PayerIQ
Production
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Tier 2OKRegional

Arkansas Blue Cross of Oklahoma

Active pursuit — access summits + value dossier

Composite
58.5
Rank
#148
Members
3.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
68
+17.0
Lives
20%
59
+11.8
Geography
20%
54
+10.8
Restrictions
15%
31
+4.6
Relationship
10%
78
+7.8
Financials
10%
65
+6.5
Composite Score58.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.0 + 11.8 + 10.8 + 4.6 + 7.8 + 6.5 = 58.5
Intelligence

Qualitative intelligence

Members
3.0M
Drug spend
$0.9B
Formulary
5-tier
PA / RA level
Moderate
Biosimilar policy
Step therapy required
Avg reimbursement
27 days
Strategic notes

Formulary restructure Q3 creates new placement window; timing is critical

Peer set

Closest peers in Regional

Tufts Health Plan of New York
NY · Tier 2
58.8
+0.2
SelectCare of New York
NY · Tier 2
58.3
-0.3
Johns Hopkins Health Plans of Missouri
MO · Tier 2
58.2
-0.3
UPMC Health Plan of Nevada
NV · Tier 2
59.1
+0.6
Mountain Health of Idaho
ID · Tier 2
59.3
+0.7
Playbook · Tier 2

Engagement timeline

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