PayerIQ
Sun, May 24, 2026
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Tier 2KSBCBS
Blue Cross Blue Shield of Rhode Island Managed Care
Active pursuit — access summits + value dossier
Composite
69.6
Rank
#36
Members
8.1M
Scoring profile
Six-criterion radar
Breakdown
Weighted score contribution
Claims
25%
95
+23.8
Lives
20%
100
+20.0
Geography
20%
45
+9.0
Restrictions
15%
47
+7.0
Relationship
10%
45
+4.5
Financials
10%
53
+5.3
Composite Score69.6
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 23.8 + 20.0 + 9.0 + 7.0 + 4.5 + 5.3 = 69.6
Intelligence
Qualitative intelligence
Members
8.1M
Drug spend
$2.5B
Formulary
2-tier
PA / RA level
Very High
Biosimilar policy
Mandatory substitution
Avg reimbursement
54 days
Strategic notes
Competitive payer landscape in state; differentiation via HEOR data essential
Playbook · Tier 2
Engagement timeline
Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review