PayerIQ
Production
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Tier 1AKBCBS

Hawaii Medical Service Association PPO

Priority engagement — executive meetings + contract acceleration

Composite
73.7
Rank
#20
Members
6.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
75
+15.0
Geography
20%
67
+13.4
Restrictions
15%
10
+1.5
Relationship
10%
100
+10.0
Financials
10%
88
+8.8
Composite Score73.7
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 15.0 + 13.4 + 1.5 + 10.0 + 8.8 = 73.7
Intelligence

Qualitative intelligence

Members
6.1M
Drug spend
$1.7B
Formulary
5-tier
PA / RA level
Moderate
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
84 days
Strategic notes

Prior collaboration on REMS program; account trust level high

Peer set

Closest peers in BCBS

Anthem Blue Cross Blue Shield of Kentucky
NH · Tier 1
72.1
-1.6
Anthem Blue Cross Blue Shield of Indiana
AK · Tier 2
71.5
-2.2
Florida Blue MCO
DC · Tier 2
70.6
-3.1
Blue Cross Blue Shield Wyoming HMO
SD · Tier 1
77.0
+3.3
Anthem Blue Cross Blue Shield Nevada
WA · Tier 1
77.8
+4.1
Playbook · Tier 1

Engagement timeline

Week 1
Executive sponsor outreach · contract review
Week 2
Account team alignment · data sharing MoU
Week 4
Strategic roadmap session
Quarterly
C-suite QBR · joint planning