Aetna Institutes of Quality® Frequently Asked Questions

What are Aetna Institutes of Quality?

  • Health care sites that demonstrate high levels of quality and efficiency
  • The Joint Commission provides the Aetna Institutes of Quality (IOQ) quality review for Aetna's total hip and knee replacement (THKR) surgery program, and AAOS American Joint Replacement Registry (AJRR) participation is a requirement for The Joint Commission Advanced Certification for THKR

What is the goal of the program?

  • To provide qualitative feedback on the institution level to Aetna so sites around the U.S. can report on the quality of care they deliver
  • AJRR developed metrics based on existing AJRR data elements and include all payer metrics for a comprehensive view of outcomes
  • To assist internal quality tracking and monitoring, which aligns with the AAOS Registry Program's mission to improve orthopaedic care through the collection, analysis, and reporting of actionable data

What are the steps to obtaining the IOQ designation?

  • Contract with AJRR to be eligible for The Joint Commission Advanced Certification
  • Sign data-sharing agreement with AAOS to submit measures to Aetna
  • Submit data for applicable measures
    • Minimum requirements include submission of THA/TKA procedures as well as postoperative case data (listed below)
  • Sites can view real-time performance in RegistryInsights® dashboards for all IOQ metrics based on reported institutional data
  • Once an institution has reported on all required metrics, AAOS staff will seek approval from the institution, and will subsequently send the report summary to Aetna for IOQ designation review
  • Only one quarterly report is required per 3-year cycle for IOQ designation
  • Once all metrics have been reported and sent to Aetna IOQ, the institution will be eligible to be reviewed for IOQ designation
  • Sites will receive a letter from Aetna with their IOQ designation decision

What if I am already an Aetna IOQ site?

  • Sign data-sharing agreement with AAOS to submit measures to Aetna
  • Follow the subsequent steps outlined in the previous question for measure-related data submission and report card review

What measures are being reported for participation?

  • In-Hospital Mortality
  • 90-Day Postoperative Mortality
  • 90-Day Readmission
  • Surgical Site Infection (SSI)

View the AJRR Grouped Performance Metrics Methodology here. A sample report sent to Aetna IOQ is shown below.

Sample Report Sent to Aetna


What are the data submission requirements for calculating the measures?

  • Procedure Date
  • Discharge Date
  • Patient Death Date (when applicable)
  • Primary Procedure Code
  • Primary Diagnosis Code
  • Readmission Date
  • Readmission Diagnosis

How do I access the metric data for my institution in the RegistryInsights® dashboards?

  • Access RegistryInsights® platform and select "AJRR"

  • Select "Institution Dashboard" from header menu tabs

    RegistryInsights Instructional Image 1

  • Select "Your Performance Measures" from footer menu tabs

    RegistryInsights Instructional Image 2

  • Set the encounter data range to the target report date range

    RegistryInsights Instructional Image 3

  • Scroll down to "Grouped Performance Metrics" to view In-Hospital Mortality, 90-Day Posteoperative Mortality, 90-Day Readmission, and SSI metrics

    RegistryInsights Instructional Image 4

    RegistryInsights Instructional Image 5

  • If your site is capturing and submitting THA and TKA procedural and postoperative data relevant to all four metrics in the target study period, you will be contacted by AAOS and may authorize us to send reporting achievement for Aetna IOQ certification on your behalf