can offer support via UPMC Prescription for Wellness
  • MarketingExpress instructions—How to order marketing materials at no cost and have them delivered to your office (everything included in this folder and more)
  • JAMA article—Titled Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review, written in part by pulmonologist Dr. Craig Riley
  • COPD Pocket Consultant Guide mobile app—Available on both iOS and Android, this COPD Foundation app is designed to support the treatment and management of COPD
  • COPD podcast instructions—How to find our podcast series discussing current practice standards for diagnosing, treating, and managing COPD, hosted by a pulmonologist (you can earn CME credits by engaging with the series)
  • Pharmacy-related information—Includes links to formularies and medication information and lets you narrow your search results by choosing type of health insurance coverage and specific pharmacy benefit program (once the directory is open, search for the drug of choice in the search window)
  • Palliative care—The UPMC Palliative and Supportive Institute is a centrally managed network of professionals who provide resources to improve the quality of life for patients with serious or life-limiting illnesses
  • Pulmonary rehabilitation—Includes a list of addresses and phone numbers of sites for adult pulmonary rehabilitation.

Patient Materials:

Educational Videos

Please see below for short and helpful educational videos:

Medications

Oxygen

Sleep Apnea

Pulmonary Rehabilitation

COPD Teaching

Heart Failure Guidelines:

Approved June 2022

Persistence of Beta-Blocker treatment After a Heart Attack (PHB) HEDIS®

The percentage of members 18 years of age and older during the measurement year who were hospitalized and discharged from July 1 of the year prior to June 30 of the measurement year with a diagnosis of AMI and who received persistent beta-blocker treatment for six months after discharge.

Controlling High Blood Pressure (CBP) HEDIS®

The percentage of members 18-85 years of age who had a diagnosis of hypertension (HTN) and whose BP was adequately controlled (<140/90 mm Hg) during the measurement year.

Nationally Recognized Sources

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
JACC: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (ahajournals.org)

Hypertension Management:

Approved June 2022

Management of all members ages 18-85 with hypertension

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan via HEDIS)

Controlling High Blood Pressure (CBP) HEDIS®

The percentage of members 18-85 years of age who had a diagnosis of hypertension (HTN) and whose BP was adequately controlled (<140/90 mmHg) during the measurement year

Nationally Recognized Sources

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

2013 ACCF/AHA Guideline for the Management of Heart Failure (jacc.org) Correction (jacc.org)

JNC 8 Guidelines for the Management of Hypertension in Adults
JNC 8 Guidelines for the Management of Hypertension in Adults (aafp.org)

Older Adults and Hypertension: Beyond the 2017 Guideline
Older Adults and Hypertension: Beyond the 2017 Guideline for Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults - American College of Cardiology (acc.org)

New Guidance on Blood Pressure Management in Low-Risk Adults with Stage 1 Hypertension
New Guidance on Blood Pressure Management in Low-Risk Adults with Stage 1 Hypertension – American College of Cardiology (acc.org)

Adult Preventive Guidelines:

Approved June 2022

Adults' Access to Preventive/Ambulatory Health Services (AAP) HEDIS®

The percentage of members 20 years old and older who had an ambulatory or preventive care visit. Three rates are reported:

  • Medicaid and Medicare members who has an ambulatory or preventive care visit during the measurement year.
  • Commercial members who has an ambulatory or preventive care visit during the measurement year or two years prior to the measurement year.

Nationally Recognized Source

Adult Preventive Health Care Schedule: Recommendations from the USPSTF (as of June 2022) USPSTF Health care Schedule 2022 (aafp.org)

Prenatal Clinical Practice Guidelines:

Approved June 2022

Care provided throughout the course of an entire pregnancy with the goal of preventing and/or minimizing complications as well as decreasing the incidence of maternal and perinatal mortality

Quality Performance Indicators

(Clinical Indicators Measured by UPMC Health Plan via HEDIS)

Prenatal and Postpartum Care (PPC) HEDIS®

The percentage of deliveries of live births assessing the following facets of prenatal and postpartum care

