PayerIQ
Production
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Tier 2OKRegional

Martin's Point Health Care of Oklahoma

Active pursuit — access summits + value dossier

Composite
60.5
Rank
#121
Members
3.6M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
97
+24.3
Lives
20%
63
+12.6
Geography
20%
33
+6.6
Restrictions
15%
38
+5.7
Relationship
10%
42
+4.2
Financials
10%
72
+7.2
Composite Score60.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 24.3 + 12.6 + 6.6 + 5.7 + 4.2 + 7.2 = 60.5
Intelligence

Qualitative intelligence

Members
3.6M
Drug spend
$1.1B
Formulary
4-tier
PA / RA level
High
Biosimilar policy
Mandatory substitution
Avg reimbursement
37 days
Strategic notes

BCBS plan with regional flexibility; negotiation via BlueCard network possible

Peer set

Closest peers in Regional

Florida Blue of South Dakota
SD · Tier 2
60.5
-0.1
Gateway Health Plan of Maine
ME · Tier 2
60.4
-0.1
Hennepin Health of Colorado
CO · Tier 2
60.8
+0.2
SCAN Health Plan of South Carolina
SC · Tier 2
60.3
-0.3
Johns Hopkins Health Plans of Oregon
OR · Tier 2
61.1
+0.6
Playbook · Tier 2

Engagement timeline

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