PayerIQ
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Tier 2GAMedicare Advantage

Imperial Health Holdings HMO

Active pursuit — access summits + value dossier

Composite
70.3
Rank
#34
Members
2.9M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
88
+22.0
Lives
20%
64
+12.8
Geography
20%
81
+16.2
Restrictions
15%
69
+10.3
Relationship
10%
38
+3.8
Financials
10%
52
+5.2
Composite Score70.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 22.0 + 12.8 + 16.2 + 10.3 + 3.8 + 5.2 = 70.3
Intelligence

Qualitative intelligence

Members
2.9M
Drug spend
$1.6B
Formulary
4-tier
PA / RA level
High
Biosimilar policy
Case-by-case review
Avg reimbursement
79 days
Strategic notes

PBM-managed rebate structure; volume-based rebate negotiation is primary lever

Peer set

Closest peers in Medicare Advantage

Friday Health Plans
CA · Tier 2
70.5
+0.2
Clover Health
NY · Tier 2
71.0
+0.7
Cigna-HealthSpring PPO
DE · Tier 2
69.5
-0.8
AARP Medicare Complete
TX · Tier 2
68.7
-1.7
Imperial Health Holdings
WY · Tier 2
68.7
-1.7
Playbook · Tier 2

Engagement timeline

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