PayerIQ
Production
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Tier 2SCRegional

SCAN Health Plan of South Carolina

Active pursuit — access summits + value dossier

Composite
60.3
Rank
#128
Members
1.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
64
+16.0
Lives
20%
20
+4.0
Geography
20%
76
+15.2
Restrictions
15%
62
+9.3
Relationship
10%
73
+7.3
Financials
10%
85
+8.5
Composite Score60.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 16.0 + 4.0 + 15.2 + 9.3 + 7.3 + 8.5 = 60.3
Intelligence

Qualitative intelligence

Members
1.1M
Drug spend
$0.3B
Formulary
6-tier
PA / RA level
Moderate
Biosimilar policy
No policy defined
Avg reimbursement
60 days
Strategic notes

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

Peer set

Closest peers in Regional

Gateway Health Plan of Maine
ME · Tier 2
60.4
+0.1
Florida Blue of South Dakota
SD · Tier 2
60.5
+0.2
Martin's Point Health Care of Oklahoma
OK · Tier 2
60.5
+0.3
EmblemHealth of Connecticut
CT · Tier 2
60.0
-0.3
Hennepin Health of Colorado
CO · Tier 2
60.8
+0.5
Playbook · Tier 2

Engagement timeline

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