  • Timeliness of Prenatal Care: The percentage of deliveries that received a prenatal care visit in the 1st trimester, on the enrollment start date or within 42 days of enrollment
  • Postpartum Care: The percentage of deliveries that had a postpartum visit on or between 7 and 84 days after delivery

Nationally Recognized Sources

U.S. Preventive Services Task Force

Recommendation: Perinatal Depression: Preventive Interventions – United States Preventive Services Taskforce (uspreventiveservicestaskforce.org)

American Congress of Obstetricians and Gynecologists (ACOG)

Clinical Search Results – ACOG

**Additional Resources for UPMC Health Plan Members

  • UPMC MyHealth 24/7 Nurse Line is staffed by experienced registered nurses and is available 24/7 to provide telephone support to members. Call 1-866-918-1591. TTY users should call 711.
  • Health coach Programs provide intensive case management for members with specific chronic illnesses or conditions. The programs are built upon best practices and accepted clinical guidelines and include:
    • Diabetes
    • Respiratory
    • Asthma
    • COPD
    • Behavioral health
    • Depression
    • Cardiovascular
    • Heart failure
    • Coronary artery disease
    • Hypertension
    • Hyperlipidemia

Members and providers can get additional health coaching program information by calling 1-866-778-6073.

UPMC Prescription for Wellness is a physician-prescribed, EMR-integrated and practice-supported health coaching program to support you, your office staff, and—most importantly—your patients and their family. Our programs extend your influence between office visits by helping your patients stay with the care plans you create for them. You simply “prescribe” healthier behaviors, common disease management skills, or decision making skills with a UPMC Health Plan health coach by “writing” a Prescription for Wellness that is placed along with all other orders at the time of the visit. Instruct the patient to read the printed prescription and call in immediately to talk to a coach. Providers can write a Prescription for Wellness in EpicCare or through Provider OnLine. You may select from the following list of health management programs and write in any concerns to be addressed. The order automatically generates a referral to the Health Plan with the referral information. If we don’t hear from your patient in 48 hours, we call the patient to get them started on their way to better health and care. Within 30 days you receive a follow-up note on your patient’s progress in EpicCare or Provider OnLine. Patients are much more likely to complete a program if their doctor “prescribes” healthy behaviors and self-management. Engagement rates in health coaching programs through Prescription for Wellness are two to 10 times greater compared to other referral routes.

Learn More About UPMC Prescription for Wellness

Health Management Programs

  • Physical health conditions
    • Respiratory health
      • Asthma (for adults and parents/caregivers)
      • COPD
    • Cardiovascular health
      • Heart failure
      • Coronary artery disease
      • Hypertension
      • Hyperlipidemia
      • A-fib
      • Post MI/CABG
    • Diabetes (for adults and parents/caregivers)
      • Low back pain
      • Chronic kidney disease
      • ESRD
  • Behavioral health
    • ADHD (for parents and caregivers)
    • Anxiety
    • Depression
    • Substance use
    • High-risk behavioral health
  • Lifestyle coaching
    • Weight management
    • Physical activity
    • Nutrition basics
    • Stress management
    • Tobacco cessation
  • Rare and chronic conditions
    • Rheumatoid arthritis
    • Parkinson’s disease
    • Sickle cell anemia
    • Hemophilia
    • Epilepsy
    • Multiple sclerosis
    • Inflammatory bowel disease
    • Hepatitis C
  • Care management (CM)
    • Adult
    • Maternity
    • Pediatrics
    • Start SMART Program (Seizure management awareness and recognition)

For additional information:

  • Providers can call 1-855-772-8762 or email healthplansparef@upmc.edu.
  • Members can call 1-866-778-6073.

Online interactive preventive health programs and resources are available in partnership with WebMD at www.upmchealthplan.com.

  • MyHealth Ready to Quit®
  • MyHealth Step Up to Wellness®
  • MyHealth Eating Well
  • MyHealth Weigh to Wellness®
  • MyHealth Less Stress
  • Emotional health program