PayerIQ
Production
Back to universe
Tier 4VTCommercial

Physicians Plus

Deprioritize — minimal contact + revisit annually

Composite
40.6
Rank
#246
Members
1.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
30
+7.5
Lives
20%
30
+6.0
Geography
20%
68
+13.6
Restrictions
15%
43
+6.5
Relationship
10%
43
+4.3
Financials
10%
28
+2.8
Composite Score40.6
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 7.5 + 6.0 + 13.6 + 6.5 + 4.3 + 2.8 = 40.6
Intelligence

Qualitative intelligence

Members
1.1M
Drug spend
$0.3B
Formulary
5-tier
PA / RA level
High
Biosimilar policy
Preferred substitution
Avg reimbursement
90 days
Strategic notes

Patient advocacy partnerships in market; leverage for formulary narrative

Peer set

Closest peers in Commercial

MDwise
AK · Tier 4
45.5
+4.9
Sunshine Health
WI · Tier 3
46.8
+6.1
Excellus BlueCross BlueShield HMO
TX · Tier 3
47.4
+6.7
WellStar Health
WI · Tier 3
48.6
+8.0
UPMC Health Plan
AK · Tier 3
49.6
+9.0
Playbook · Tier 4

Engagement timeline

Annually
Maintenance review · revisit tier