PayerIQ
Production
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Tier 3WVBCBS

Blue Cross Blue Shield of Michigan

Monitor & nurture — quarterly touchpoints + data sharing

Composite
54.6
Rank
#184
Members
5.7M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
48
+12.0
Lives
20%
57
+11.4
Geography
20%
70
+14.0
Restrictions
15%
27
+4.0
Relationship
10%
64
+6.4
Financials
10%
68
+6.8
Composite Score54.6
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 12.0 + 11.4 + 14.0 + 4.0 + 6.4 + 6.8 = 54.6
Intelligence

Qualitative intelligence

Members
5.7M
Drug spend
$2.2B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Preferred substitution
Avg reimbursement
54 days
Strategic notes

CMS Star Rating above 4.0; quality bonus payments create room for contract flexibility

Peer set

Closest peers in BCBS

Regence BlueCross BlueShield Oregon
OR · Tier 3
53.8
-0.9
Medical Mutual of Ohio
MN · Tier 3
56.3
+1.6
Blue Cross Blue Shield of Rhode Island
NM · Tier 3
53.0
-1.7
Anthem Blue Cross Blue Shield New Hampshire
TX · Tier 3
56.5
+1.9
Arkansas Blue Cross and Blue Shield HMO
TX · Tier 3
56.8
+2.1
Playbook · Tier 3

Engagement timeline

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