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Program/Recognition Description
Accepts Online Visits Aetna provides a secure, web-based service through RelayHealth that makes it easy for you to contact with your doctor's office. You can make appointments, renew prescriptions, ask non-urgent questions, and get lab results all from your home computer.
Bridges To Excellence (BTE) Recognition in Asthma Care Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. It rewards doctors who meet standards for excellent care.

BTE has a program for asthma experts. To earn recognition, primary care doctors, lung specialists, and allergy and immunology specialists must meet standards in areas such as:

  • Lung function test and monitoring
  • Drug therapy
  • Smoking cessation
  • Annual flu vaccines
Bridges To Excellence (BTE) Recognition in Back Pain Care Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. It rewards doctors who meet standards for excellent care.

Treatments for low-back pain range from simple self care to costly surgery that often doesn't help. BTE has a program for back pain experts. To earn recognition, primary care doctors must meet standards in areas such as:

  • Recommendations for appropriate physical activity
  • Avoidance of unnecessary imaging
  • Use of epidural injections and surgery
  • Patient education
  • Inclusion of the patient in decisions about surgery and alternatives to surgery
Bridges To Excellence (BTE) Recognition in Congestive Heart Failure (CHF) Care Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. The program rewards doctors who meet standards for excellent care.

BTE has a program for Congestive Heart Failure (CHF). This debilitating illness affects more Americans each year.

To earn recognition, primary care doctors and heart specialists (cardiologists) must meet standards in areas such as:
  • Beta Blocker therapy
  • LV function assessment
  • Appropriate ACE-I/ARB therapy
  • Assessment of patient weight and activity level
  • Patient education
Bridges To Excellence (BTE) Recognition in Chronic Obstructive Pulmonary Disease (COPD) Care Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. The program rewards doctors who meet standards for excellent care.

BTE has a program for Chronic Obstructive Pulmonary Disease (COPD). COPD is one of the leading causes of death in the United States. To earn recognition, primary care doctors, lung specialists (pulmonologists), and allergy and immunology specialists must meet standards in areas such as:

  • Spirometry evaluation and monitoring
  • Inhaled bronchodilator therapy
  • Smoking cessation
  • Assessment of oxygen saturation and long-term oxygen therapy
  • Annual flu vaccines
Bridges To Excellence (BTE) Recognition in Coronary Artery Disease (CAD) Care Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. The program rewards doctors who meet standards for excellent care.

BTE has a program in Coronary Artery Disease (CAD). CAD disease is the leading cause of death in the United States for both men and women. To earn recognition, primary care doctors and heart specialists (cardiologists) must meet standards in areas such as:

  • Blood pressure and lipid management
  • Evaluation of activity level and anginal symptoms
  • Smoking cessation
  • Aspirin/antiplatelet therapy
  • Beta blocker treatment after a heart attack
Bridges To Excellence (BTE) Recognition in Diabetes Care Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. The program rewards doctors who meet standards for excellent care.

BTE has a program in Diabetes Care. Millions of Americans have diabetes. Many more people don't know they have diabetes. To earn recognition, primary care doctors and diabetes specialists (endocrinologists) must meet standards in areas such as:

  • Blood pressure
  • LDL levels
  • HgBA1c levels
  • Vision and foot care exams
  • Assessment of nerve damage
Bridges To Excellence (BTE) Recognition in Cardiac Care Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. The program rewards doctors who meet standards for excellent care.

BTE has a program in Cardiac Care. Heart (cardiovascular) disease includes many very serious and costly conditions. One of these is Ischemic Heart Disease (IHD). To earn recognition, primary care doctors heart specialists (cardiologists), and neurologists must meet standards in areas such as:

  • Blood pressure and LDL levels
  • Complete lipid profile
  • Use of aspirin or other antithrombotic medicines
  • Smoking cessation
Bridges To Excellence (BTE) Recognition in Hypertension Care Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. The program rewards doctors who meet standards for excellent care.

BTE has a program in Hypertension Care. High blood pressure, or hypertension, affects millions of Americans. It costs billions of dollars to treat every year.

