PayerIQ
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Tier 2KSMedicare Advantage

United AARP MedicareComplete

Active pursuit — access summits + value dossier

Composite
62.7
Rank
#96
Members
2.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
81
+20.3
Lives
20%
56
+11.2
Geography
20%
64
+12.8
Restrictions
15%
13
+1.9
Relationship
10%
65
+6.5
Financials
10%
100
+10.0
Composite Score62.7
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 20.3 + 11.2 + 12.8 + 1.9 + 6.5 + 10.0 = 62.7
Intelligence

Qualitative intelligence

Members
2.5M
Drug spend
$1.5B
Formulary
4-tier
PA / RA level
Very High
Biosimilar policy
No policy defined
Avg reimbursement
41 days
Strategic notes

CMS Star Rating above 4.0; quality bonus payments create room for contract flexibility

Peer set

Closest peers in Medicare Advantage

InnovAge PACE
AK · Tier 2
63.0
+0.3
Humana Gold Plus HMO
GA · Tier 2
62.4
-0.3
United AARP MedicareComplete Managed Care
IL · Tier 2
62.4
-0.4
Blue Shield Medicare Advantage
AL · Tier 2
63.3
+0.5
Commonwealth Care Alliance
AZ · Tier 2
63.9
+1.1
Playbook · Tier 2

Engagement timeline

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