PayerIQ
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Tier 2MAPBM

Abarca Health

Active pursuit — access summits + value dossier

Composite
67.2
Rank
#58
Members
25.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
64
+12.8
Geography
20%
45
+9.0
Restrictions
15%
44
+6.6
Relationship
10%
47
+4.7
Financials
10%
91
+9.1
Composite Score67.2
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 12.8 + 9.0 + 6.6 + 4.7 + 9.1 = 67.2
Intelligence

Qualitative intelligence

Members
25.0M
Drug spend
$11.4B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
21 days
Strategic notes

High claims volume but federal formulary restrictions require CMS waiver pathway

Peer set

Closest peers in PBM

Abarca Health Managed Care
TN · Tier 2
65.5
-1.7
Zinc Health Services
GA · Tier 2
63.8
-3.5
AllianceRx Walgreens Prime
TX · Tier 2
63.0
-4.3
MedImpact Healthcare Systems
OK · Tier 2
71.9
+4.7
InfuSystem Holdings Health Plan
ND · Tier 2
60.5
-6.7
Playbook · Tier 2

Engagement timeline

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