PayerIQ
Production
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Tier 3NMRegional

SilverSummit Healthplan of New Mexico

Monitor & nurture — quarterly touchpoints + data sharing

Composite
52.0
Rank
#198
Members
2.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
59
+14.8
Lives
20%
39
+7.8
Geography
20%
65
+13.0
Restrictions
15%
10
+1.5
Relationship
10%
96
+9.6
Financials
10%
54
+5.4
Composite Score52.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 14.8 + 7.8 + 13.0 + 1.5 + 9.6 + 5.4 = 52.0
Intelligence

Qualitative intelligence

Members
2.0M
Drug spend
$0.7B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Mandatory substitution
Avg reimbursement
90 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in Regional

Paramount Health Care of Oklahoma
OK · Tier 3
52.3
+0.2
Dean Health Plan of Georgia
GA · Tier 3
52.3
+0.3
Fallon Health of Wyoming
WY · Tier 3
51.3
-0.8
Cherokee Health Systems of New Jersey
NJ · Tier 3
53.4
+1.3
MedStar Health of Vermont
VT · Tier 3
54.1
+2.1
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report