PayerIQ
Production
Back to universe
Tier 4CORegional

UCare of Colorado

Deprioritize — minimal contact + revisit annually

Composite
42.4
Rank
#242
Members
1.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
72
+18.0
Lives
20%
26
+5.2
Geography
20%
13
+2.6
Restrictions
15%
29
+4.3
Relationship
10%
52
+5.2
Financials
10%
70
+7.0
Composite Score42.4
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 18.0 + 5.2 + 2.6 + 4.3 + 5.2 + 7.0 = 42.4
Intelligence

Qualitative intelligence

Members
1.5M
Drug spend
$0.5B
Formulary
2-tier
PA / RA level
Very High
Biosimilar policy
Preferred substitution
Avg reimbursement
58 days
Strategic notes

Prior collaboration on REMS program; account trust level high

Peer set

Closest peers in Regional

Oscar Health of Kentucky
KY · Tier 4
42.4
0.0
Capital Health Plan of South Carolina
SC · Tier 4
41.6
-0.7
Physicians Health Plan of Maryland
MD · Tier 4
43.1
+0.8
CareFirst of Wisconsin
WI · Tier 4
40.4
-2.0
Tufts Health Plan of Texas
TX · Tier 4
45.1
+2.8
Playbook · Tier 4

Engagement timeline

Annually
Maintenance review · revisit tier