PayerIQ
Production
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Tier 2MNPBM

BioScrip

Active pursuit — access summits + value dossier

Composite
59.3
Rank
#140
Members
25.8M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
67
+13.4
Geography
20%
48
+9.6
Restrictions
15%
31
+4.6
Relationship
10%
10
+1.0
Financials
10%
56
+5.6
Composite Score59.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 13.4 + 9.6 + 4.6 + 1.0 + 5.6 = 59.3
Intelligence

Qualitative intelligence

Members
25.8M
Drug spend
$11.3B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Mandatory substitution
Avg reimbursement
46 days
Strategic notes

CMS Star Rating above 4.0; quality bonus payments create room for contract flexibility

Peer set

Closest peers in PBM

WellDyneRx
KS · Tier 2
59.4
+0.1
OptumRx
CT · Tier 2
58.3
-1.0
InfuSystem Holdings Health Plan
ND · Tier 2
60.5
+1.3
OptumRx MCO
MD · Tier 3
56.9
-2.4
Zinc Health Services HMO
WA · Tier 3
56.9
-2.4
Playbook · Tier 2

Engagement timeline

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