PayerIQ
Production
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Tier 2AKBCBS

Anthem Blue Cross Blue Shield of Indiana

Active pursuit — access summits + value dossier

Composite
71.5
Rank
#26
Members
7.9M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
61
+15.3
Lives
20%
89
+17.8
Geography
20%
100
+20.0
Restrictions
15%
24
+3.6
Relationship
10%
69
+6.9
Financials
10%
80
+8.0
Composite Score71.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 15.3 + 17.8 + 20.0 + 3.6 + 6.9 + 8.0 = 71.5
Intelligence

Qualitative intelligence

Members
7.9M
Drug spend
$3.0B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Step therapy required
Avg reimbursement
41 days
Strategic notes

High claims volume but federal formulary restrictions require CMS waiver pathway

Peer set

Closest peers in BCBS

Anthem Blue Cross Blue Shield of Kentucky
NH · Tier 1
72.1
+0.5
Florida Blue MCO
DC · Tier 2
70.6
-1.0
Blue Cross Blue Shield of Rhode Island Managed Care
KS · Tier 2
69.6
-2.0
Hawaii Medical Service Association PPO
AK · Tier 1
73.7
+2.2
Blue Cross Blue Shield of Alabama
ID · Tier 2
69.3
-2.3
Playbook · Tier 2

Engagement timeline

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