The 2023 Preventive Health Guidelines are now available on the Provider Resource Center.

Every year, Highmark and participating network physicians review and update the Preventive Health Guidelines, which are made available to the practitioner community as a reference tool to encourage and assist you in planning your patients’ care.

What’s Changing

For 2023, Highmark’s Preventive Health Guidelines feature these changes:

Under the Expanded Patient Protection and Affordable Care Act (PPACA), mandated benefits include:


Women’s Health:

Nutritional counseling for Obesity Prevention in midlife women, ages 40 to 60 years old, with normal body mass index (BMI) and overweight BMI.

  • Explanation: Women’s Preventive Services Initiative recommends counseling midlife women with normal or overweight BMI (18.5-29.9 kg/m2) to maintain weight or limit weight gain for preventing obesity. Counseling may include individualized discussion of healthy eating and physical activity.


Aspirin No Longer Recommended:

Taking a small daily dose of aspirin to reduce the risk of stroke and heart attack is no longer recommended for healthy people between the ages 50 to 59.

  • Explanation: United States Preventive Services Task Force (USPSTF) update removed B rating grade and lowered the recommendation to a C grade, which does not require a zero-cost share under the preventive Affordable Care Act mandate. The midyear 2022 update notified members via a footnote that the benefit would no longer be effective beginning January 1, 2023.

Download the Guidelines

To help make the information more accessible and convenient for you, the complete set of 2023 Preventive Health Guidelines is posted online. Just visit the Provider Resource Center, go to EDUCATION/MANUALS, and then select Preventive Health Guidelines.

The page includes the following downloadable guidelines:

pdf

To obtain a paper copy of the guidelines, write to:

Highmark
Director, Health Plan Quality
Fifth Avenue Place
120 Fifth Avenue, Suite P4425
Pittsburgh, PA 15222

 

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