PayerIQ
Production
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Tier 1HIPBM

Rightway Healthcare

Priority engagement — executive meetings + contract acceleration

Composite
76.1
Rank
#12
Members
32.6M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
91
+22.8
Lives
20%
99
+19.8
Geography
20%
51
+10.2
Restrictions
15%
79
+11.8
Relationship
10%
61
+6.1
Financials
10%
54
+5.4
Composite Score76.1
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 22.8 + 19.8 + 10.2 + 11.8 + 6.1 + 5.4 = 76.1
Intelligence

Qualitative intelligence

Members
32.6M
Drug spend
$11.0B
Formulary
5-tier
PA / RA level
Very High
Biosimilar policy
Case-by-case review
Avg reimbursement
53 days
Strategic notes

High claims volume but federal formulary restrictions require CMS waiver pathway

Peer set

Closest peers in PBM

CVS Caremark PBM
AZ · Tier 1
75.5
-0.5
Magellan Rx Management
AZ · Tier 1
75.0
-1.1
InfuSystem Holdings Insurance
MN · Tier 1
74.8
-1.3
MedImpact Healthcare Systems
OK · Tier 2
71.9
-4.2
Abarca Health
MA · Tier 2
67.2
-8.9
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