PayerIQ
Production
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Tier 3NYBCBS

Blue Cross Blue Shield of Texas

Monitor & nurture — quarterly touchpoints + data sharing

Composite
50.7
Rank
#203
Members
5.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
58
+14.5
Lives
20%
58
+11.6
Geography
20%
55
+11.0
Restrictions
15%
10
+1.5
Relationship
10%
68
+6.8
Financials
10%
53
+5.3
Composite Score50.7
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 14.5 + 11.6 + 11.0 + 1.5 + 6.8 + 5.3 = 50.7
Intelligence

Qualitative intelligence

Members
5.0M
Drug spend
$1.6B
Formulary
4-tier
PA / RA level
High
Biosimilar policy
Mandatory substitution
Avg reimbursement
43 days
Strategic notes

Large covered lives base; formulary team open to outcomes-based contracts

Peer set

Closest peers in BCBS

Blue Cross Blue Shield of Massachusetts
LA · Tier 3
49.0
-1.7
Blue Cross Blue Shield of Rhode Island
NM · Tier 3
53.0
+2.3
Regence BlueCross BlueShield Oregon
OR · Tier 3
53.8
+3.1
Blue Cross Blue Shield of Michigan
WV · Tier 3
54.6
+3.9
Medical Mutual of Ohio
MN · Tier 3
56.3
+5.5
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report