PayerIQ
Production
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Tier 2MDFederal

Indian Health Service

Active pursuit — access summits + value dossier

Composite
68.8
Rank
#42
Members
22.2M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
90
+22.5
Lives
20%
69
+13.8
Geography
20%
87
+17.4
Restrictions
15%
17
+2.5
Relationship
10%
39
+3.9
Financials
10%
86
+8.6
Composite Score68.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 22.5 + 13.8 + 17.4 + 2.5 + 3.9 + 8.6 = 68.8
Intelligence

Qualitative intelligence

Members
22.2M
Drug spend
$6.6B
Formulary
5-tier
PA / RA level
Moderate
Biosimilar policy
No policy defined
Avg reimbursement
93 days
Strategic notes

PBM-managed rebate structure; volume-based rebate negotiation is primary lever

Peer set

Closest peers in Federal

Medicaid Federal Match Program
VA · Tier 2
68.3
-0.4
Medicare Advantage National
DC · Tier 2
67.2
-1.6
Medicare Part D National Program HMO
VA · Tier 2
71.3
+2.5
CHAMPVA (Civilian Health and Medical Program of VA)
MD · Tier 1
75.5
+6.8
Medicare Advantage National HMO
DC · Tier 2
62.0
-6.8
Playbook · Tier 2

Engagement timeline

Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review