PayerIQ
Sun, May 24, 2026
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Tier 3DCFederal
CHAMPVA (Civilian Health and Medical Program of VA) Managed Care
Monitor & nurture — quarterly touchpoints + data sharing
Composite
54.3
Rank
#186
Members
19.6M
Scoring profile
Six-criterion radar
Breakdown
Weighted score contribution
Claims
25%
44
+11.0
Lives
20%
57
+11.4
Geography
20%
52
+10.4
Restrictions
15%
44
+6.6
Relationship
10%
55
+5.5
Financials
10%
94
+9.4
Composite Score54.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 11.0 + 11.4 + 10.4 + 6.6 + 5.5 + 9.4 = 54.3
Intelligence
Qualitative intelligence
Members
19.6M
Drug spend
$5.2B
Formulary
5-tier
PA / RA level
High
Biosimilar policy
No policy defined
Avg reimbursement
31 days
Strategic notes
Strong balance sheet; specialty pipeline access discussion underway
Peer set
Closest peers in Federal
Centers for Medicare & Medicaid Services (CMS) Insurance
MD · Tier 2
58.2
+3.9
TRICARE (Defense Health Agency)
DC · Tier 2
58.3
+4.0
Centers for Medicare & Medicaid Services (CMS)
VA · Tier 2
58.8
+4.5
Veterans Affairs Pharmacy Benefits
DC · Tier 3
49.6
-4.6
Centers for Medicare & Medicaid Services (CMS) Health Plan
DC · Tier 2
59.8
+5.5
Playbook · Tier 3
Engagement timeline
Week 2
Account manager check-in
Bi-annually
Formulary monitoring report