PayerIQ
Sun, May 24, 2026
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Tier 2TNPBM
Abarca Health Managed Care
Active pursuit — access summits + value dossier
Composite
65.5
Rank
#74
Members
19.0M
Scoring profile
Six-criterion radar
Breakdown
Weighted score contribution
Claims
25%
67
+16.8
Lives
20%
27
+5.4
Geography
20%
100
+20.0
Restrictions
15%
61
+9.2
Relationship
10%
71
+7.1
Financials
10%
71
+7.1
Composite Score65.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 16.8 + 5.4 + 20.0 + 9.2 + 7.1 + 7.1 = 65.5
Intelligence
Qualitative intelligence
Members
19.0M
Drug spend
$9.2B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
58 days
Strategic notes
Large dual-eligible population; PA/RA process requires clinical evidence package
Playbook · Tier 2
Engagement timeline
Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review