PayerIQ
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Tier 1TXMedicare Advantage

Imperial Health Holdings Insurance

Priority engagement — executive meetings + contract acceleration

Composite
73.2
Rank
#21
Members
3.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
70
+14.0
Geography
20%
70
+14.0
Restrictions
15%
37
+5.5
Relationship
10%
97
+9.7
Financials
10%
49
+4.9
Composite Score73.2
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 14.0 + 14.0 + 5.5 + 9.7 + 4.9 = 73.2
Intelligence

Qualitative intelligence

Members
3.1M
Drug spend
$1.4B
Formulary
4-tier
PA / RA level
Moderate
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
95 days
Strategic notes

Large dual-eligible population; PA/RA process requires clinical evidence package

Peer set

Closest peers in Medicare Advantage

Clover Health
NY · Tier 2
71.0
-2.1
Friday Health Plans
CA · Tier 2
70.5
-2.6
Aetna Medicare Select Managed Care
FL · Tier 1
75.8
+2.7
Imperial Health Holdings HMO
GA · Tier 2
70.3
-2.8
Cigna-HealthSpring PPO
DE · Tier 2
69.5
-3.6
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