PayerIQ
Production
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Tier 3VTRegional

MedStar Health of Vermont

Monitor & nurture — quarterly touchpoints + data sharing

Composite
54.1
Rank
#189
Members
3.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
69
+17.3
Lives
20%
62
+12.4
Geography
20%
40
+8.0
Restrictions
15%
35
+5.3
Relationship
10%
25
+2.5
Financials
10%
87
+8.7
Composite Score54.1
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.3 + 12.4 + 8.0 + 5.3 + 2.5 + 8.7 = 54.1
Intelligence

Qualitative intelligence

Members
3.5M
Drug spend
$0.9B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Mandatory substitution
Avg reimbursement
64 days
Strategic notes

Competitive payer landscape in state; differentiation via HEOR data essential

Peer set

Closest peers in Regional

Cherokee Health Systems of New Jersey
NJ · Tier 3
53.4
-0.8
Rocky Mountain Health Plans of North Dakota
ND · Tier 3
55.6
+1.5
Dean Health Plan of Georgia
GA · Tier 3
52.3
-1.8
Paramount Health Care of Oklahoma
OK · Tier 3
52.3
-1.9
SilverSummit Healthplan of New Mexico
NM · Tier 3
52.0
-2.1
Playbook · Tier 3

Engagement timeline

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