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Aetna Smart Compare™ designation

We’re recognizing physicians who use health care resources effectively, so your patients can make smart choices for their health.

What is Aetna Smart Compare?

What is Aetna Smart Compare?

A health care system that’s more transparent and consumer focused is a better health care system. Part of that is recognizing physicians for clinical quality and effective use of care. With the Aetna Smart Compare designation, which recognizes high-performing physicians and provider groups, we’re helping build a better care experience for everyone.

 

The goal? We’re giving members more information to help choose the right practice for themselves and their families. So they can get better faster and reach their best health.

 

Our quality certification

 

Learn how the National Committee for Quality Assurance (NCQA) — an independent, not-for-profit group that accredits health care organizations — reviews our designation programs to meet criteria for their Physician Quality Certification.

 

NCQA report on Aetna compliance

How we choose physicians and other providers

How we choose physicians and other providers

Currently, we’re evaluating providers for the specialties below. To earn Aetna Smart Compare designation, physicians and other providers need to exceed clinical quality and cost-effectiveness measures.

 

Aetna Smart Compare designations for commercial plans are limited to self-insured plans in California and Texas. Members excluded from the program will not see designations in Aetna's secure member portal, and they will not receive designations through other communication channels. Aetna Smart Compare designation has no bearing on a physician, physician practice or medical group’s contract or how they are reimbursed by Aetna.

 

These measures include:

 

  • Number and types of services performed
  • How often patients return to the hospital
  • Rates of health complications during hospital stays
  • Use of technology
  • Cost of services

Browse the guides below for a full view of our measurement criteria and how we choose specialists.

Answers to your patients’ questions

 

If you’d like more details about Aetna Smart Compare or want to share information with your patients, we’ve answered our members’ most frequently asked questions below.

 

 

The goal of the Aetna Smart Compare designation is to give our members more information to help them choose a practice for themselves and their families. During provider or procedure searches on our Aetna Health app and Aetna® member website, members simply look for the Quality Care and Effective Care labels as another item to consider when choosing a physician.

We evaluate both primary care and specialists for this program. Please refer to the list above for what is currently supported. The program will be expanding to additional specialties in 2022 and beyond.

The Aetna Smart Compare designation is only a guide to help members choose a physician that’s for them, not the sole basis for selecting their doctor. There is no impact on a member’s plan, whether they seek care from a designated provider or not.

Physicians and other providers who receive this designation exceed clinical quality measures under the program, have demonstrated improved outcomes for their patients and provide a high quality of care. For more information, take a look at our designation guides above for primary care physicians and orthopedic specialists.

Physicians and other providers who receive this designation exceed efficiency measures under the program by efficiently managing costs and recommending only appropriate testing and treatments for their patients while providing quality care.

There are three reasons why a physician may not have this designation:

  1. They’re not in a specialty or specialty procedures type that the program is currently designating. 
  2. They couldn’t be evaluated for the designation because of not meeting minimum volume requirements. 
  3. They didn’t meet the criteria to receive the designation.
 

Your feedback matters

Share your thoughts about Aetna Smart Compare to help us improve your experience.

 

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.