PayerIQ
Production
Back to universe
Tier 2TXRegional

Buckeye Health Plan of Texas

Active pursuit — access summits + value dossier

Composite
59.5
Rank
#135
Members
2.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
38
+7.6
Geography
20%
70
+14.0
Restrictions
15%
23
+3.4
Relationship
10%
64
+6.4
Financials
10%
30
+3.0
Composite Score59.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 7.6 + 14.0 + 3.4 + 6.4 + 3.0 = 59.5
Intelligence

Qualitative intelligence

Members
2.1M
Drug spend
$0.5B
Formulary
4-tier
PA / RA level
Very High
Biosimilar policy
Mandatory substitution
Avg reimbursement
78 days
Strategic notes

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

Peer set

Closest peers in Regional

MedStar Health of Utah
UT · Tier 2
59.5
0.0
WellStar Health of New Hampshire
NH · Tier 2
59.4
-0.1
Mountain Health of Idaho
ID · Tier 2
59.3
-0.2
UPMC Health Plan of Nevada
NV · Tier 2
59.1
-0.4
EmblemHealth of Connecticut
CT · Tier 2
60.0
+0.5
Playbook · Tier 2

Engagement timeline

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