PayerIQ
Production
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Tier 2MABCBS

Blue Cross Blue Shield North Dakota

Active pursuit — access summits + value dossier

Composite
58.5
Rank
#147
Members
5.2M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
77
+19.3
Lives
20%
64
+12.8
Geography
20%
54
+10.8
Restrictions
15%
10
+1.5
Relationship
10%
84
+8.4
Financials
10%
58
+5.8
Composite Score58.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 19.3 + 12.8 + 10.8 + 1.5 + 8.4 + 5.8 = 58.5
Intelligence

Qualitative intelligence

Members
5.2M
Drug spend
$1.6B
Formulary
2-tier
PA / RA level
High
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
71 days
Strategic notes

Large covered lives base; formulary team open to outcomes-based contracts

Peer set

Closest peers in BCBS

Anthem HealthKeepers Virginia
AZ · Tier 2
58.9
+0.4
CareFirst BlueCross BlueShield
MO · Tier 3
57.6
-0.9
Horizon Blue Cross Blue Shield NJ
OR · Tier 2
59.8
+1.2
Blue Shield of California
HI · Tier 2
59.8
+1.2
Regence BlueCross BlueShield Oregon HMO
GA · Tier 2
60.0
+1.5
Playbook · Tier 2

Engagement timeline

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