PayerIQ
Production
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Tier 1ILCommercial

Rocky Mountain Health Plans

Priority engagement — executive meetings + contract acceleration

Composite
76.8
Rank
#10
Members
3.6M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
80
+20.0
Lives
20%
100
+20.0
Geography
20%
76
+15.2
Restrictions
15%
35
+5.3
Relationship
10%
74
+7.4
Financials
10%
90
+9.0
Composite Score76.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 20.0 + 20.0 + 15.2 + 5.3 + 7.4 + 9.0 = 76.8
Intelligence

Qualitative intelligence

Members
3.6M
Drug spend
$0.9B
Formulary
6-tier
PA / RA level
Low
Biosimilar policy
Step therapy required
Avg reimbursement
85 days
Strategic notes

BCBS plan with regional flexibility; negotiation via BlueCard network possible

Peer set

Closest peers in Commercial

Sharp Health Plan
ND · Tier 1
75.0
-1.9
Rocky Mountain Health Plans Insurance
VT · Tier 1
82.3
+5.5
UCare
IA · Tier 2
70.5
-6.3
Paramount Health Care
MA · Tier 2
68.9
-7.9
Hennepin Health
ND · Tier 2
67.3
-9.6
Playbook · Tier 1

Engagement timeline

Week 1
Executive sponsor outreach · contract review
Week 2
Account team alignment · data sharing MoU
Week 4
Strategic roadmap session
Quarterly
C-suite QBR · joint planning