PayerIQ
Production
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Tier 2NDPBM

InfuSystem Holdings Health Plan

Active pursuit — access summits + value dossier

Composite
60.5
Rank
#123
Members
20.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
45
+9.0
Geography
20%
46
+9.2
Restrictions
15%
25
+3.8
Relationship
10%
71
+7.1
Financials
10%
65
+6.5
Composite Score60.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 9.0 + 9.2 + 3.8 + 7.1 + 6.5 = 60.5
Intelligence

Qualitative intelligence

Members
20.4M
Drug spend
$7.8B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Step therapy required
Avg reimbursement
50 days
Strategic notes

Executive sponsor identified at VP of Pharmacy level; schedule quarterly touchpoint

Peer set

Closest peers in PBM

WellDyneRx
KS · Tier 2
59.4
-1.2
BioScrip
MN · Tier 2
59.3
-1.3
OptumRx
CT · Tier 2
58.3
-2.3
AllianceRx Walgreens Prime
TX · Tier 2
63.0
+2.4
Zinc Health Services
GA · Tier 2
63.8
+3.2
Playbook · Tier 2

Engagement timeline

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