PayerIQ
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Tier 1VTCommercial

Rocky Mountain Health Plans Insurance

Priority engagement — executive meetings + contract acceleration

Composite
82.3
Rank
#2
Members
3.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
94
+18.8
Geography
20%
79
+15.8
Restrictions
15%
38
+5.7
Relationship
10%
93
+9.3
Financials
10%
77
+7.7
Composite Score82.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 18.8 + 15.8 + 5.7 + 9.3 + 7.7 = 82.3
Intelligence

Qualitative intelligence

Members
3.1M
Drug spend
$0.8B
Formulary
3-tier
PA / RA level
Very High
Biosimilar policy
Mandatory substitution
Avg reimbursement
62 days
Strategic notes

Strong balance sheet; specialty pipeline access discussion underway

Peer set

Closest peers in Commercial

Rocky Mountain Health Plans
IL · Tier 1
76.8
-5.5
Sharp Health Plan
ND · Tier 1
75.0
-7.3
UCare
IA · Tier 2
70.5
-11.8
Paramount Health Care
MA · Tier 2
68.9
-13.4
Hennepin Health
ND · Tier 2
67.3
-15.0
Playbook · Tier 1

Engagement timeline

Week 1
Executive sponsor outreach · contract review
Week 2
Account team alignment · data sharing MoU
Week 4
Strategic roadmap session
Quarterly
C-suite QBR · joint planning