PayerIQ
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Tier 2ILMedicare Advantage

United AARP MedicareComplete Managed Care

Active pursuit — access summits + value dossier

Composite
62.4
Rank
#101
Members
2.3M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
78
+19.5
Lives
20%
58
+11.6
Geography
20%
82
+16.4
Restrictions
15%
31
+4.6
Relationship
10%
57
+5.7
Financials
10%
45
+4.5
Composite Score62.4
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 19.5 + 11.6 + 16.4 + 4.6 + 5.7 + 4.5 = 62.4
Intelligence

Qualitative intelligence

Members
2.3M
Drug spend
$1.3B
Formulary
3-tier
PA / RA level
Low
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
51 days
Strategic notes

Executive sponsor identified at VP of Pharmacy level; schedule quarterly touchpoint

Peer set

Closest peers in Medicare Advantage

Humana Gold Plus HMO
GA · Tier 2
62.4
+0.0
United AARP MedicareComplete
KS · Tier 2
62.7
+0.4
InnovAge PACE
AK · Tier 2
63.0
+0.6
Blue Shield Medicare Advantage
AL · Tier 2
63.3
+0.9
Commonwealth Care Alliance
AZ · Tier 2
63.9
+1.5
Playbook · Tier 2

Engagement timeline

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