PayerIQ
Production
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Tier 2UTRegional

MedStar Health of Utah

Active pursuit — access summits + value dossier

Composite
59.5
Rank
#136
Members
2.3M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
77
+19.3
Lives
20%
51
+10.2
Geography
20%
83
+16.6
Restrictions
15%
10
+1.5
Relationship
10%
71
+7.1
Financials
10%
48
+4.8
Composite Score59.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 19.3 + 10.2 + 16.6 + 1.5 + 7.1 + 4.8 = 59.5
Intelligence

Qualitative intelligence

Members
2.3M
Drug spend
$0.8B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Mandatory substitution
Avg reimbursement
86 days
Strategic notes

Patient advocacy partnerships in market; leverage for formulary narrative

Peer set

Closest peers in Regional

Buckeye Health Plan of Texas
TX · Tier 2
59.5
0.0
WellStar Health of New Hampshire
NH · Tier 2
59.4
-0.1
Mountain Health of Idaho
ID · Tier 2
59.3
-0.2
UPMC Health Plan of Nevada
NV · Tier 2
59.1
-0.4
EmblemHealth of Connecticut
CT · Tier 2
60.0
+0.5
Playbook · Tier 2

Engagement timeline

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