PayerIQ
Production
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Tier 2NHBCBS

Blue Cross Blue Shield of Georgia

Active pursuit — access summits + value dossier

Composite
62.9
Rank
#95
Members
5.9M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
72
+18.0
Lives
20%
68
+13.6
Geography
20%
82
+16.4
Restrictions
15%
10
+1.5
Relationship
10%
95
+9.5
Financials
10%
39
+3.9
Composite Score62.9
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 18.0 + 13.6 + 16.4 + 1.5 + 9.5 + 3.9 = 62.9
Intelligence

Qualitative intelligence

Members
5.9M
Drug spend
$2.0B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
49 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 Louisiana
VT · Tier 2
63.4
+0.5
Blue Cross Blue Shield Montana
VA · Tier 2
62.4
-0.5
Blue Cross Blue Shield Nebraska
ND · Tier 2
63.8
+0.9
Anthem Blue Cross Blue Shield of Maine MCO
CT · Tier 2
61.6
-1.3
Blue Cross Blue Shield Wyoming
NJ · Tier 2
61.5
-1.4
Playbook · Tier 2

Engagement timeline

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