Members often have little access to independent, objective information when they choose specialists. The Aetna performance network provides our members with easy access to care from specialists who are high performers in their field. It is one in a series of industry-leading initiatives from Aetna designed to:

• Address rising medical costs
• Maintain access to quality care
• Help consumers make more informed health care decisions

• are part of the Aetna network of health care providers
• have met industry-accepted practices for clinical performance
• have met Aetna’s efficiency standards

Our clinical performance criteria are based on nationally-recognized standards, consistent with leading associations such as the National Quality Forum, National Committee for Quality Assurance, American Board of Medical Specialties, American Osteopathic Association, American Heart Association, American College of Obstetricians and Gynecologists, Agency for Health research and Quality, Society of Thoracic Surgeons, and Centers for Medicare & Medicaid Services.

Members of an Aexcel plan can access care from Aexcel-designated physicians in 12 specialty categories without a referral. At the same time, they may be able to lower their out-of-pocket costs.

For an overview of the program, including performance measures, evaluation process and important member information, refer to the Understanding Aexcel brochure.  (8 pages)

For details regarding evaluation methodology, data sources, reconsideration process and other important physician information, refer to the Physician Guide to Aexcel.  (16 pages)

For a complete description of methodology, including explanations of provider attribution, risk-adjustments, statistical significance and other technical information, refer to Aexcel Methodology.  (103 pages) Upon request, Aetna will discuss with physicians more detailed information regarding the Episode Treatment Groups that were managed by the physicians.

The Aetna Performance Network can be coupled with most Aetna products, including our consumer-directed Aetna HealthFund^® plans.

Aexcel-designated specialists are easy to locate within our online DocFind^® provider directory or printed directories - just look for the star!

The National Committee for Quality Assurance (NCQA) is an independent not-for-profit organization that accredits and evaluates a wide range of health care organizations and recognizes physicians in key clinical areas. Its mission is to improve the quality of health care. NCQA serves as an independent ratings examiner for Aetna, reviewing how Aetna’s Aexcel program meets criteria required by the State of New York.

The results of the NCQA reviews are available on the NCQA web site at nyrxreport.ncqa.org and allow for a comparison on the extent to which reviewed health plans in New York State comply with provisions of the New York Attorney General agreement.