PayerIQ
Production
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Tier 2GABCBS

Regence BlueCross BlueShield Oregon HMO

Active pursuit — access summits + value dossier

Composite
60.0
Rank
#129
Members
4.8M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
92
+23.0
Lives
20%
54
+10.8
Geography
20%
67
+13.4
Restrictions
15%
40
+6.0
Relationship
10%
10
+1.0
Financials
10%
58
+5.8
Composite Score60.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 23.0 + 10.8 + 13.4 + 6.0 + 1.0 + 5.8 = 60.0
Intelligence

Qualitative intelligence

Members
4.8M
Drug spend
$1.4B
Formulary
4-tier
PA / RA level
Very High
Biosimilar policy
No policy defined
Avg reimbursement
64 days
Strategic notes

PBM-managed rebate structure; volume-based rebate negotiation is primary lever

Peer set

Closest peers in BCBS

Horizon Blue Cross Blue Shield NJ
OR · Tier 2
59.8
-0.3
Blue Shield of California
HI · Tier 2
59.8
-0.3
Blue Cross Blue Shield of Kansas
NV · Tier 2
60.5
+0.5
Anthem HealthKeepers Virginia
AZ · Tier 2
58.9
-1.1
Blue Cross Blue Shield Nebraska HMO
ME · Tier 2
61.1
+1.1
Playbook · Tier 2

Engagement timeline

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