PayerIQ
Production
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Tier 3OHCommercial

Sutter Health Plus

Monitor & nurture — quarterly touchpoints + data sharing

Composite
57.2
Rank
#164
Members
2.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
69
+17.3
Lives
20%
68
+13.6
Geography
20%
53
+10.6
Restrictions
15%
35
+5.3
Relationship
10%
51
+5.1
Financials
10%
54
+5.4
Composite Score57.2
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.3 + 13.6 + 10.6 + 5.3 + 5.1 + 5.4 = 57.2
Intelligence

Qualitative intelligence

Members
2.4M
Drug spend
$0.5B
Formulary
4-tier
PA / RA level
Very High
Biosimilar policy
Preferred substitution
Avg reimbursement
34 days
Strategic notes

Recent merger with regional system creates expanded formulary committee access

Peer set

Closest peers in Commercial

PreferredOne
RI · Tier 3
58.0
+0.8
Superior HealthPlan
LA · Tier 2
58.3
+1.1
Excellus BlueCross BlueShield
MS · Tier 3
56.0
-1.3
ConnectiCare
DE · Tier 3
54.7
-2.5
SilverSummit Healthplan
MD · Tier 3
54.5
-2.8
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report