PayerIQ
Production
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Tier 2ORRegional

Johns Hopkins Health Plans of Oregon

Active pursuit — access summits + value dossier

Composite
61.1
Rank
#117
Members
2.2M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
47
+11.8
Lives
20%
37
+7.4
Geography
20%
67
+13.4
Restrictions
15%
73
+10.9
Relationship
10%
81
+8.1
Financials
10%
95
+9.5
Composite Score61.1
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 11.8 + 7.4 + 13.4 + 10.9 + 8.1 + 9.5 = 61.1
Intelligence

Qualitative intelligence

Members
2.2M
Drug spend
$0.5B
Formulary
4-tier
PA / RA level
Moderate
Biosimilar policy
Mandatory substitution
Avg reimbursement
31 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in Regional

PreferredOne of Wyoming
WY · Tier 2
61.4
+0.3
Hennepin Health of Colorado
CO · Tier 2
60.8
-0.4
Martin's Point Health Care of Oklahoma
OK · Tier 2
60.5
-0.6
Medica Health Plans of Tennessee
TN · Tier 2
61.8
+0.6
Florida Blue of South Dakota
SD · Tier 2
60.5
-0.6
Playbook · Tier 2

Engagement timeline

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