PayerIQ
Production
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Tier 1NHBCBS

Anthem Blue Cross Blue Shield of Kentucky

Priority engagement — executive meetings + contract acceleration

Composite
72.1
Rank
#23
Members
7.7M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
90
+22.5
Lives
20%
98
+19.6
Geography
20%
45
+9.0
Restrictions
15%
30
+4.5
Relationship
10%
71
+7.1
Financials
10%
94
+9.4
Composite Score72.1
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 22.5 + 19.6 + 9.0 + 4.5 + 7.1 + 9.4 = 72.1
Intelligence

Qualitative intelligence

Members
7.7M
Drug spend
$3.0B
Formulary
5-tier
PA / RA level
Low
Biosimilar policy
No policy defined
Avg reimbursement
93 days
Strategic notes

Restrictive formulary; outcomes-based arrangement may unlock Tier 2 placement

Peer set

Closest peers in BCBS

Anthem Blue Cross Blue Shield of Indiana
AK · Tier 2
71.5
-0.5
Florida Blue MCO
DC · Tier 2
70.6
-1.5
Hawaii Medical Service Association PPO
AK · Tier 1
73.7
+1.6
Blue Cross Blue Shield of Rhode Island Managed Care
KS · Tier 2
69.6
-2.5
Blue Cross Blue Shield of Alabama
ID · Tier 2
69.3
-2.8
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