PayerIQ
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Tier 1FLMedicare Advantage

Aetna Medicare Select Managed Care

Priority engagement — executive meetings + contract acceleration

Composite
75.8
Rank
#14
Members
4.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
100
+20.0
Geography
20%
70
+14.0
Restrictions
15%
29
+4.3
Relationship
10%
77
+7.7
Financials
10%
48
+4.8
Composite Score75.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 20.0 + 14.0 + 4.3 + 7.7 + 4.8 = 75.8
Intelligence

Qualitative intelligence

Members
4.5M
Drug spend
$2.8B
Formulary
5-tier
PA / RA level
High
Biosimilar policy
Preferred substitution
Avg reimbursement
33 days
Strategic notes

Data-sharing agreement pending legal review; delay contracting until finalized

Peer set

Closest peers in Medicare Advantage

Imperial Health Holdings Insurance
TX · Tier 1
73.2
-2.7
Clover Health
NY · Tier 2
71.0
-4.8
Friday Health Plans
CA · Tier 2
70.5
-5.3
Imperial Health Holdings HMO
GA · Tier 2
70.3
-5.5
Cigna-HealthSpring PPO
DE · Tier 2
69.5
-6.3
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