PayerIQ
Sun, May 24, 2026
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Tier 2VAFederal
Centers for Medicare & Medicaid Services (CMS)
Active pursuit — access summits + value dossier
Composite
58.8
Rank
#145
Members
30.1M
Scoring profile
Six-criterion radar
Breakdown
Weighted score contribution
Claims
25%
55
+13.8
Lives
20%
100
+20.0
Geography
20%
29
+5.8
Restrictions
15%
30
+4.5
Relationship
10%
69
+6.9
Financials
10%
78
+7.8
Composite Score58.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 13.8 + 20.0 + 5.8 + 4.5 + 6.9 + 7.8 = 58.8
Intelligence
Qualitative intelligence
Members
30.1M
Drug spend
$7.9B
Formulary
5-tier
PA / RA level
High
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
22 days
Strategic notes
Patient advocacy partnerships in market; leverage for formulary narrative
Peer set
Closest peers in Federal
TRICARE (Defense Health Agency)
DC · Tier 2
58.3
-0.5
Centers for Medicare & Medicaid Services (CMS) Insurance
MD · Tier 2
58.2
-0.5
Centers for Medicare & Medicaid Services (CMS) Health Plan
DC · Tier 2
59.8
+1.0
Medicare Part D National Program
MD · Tier 2
59.8
+1.0
Centers for Medicare & Medicaid Services (CMS) HMO
VA · Tier 2
61.6
+2.9
Playbook · Tier 2
Engagement timeline
Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review