PayerIQ
Production
Back to universe
Tier 2NMRegional

Paramount Health Care of New Mexico

Active pursuit — access summits + value dossier

Composite
64.7
Rank
#78
Members
4.2M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
62
+15.5
Lives
20%
85
+17.0
Geography
20%
69
+13.8
Restrictions
15%
56
+8.4
Relationship
10%
53
+5.3
Financials
10%
47
+4.7
Composite Score64.7
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 15.5 + 17.0 + 13.8 + 8.4 + 5.3 + 4.7 = 64.7
Intelligence

Qualitative intelligence

Members
4.2M
Drug spend
$1.5B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Case-by-case review
Avg reimbursement
41 days
Strategic notes

Large covered lives base; formulary team open to outcomes-based contracts

Peer set

Closest peers in Regional

HarmonyCare of California
CA · Tier 2
64.8
+0.1
HealthNew England of Nevada
NV · Tier 2
64.5
-0.2
Crystal Run Health Plan of Illinois
IL · Tier 2
66.0
+1.3
HarmonyCare of Virginia
VA · Tier 2
66.2
+1.5
WPS Health Solutions of California
CA · Tier 2
66.2
+1.5
Playbook · Tier 2

Engagement timeline

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