PayerIQ
Production
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Tier 2NHRegional

WellStar Health of New Hampshire

Active pursuit — access summits + value dossier

Composite
59.4
Rank
#137
Members
4.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
46
+11.5
Lives
20%
83
+16.6
Geography
20%
40
+8.0
Restrictions
15%
50
+7.5
Relationship
10%
80
+8.0
Financials
10%
78
+7.8
Composite Score59.4
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 11.5 + 16.6 + 8.0 + 7.5 + 8.0 + 7.8 = 59.4
Intelligence

Qualitative intelligence

Members
4.4M
Drug spend
$1.6B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Step therapy required
Avg reimbursement
84 days
Strategic notes

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

Peer set

Closest peers in Regional

Buckeye Health Plan of Texas
TX · Tier 2
59.5
+0.1
MedStar Health of Utah
UT · Tier 2
59.5
+0.1
Mountain Health of Idaho
ID · Tier 2
59.3
-0.1
UPMC Health Plan of Nevada
NV · Tier 2
59.1
-0.3
EmblemHealth of Connecticut
CT · Tier 2
60.0
+0.6
Playbook · Tier 2

Engagement timeline

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