PayerIQ
Production
Back to universe
Tier 3NJRegional

Cherokee Health Systems of New Jersey

Monitor & nurture — quarterly touchpoints + data sharing

Composite
53.4
Rank
#192
Members
3.6M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
75
+18.8
Lives
20%
70
+14.0
Geography
20%
26
+5.2
Restrictions
15%
10
+1.5
Relationship
10%
92
+9.2
Financials
10%
47
+4.7
Composite Score53.4
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 18.8 + 14.0 + 5.2 + 1.5 + 9.2 + 4.7 = 53.4
Intelligence

Qualitative intelligence

Members
3.6M
Drug spend
$1.0B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Case-by-case review
Avg reimbursement
37 days
Strategic notes

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

Peer set

Closest peers in Regional

MedStar Health of Vermont
VT · Tier 3
54.1
+0.8
Dean Health Plan of Georgia
GA · Tier 3
52.3
-1.1
Paramount Health Care of Oklahoma
OK · Tier 3
52.3
-1.1
SilverSummit Healthplan of New Mexico
NM · Tier 3
52.0
-1.3
Fallon Health of Wyoming
WY · Tier 3
51.3
-2.1
Playbook · Tier 3

Engagement timeline

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