PayerIQ
Production
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Tier 1VTNational

HealthMarket

Priority engagement — executive meetings + contract acceleration

Composite
77.0
Rank
#7
Members
39.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
92
+23.0
Lives
20%
99
+19.8
Geography
20%
77
+15.4
Restrictions
15%
27
+4.0
Relationship
10%
94
+9.4
Financials
10%
54
+5.4
Composite Score77.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 23.0 + 19.8 + 15.4 + 4.0 + 9.4 + 5.4 = 77.0
Intelligence

Qualitative intelligence

Members
39.5M
Drug spend
$15.3B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
62 days
Strategic notes

Strong balance sheet; specialty pipeline access discussion underway

Peer set

Closest peers in National

Optum Rx
IL · Tier 1
76.1
-1.0
Highmark Health
HI · Tier 2
71.3
-5.7
Inland Empire Health Plan
DE · Tier 2
66.8
-10.3
Harvard Pilgrim Health Plan
VT · Tier 2
66.0
-11.0
Harvard Pilgrim
NH · Tier 2
65.8
-11.2
Playbook · Tier 1

Engagement timeline

Week 1
Executive sponsor outreach · contract review
Week 2
Account team alignment · data sharing MoU
Week 4
Strategic roadmap session
Quarterly
C-suite QBR · joint planning