PayerIQ
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Tier 3KYRegional

CareFirst of Kentucky

Monitor & nurture — quarterly touchpoints + data sharing

Composite
49.0
Rank
#212
Members
3.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
68
+17.0
Lives
20%
65
+13.0
Geography
20%
35
+7.0
Restrictions
15%
18
+2.7
Relationship
10%
57
+5.7
Financials
10%
36
+3.6
Composite Score49.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.0 + 13.0 + 7.0 + 2.7 + 5.7 + 3.6 = 49.0
Intelligence

Qualitative intelligence

Members
3.4M
Drug spend
$1.0B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Step therapy required
Avg reimbursement
94 days
Strategic notes

Prior collaboration on REMS program; account trust level high

Peer set

Closest peers in Regional

New Mexico Health Connections of Kansas
KS · Tier 3
48.8
-0.3
Tufts Health Plan of Connecticut
CT · Tier 3
48.7
-0.3
New Mexico Health Connections of Wyoming
WY · Tier 3
49.9
+0.9
Premera Blue Cross of Louisiana
LA · Tier 3
48.0
-1.0
New Mexico Health Connections of Washington
WA · Tier 3
47.8
-1.2
Playbook · Tier 3

Engagement timeline

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