PayerIQ
Production
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Tier 3WICommercial

WellStar Health

Monitor & nurture — quarterly touchpoints + data sharing

Composite
48.6
Rank
#216
Members
1.8M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
36
+9.0
Lives
20%
48
+9.6
Geography
20%
51
+10.2
Restrictions
15%
60
+9.0
Relationship
10%
92
+9.2
Financials
10%
16
+1.6
Composite Score48.6
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 9.0 + 9.6 + 10.2 + 9.0 + 9.2 + 1.6 = 48.6
Intelligence

Qualitative intelligence

Members
1.8M
Drug spend
$0.4B
Formulary
4-tier
PA / RA level
Low
Biosimilar policy
Mandatory substitution
Avg reimbursement
35 days
Strategic notes

Large dual-eligible population; PA/RA process requires clinical evidence package

Peer set

Closest peers in Commercial

UPMC Health Plan
AK · Tier 3
49.6
+1.0
Excellus BlueCross BlueShield HMO
TX · Tier 3
47.4
-1.3
Sunshine Health
WI · Tier 3
46.8
-1.9
Tufts Health Plan
WA · Tier 3
50.8
+2.2
MDwise
AK · Tier 4
45.5
-3.1
Playbook · Tier 3

Engagement timeline

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