PayerIQ
Production
Back to universe
Tier 3ORBCBS

Regence BlueCross BlueShield Oregon

Monitor & nurture — quarterly touchpoints + data sharing

Composite
53.8
Rank
#191
Members
5.7M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
34
+8.5
Lives
20%
65
+13.0
Geography
20%
75
+15.0
Restrictions
15%
10
+1.5
Relationship
10%
100
+10.0
Financials
10%
58
+5.8
Composite Score53.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 8.5 + 13.0 + 15.0 + 1.5 + 10.0 + 5.8 = 53.8
Intelligence

Qualitative intelligence

Members
5.7M
Drug spend
$1.9B
Formulary
3-tier
PA / RA level
Low
Biosimilar policy
Mandatory substitution
Avg reimbursement
78 days
Strategic notes

High claims volume but federal formulary restrictions require CMS waiver pathway

Peer set

Closest peers in BCBS

Blue Cross Blue Shield of Rhode Island
NM · Tier 3
53.0
-0.8
Blue Cross Blue Shield of Michigan
WV · Tier 3
54.6
+0.9
Medical Mutual of Ohio
MN · Tier 3
56.3
+2.5
Anthem Blue Cross Blue Shield New Hampshire
TX · Tier 3
56.5
+2.7
Arkansas Blue Cross and Blue Shield HMO
TX · Tier 3
56.8
+3.0
Playbook · Tier 3

Engagement timeline

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