To earn recognition, primary care doctors, heart specialists (cardiologists), and kidney specialists (nephrologists) must meet standards in areas such as:

  • Blood pressure and lipid management
  • Aspirin use
  • Diabetes screening
  • Smoking cessation
  • Urine protein test
  • Counseling for diet and physical activity
Bridges To Excellence (BTE) Recognition in Office Systems Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. The program rewards doctors who meet standards for excellent care.

BTE has a program for Office Systems. To earn recognition, medical practices must show that their office processes reduce errors and increase quality of care. The program includes three levels of recognition.
Bridges To Excellence (BTE) Recognition in Patient Centered Medical Home Bridges To Excellence (BTE) is a recognition program for doctors of the Health Care Incentives Improvement Institute (HCI3). HCI3 is a non-profit organization, guided by a Board of Directors that includes physicians, employers, health plans, and others. BTE measures the quality of care doctors provide to patients. The program rewards doctors who meet standards for excellent care.

BTE has a program in Patient Centered Medical Home. One doctor coordinates a patient's care with a team of doctors. To earn BTE Medical Home designation, doctors must follow certain treatment guidelines and "best practices." And they must use appropriate health information technology to provide better care and improve patients' health. Doctors are then held responsible for the results.
Elective Delivery Infant Safety Program An elective delivery means that the doctor and patient schedule a date for the baby to be born. Deliveries scheduled before 39 completed weeks of pregnancy, can be harmful to a mother and her baby. It increases the risk of premature birth, for example: Babies born before 39 completed weeks of pregnancy may have medical problems that need extra medical care. This means they may need to spend more time in the hospital or in the neonatal intensive care unit (NICU).

This program recognizes facilities that have safety guidelines to prevent these deliveries. They also must have quality improvement programs.

To be recognized, a facility must complete an Aetna Infant Safety Program survey. The survey asks about the facility's policies, programs and outcomes to prevent early elective deliveries. Aetna developed the program along with the American College of Obstetricians and Gynecologists (ACOG), the March of Dimes, and the Leapfrog Group.
ePrescribing (eRX) This doctor or pharmacy participates in ePrescribing (eRX).

This program lets doctors use a computer and software to write and send prescriptions over the Internet to a pharmacy that also participates.

With the software, the doctor can see important information, such as drug potential interactions and your prescription history.
Improving Practice Performance The American Board of Internal Medicine (ABIM) certifies doctors who practice Internal Medicine. This means a doctor has certain knowledge and skills. As part of this process, doctors must complete PIMSM Practice Improvement Modules (PIMs). PIMs have tools that help doctors improve care to patients.
Institutes of Quality® (IOQ) Bariatric Surgery Facility The facilities in Aetna's Institutes of Quality (IOQ) Bariatric Surgery Network are designated based on measures of clinical performance, access and efficiency for bariatric surgery. These standards provide value and quality to our members.

Some plans do not cover bariatric surgery. The Bariatric network is not available for all plans. Some facilities outside of the Bariatric network do not have surgeons who contract with Aetna. You may have to pay extra if you use a center that does not have doctors who contract with Aetna. Please check your benefits plan to find out.
Institutes of Quality® (IOQ) Cardiac Rhythm

Institutes of Quality® (IOQ) Cardiac Intervention

Institutes of Quality® (IOQ) Cardiovascular Surgery		 The facilities in Aetna's Institutes of Quality (IOQ) Cardiac Care Network are designated based on measures of clinical performance, access and efficiency for cardiac care. IOQ Cardiac Care facilities include comprehensive heart and vascular treatment centers that provide both inpatient and outpatient procedures. They also offer medical care for cardiac conditions that do not involve surgery or procedures. These standards provide value and quality to our members.

