PayerIQ
Production
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Tier 2NYRegional

SelectCare of New York

Active pursuit — access summits + value dossier

Composite
58.3
Rank
#150
Members
3.6M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
43
+10.8
Lives
20%
76
+15.2
Geography
20%
99
+19.8
Restrictions
15%
19
+2.9
Relationship
10%
19
+1.9
Financials
10%
78
+7.8
Composite Score58.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 10.8 + 15.2 + 19.8 + 2.9 + 1.9 + 7.8 = 58.3
Intelligence

Qualitative intelligence

Members
3.6M
Drug spend
$0.9B
Formulary
5-tier
PA / RA level
Low
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
56 days
Strategic notes

Strong legacy relationship with regional medical director; preferred placement feasible

Peer set

Closest peers in Regional

Johns Hopkins Health Plans of Missouri
MO · Tier 2
58.2
-0.1
Arkansas Blue Cross of Oklahoma
OK · Tier 2
58.5
+0.3
Tufts Health Plan of New York
NY · Tier 2
58.8
+0.5
CareFirst of Ohio
OH · Tier 3
57.8
-0.5
UPMC Health Plan of Nevada
NV · Tier 2
59.1
+0.8
Playbook · Tier 2

Engagement timeline

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