PayerIQ
Production
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Tier 2AKBCBS

Anthem Blue Cross Blue Shield of Colorado

Active pursuit — access summits + value dossier

Composite
67.8
Rank
#50
Members
5.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
90
+22.5
Lives
20%
63
+12.6
Geography
20%
69
+13.8
Restrictions
15%
10
+1.5
Relationship
10%
85
+8.5
Financials
10%
89
+8.9
Composite Score67.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 22.5 + 12.6 + 13.8 + 1.5 + 8.5 + 8.9 = 67.8
Intelligence

Qualitative intelligence

Members
5.5M
Drug spend
$2.0B
Formulary
4-tier
PA / RA level
Moderate
Biosimilar policy
Step therapy required
Avg reimbursement
60 days
Strategic notes

BCBS plan with regional flexibility; negotiation via BlueCard network possible

Peer set

Closest peers in BCBS

Blue Cross Blue Shield of Rhode Island Health Plan
TN · Tier 2
67.7
-0.1
Blue Cross Blue Shield of Massachusetts Insurance
GA · Tier 2
68.0
+0.2
Hawaii Medical Service Association
SC · Tier 2
67.5
-0.3
Florida Blue
ME · Tier 2
68.1
+0.3
CareFirst BlueCross BlueShield Managed Care
MA · Tier 2
68.7
+0.9
Playbook · Tier 2

Engagement timeline

Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review