PayerIQ
Production
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Tier 2NDBCBS

Blue Cross Blue Shield Nebraska

Active pursuit — access summits + value dossier

Composite
63.8
Rank
#86
Members
8.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
32
+8.0
Lives
20%
100
+20.0
Geography
20%
78
+15.6
Restrictions
15%
55
+8.3
Relationship
10%
55
+5.5
Financials
10%
64
+6.4
Composite Score63.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 8.0 + 20.0 + 15.6 + 8.3 + 5.5 + 6.4 = 63.8
Intelligence

Qualitative intelligence

Members
8.4M
Drug spend
$2.7B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Case-by-case review
Avg reimbursement
84 days
Strategic notes

Geographic advantage in target region; growing Medicare Advantage enrollment

Peer set

Closest peers in BCBS

Blue Cross Blue Shield of Louisiana
VT · Tier 2
63.4
-0.4
Blue Cross Blue Shield of Georgia
NH · Tier 2
62.9
-0.9
Blue Cross Blue Shield Montana
VA · Tier 2
62.4
-1.4
Arkansas Blue Cross and Blue Shield
PA · Tier 2
65.5
+1.8
Anthem Blue Cross Blue Shield of Maine MCO
CT · Tier 2
61.6
-2.1
Playbook · Tier 2

Engagement timeline

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