PayerIQ
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Tier 3OKRegional

Oscar Health of Oklahoma

Monitor & nurture — quarterly touchpoints + data sharing

Composite
47.4
Rank
#221
Members
3.3M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
44
+11.0
Lives
20%
62
+12.4
Geography
20%
59
+11.8
Restrictions
15%
10
+1.5
Relationship
10%
75
+7.5
Financials
10%
32
+3.2
Composite Score47.4
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 11.0 + 12.4 + 11.8 + 1.5 + 7.5 + 3.2 = 47.4
Intelligence

Qualitative intelligence

Members
3.3M
Drug spend
$1.0B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
No policy defined
Avg reimbursement
19 days
Strategic notes

Medicare Part D plan with stable formulary; step edit removal is key ask

Peer set

Closest peers in Regional

HarmonyCare of Delaware
DE · Tier 3
47.6
+0.3
New Mexico Health Connections of Washington
WA · Tier 3
47.8
+0.4
Premera Blue Cross of Louisiana
LA · Tier 3
48.0
+0.6
Group Health of Delaware
DE · Tier 3
46.5
-0.9
Priority Health of New York
NY · Tier 3
46.3
-1.1
Playbook · Tier 3

Engagement timeline

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