PayerIQ
Sun, May 24, 2026
Back to universe
Tier 2TNBCBS
Blue Cross Blue Shield of Rhode Island Health Plan
Active pursuit — access summits + value dossier
Composite
67.7
Rank
#52
Members
6.6M
Scoring profile
Six-criterion radar
Breakdown
Weighted score contribution
Claims
25%
100
+25.0
Lives
20%
81
+16.2
Geography
20%
65
+13.0
Restrictions
15%
19
+2.9
Relationship
10%
64
+6.4
Financials
10%
42
+4.2
Composite Score67.7
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 16.2 + 13.0 + 2.9 + 6.4 + 4.2 = 67.7
Intelligence
Qualitative intelligence
Members
6.6M
Drug spend
$2.5B
Formulary
2-tier
PA / RA level
High
Biosimilar policy
No policy defined
Avg reimbursement
68 days
Strategic notes
Medicare Part D plan with stable formulary; step edit removal is key ask
Playbook · Tier 2
Engagement timeline
Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review