PayerIQ
Production
Back to universe
Tier 2DCCommercial

CareOregon Managed Care

Active pursuit — access summits + value dossier

Composite
67.3
Rank
#57
Members
2.2M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
51
+12.8
Lives
20%
68
+13.6
Geography
20%
75
+15.0
Restrictions
15%
42
+6.3
Relationship
10%
96
+9.6
Financials
10%
100
+10.0
Composite Score67.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 12.8 + 13.6 + 15.0 + 6.3 + 9.6 + 10.0 = 67.3
Intelligence

Qualitative intelligence

Members
2.2M
Drug spend
$0.7B
Formulary
6-tier
PA / RA level
High
Biosimilar policy
Preferred substitution
Avg reimbursement
91 days
Strategic notes

Strong legacy relationship with regional medical director; preferred placement feasible

Peer set

Closest peers in Commercial

Hennepin Health
ND · Tier 2
67.3
0.0
CareOregon
NH · Tier 2
67.2
-0.1
Paramount Health Care
MA · Tier 2
68.9
+1.7
UCare
IA · Tier 2
70.5
+3.3
MDwise HMO
HI · Tier 2
63.4
-3.9
Playbook · Tier 2

Engagement timeline

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