PayerIQ
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Tier 1MNRegional

Denver Health Medical Plan of Minnesota

Priority engagement — executive meetings + contract acceleration

Composite
79.1
Rank
#3
Members
4.2M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
89
+22.3
Lives
20%
82
+16.4
Geography
20%
100
+20.0
Restrictions
15%
37
+5.5
Relationship
10%
77
+7.7
Financials
10%
72
+7.2
Composite Score79.1
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 22.3 + 16.4 + 20.0 + 5.5 + 7.7 + 7.2 = 79.1
Intelligence

Qualitative intelligence

Members
4.2M
Drug spend
$0.9B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
58 days
Strategic notes

Medicare Part D plan with stable formulary; step edit removal is key ask

Peer set

Closest peers in Regional

CareFirst of Massachusetts
MA · Tier 1
77.1
-2.0
Sunshine Health of South Carolina
SC · Tier 1
76.7
-2.4
Providence Health of Connecticut
CT · Tier 1
72.7
-6.4
ConnectiCare of North Carolina
NC · Tier 2
70.9
-8.2
Dean Health Plan of Mississippi
MS · Tier 2
69.8
-9.3
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