PayerIQ
Production
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Tier 3UTNational

AmeriHealth

Monitor & nurture — quarterly touchpoints + data sharing

Composite
54.1
Rank
#188
Members
20.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
64
+16.0
Lives
20%
41
+8.2
Geography
20%
80
+16.0
Restrictions
15%
10
+1.5
Relationship
10%
83
+8.3
Financials
10%
41
+4.1
Composite Score54.1
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 16.0 + 8.2 + 16.0 + 1.5 + 8.3 + 4.1 = 54.1
Intelligence

Qualitative intelligence

Members
20.5M
Drug spend
$5.8B
Formulary
5-tier
PA / RA level
Low
Biosimilar policy
No policy defined
Avg reimbursement
85 days
Strategic notes

Recent merger with regional system creates expanded formulary committee access

Peer set

Closest peers in National

HealthSpring
AR · Tier 3
54.0
-0.1
Independence Blue Cross
KS · Tier 3
54.3
+0.1
Centene Corporation
GA · Tier 3
56.8
+2.7
Kaiser Permanente Insurance
MT · Tier 3
57.1
+3.0
Regence BlueCross BlueShield
MN · Tier 3
57.5
+3.4
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report