PayerIQ
Production
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Tier 3RICommercial

PreferredOne

Monitor & nurture — quarterly touchpoints + data sharing

Composite
58.0
Rank
#157
Members
2.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
69
+17.3
Lives
20%
49
+9.8
Geography
20%
56
+11.2
Restrictions
15%
48
+7.2
Relationship
10%
35
+3.5
Financials
10%
90
+9.0
Composite Score58.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.3 + 9.8 + 11.2 + 7.2 + 3.5 + 9.0 = 58.0
Intelligence

Qualitative intelligence

Members
2.0M
Drug spend
$0.5B
Formulary
4-tier
PA / RA level
High
Biosimilar policy
Step therapy required
Avg reimbursement
58 days
Strategic notes

Strong legacy relationship with regional medical director; preferred placement feasible

Peer set

Closest peers in Commercial

Superior HealthPlan
LA · Tier 2
58.3
+0.3
Sutter Health Plus
OH · Tier 3
57.2
-0.8
Excellus BlueCross BlueShield
MS · Tier 3
56.0
-2.0
ConnectiCare
DE · Tier 3
54.7
-3.3
Sunshine Health MCO
NH · Tier 2
61.2
+3.3
Playbook · Tier 3

Engagement timeline

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