IOQ Cardiac Care facilities provide many services. These include:

  • Inpatient cardiac care
  • Cardiac catheterization, angioplasty and stents
  • Cardiac surgery (including coronary artery bypass graft surgery and heart valve surgery)
  • Management of heart rhythm conditions
Institutes of Quality® (IOQ) Spine/Orthopedic

Institutes of Quality® (IOQ) Total Joint Replacement/Orthopedic		 The facilities in the Aetna Institutes of Quality (IOQ) Orthopedic Care network that are designated based on measures of clinical performance, access and efficiency for orthopedic care. In reviewing these facilities, we seek to identify comprehensive orthopedic treatment centers that can provide both inpatient and outpatient procedures. These standards provide value and quality to our members.

Aetna IOQ Orthopedic Care facilities provide a full range of orthopedic care services. These include:

  • Inpatient and outpatient orthopedic care
  • Total knee replacement surgery
  • Total hip replacement surgery
  • Spine surgery
National Committee for Quality Assurance (NCQA) Back Pain Recognized National Committee for Quality Assurance (NCQA) Back Pain Recognition Program (BPRP) recognizes physicians and chiropractors who have met quality requirements. NCQA's standards seek to provide superior care to people with low back pain. Measures include:

  • Appropriate Imaging for Acute Back Pain
  • Advice for Normal Activities
  • Appropriate Use of Epidural Steroid Injections
  • Post-Surgical Outcomes


NCQA is a private, 501(c) (3) not-for-profit organization dedicated to improving health care quality.
National Committee for Quality Assurance (NCQA) Diabetes Recognized Doctors and doctor groups that treat people with diabetes can earn special recognition. The Diabetes Physician Recognition Program is from the National Committee for Quality Assurance (NCQA). It is co-sponsored by the American Diabetes Association.

To be recognized, doctors have to show they are providing quality diabetes care in areas such as:

  • HbA1c control
  • Blood Pressure control
  • LDL control
  • Eye examinations
  • Nephropathy Assessment
  • Smoking status and cessation advice or treatment
NCQA is a private, 501(c) (3) not-for-profit organization dedicated to improving health care quality.
National Committee for Quality Assurance (NCQA) Heart Stroke Recognized The Heart/Stroke Recognition Program (HSRP) recognizes doctors or doctor groups that provide care to patients with heart disease or who have had a stroke. It is a partnership of the American Heart Association (AHA), American Stroke Association (ASA) and National Committee for Quality Assurance (NCQA).

To ear recognition, doctors must show they are providing quality care that helps their patients avoid further complications of heart disease and another stroke.

Program measures include:

  • Blood pressure control
  • Complete lipid profile
  • Cholesterol control
  • Use of aspirin or another antithrombotic
  • Smoking status and cessation advice or treatment
NCQA is a private, 501(c) (3) not-for-profit organization dedicated to improving health care quality.
National Committee for Quality Assurance (NCQA) Patient Centered Medical Home (PCMHTM) Recognized The Patient Centered Medical Home (PCMHTM) program is a way of providing primary care to patients. Each patient has a primary care physician who leads a team of health care professionals. They use technology to help track and coordinate care related to a person's specific health needs.

The program is voluntary. It recognizes doctors who meet the standards for their practices set by the National Committee for Quality Assurance (NCQA), the American College of Physicians (ACP), American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American Osteopathic Association (AOA) and others. Doctors listed in DocFind® who meet the standards have a symbol next to their name.

The standards cover these six areas:

  • Enhance Access and Continuity
  • Identify and Manage Patient Populations
  • Plan and Manage Care
  • Provide Self-Care and Community Support
  • Track and Coordinate Care
  • Measure and Improve Performance
NCQA is a private, 501(c) (3) not-for-profit organization dedicated to improving health care quality.
National Committee for Quality Assurance (NCQA) Physician Practice Connections (PPC®) Recognized The National Committee for Quality Assurance's (NCQA) Physician Practice Connections (PPC®) Recognition Program recognizes physician practices that use clinical information to help them provide high quality care.

To be recognized, a physician practices have to:

  • Know and use their patients' histories
  • Work with patients over time and not just at office visits
  • Follow up with patients and with other providers to get the best results
  • Manage populations, not just individuals, using evidence-based care
  • Employ electronic tools to prevent medical adverse events
NCQA is a private, 501(c) (3) not-for-profit organization dedicated to improving health care quality.
Participates in Quality Oncology Program The goal of the Quality Oncology Practice Initiative (QOPI®) is to help cancer doctors provide the best possible care to cancer patients. The American Society of Clinical Oncology® (ASCO®) developed the program for medical oncology doctors and practices.

To participate in the program, practices collect information from patient charts and submit it for review.

QOPI® is a registered trademark of the American Society of Clinical Oncology.
Cost-Effective Provider-Cardiac Catheterization This facility has been identified as a cost-effective provider (according to Aetna claim's data) for an outpatient procedure called heart catheterization that helps to diagnose heart problems. Only certain facilities can perform this test. The cost of this test can vary among participating facilities. This can affect your out-of-pocket costs. Using providers that have been identified as cost effective can help control these costs. This program is available in most major areas where Aetna is available.
Cost-Effective Provider-CT Scan This facility has been identified as a cost-effective provider (according to Aetna claim's data) for an outpatient procedure called Outpatient High Technology Radiology Computed Tomography (CT) test. The cost of this test can vary among participating facilities. This affects a member's out-of-pocket costs for certain services. Using cost-effective providers can help control these costs. In some cases, the cost of care from these providers may only be half as much as the cost of a non-cost-effective provider (according to Aetna claims data). This program is available in most major areas where Aetna is available.
Cost-Effective Provider- Outpatient Magnetic Resonance Imaging (MRI) This facility has been identified as a cost-effective provider (according to Aetna claim's data) for an outpatient procedure called Outpatient High Technology Radiology Magnetic Resonance Imaging (MRI). The cost of this test can vary among participating facilities. This affects a member's out-of-pocket costs for certain services. Using cost-effective providers can help control these costs. In some cases, the cost of care from cost-effective providers may only be half as much as the cost of a non-cost-effective provider (according to Aetna claims data). This program is available in most major areas where Aetna is available.
Cost-Effective Provider- Outpatient Nuclear Cardiology This facility has been identified as a cost-effective provider (according to Aetna claim's data) for an outpatient procedure called High Technology Radiology Nuclear Cardiology Studies. The cost of this test can vary among participating facilities. This affects a member's out-of-pocket costs for certain services. Using cost-effective providers can help control these costs. In some cases, the cost of care from cost-effective providers may only be up to half as much as a non-cost-effective provider (according to Aetna claims data). This program is available in most major areas where Aetna is available.
Cost-Effective Provider- Outpatient Positron Emission Tomography (PET) Scans This facility has been identified as a cost-effective provider (according to Aetna claim's data) for an outpatient procedure called High Technology Radiology Positron Emission Tomography (PET) scans. The cost of this test can vary among participating facilities. This affects a member's out-of-pocket costs for certain services. Using cost-effective providers can help control these costs. In some cases, the cost of care from cost-effective providers may only be up to half as much as a non-cost-effective provider (according to Aetna claims data). This program is available in most major areas where Aetna is available.
Cost-Effective Provider for Outpatient Surgery This facility is a cost-effective provider (according to Aetna claim's data) for outpatient procedures. With some procedures (colonoscopy and other scope procedures) the doctor must notify Aetna before performing the service. For the procedures where we request notification are not used to determine "cost-effective" status. The cost of the outpatient procedures can vary among participating facilities. This affects a member’s out-of-pocket costs for certain services. Using cost-effective facilities can help control these costs. In some cases, the cost of care from a cost-effective facility may be 40% as much as a non-cost-effective facility (according to Aetna claims data). This program is available in most major areas where Aetna is available.
Cost-Effective Provider- Stress Echocardiogram This facility has been identified as a cost-effective provider (according to Aetna claim’s data) for an outpatient procedure called stress echocardiography. The cost of High Technology Radiology procedures can affect a member’s out-of-pocket costs. Using cost-effective providers can help control these costs. In some cases, the cost of care from a cost-effective provider may only be half the cost as a non-cost-effective provider (according to Aetna claims data). This program is available in most major areas where Aetna is available.