PayerIQ
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Tier 3TXBCBS

Anthem Blue Cross Blue Shield New Hampshire

Monitor & nurture — quarterly touchpoints + data sharing

Composite
56.5
Rank
#171
Members
4.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
44
+8.8
Geography
20%
60
+12.0
Restrictions
15%
18
+2.7
Relationship
10%
35
+3.5
Financials
10%
45
+4.5
Composite Score56.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 8.8 + 12.0 + 2.7 + 3.5 + 4.5 = 56.5
Intelligence

Qualitative intelligence

Members
4.4M
Drug spend
$1.6B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Preferred substitution
Avg reimbursement
21 days
Strategic notes

Strong legacy relationship with regional medical director; preferred placement feasible

Peer set

Closest peers in BCBS

Medical Mutual of Ohio
MN · Tier 3
56.3
-0.3
Arkansas Blue Cross and Blue Shield HMO
TX · Tier 3
56.8
+0.3
CareFirst BlueCross BlueShield
MO · Tier 3
57.6
+1.1
Blue Cross Blue Shield of Michigan
WV · Tier 3
54.6
-1.9
Blue Cross Blue Shield North Dakota
MA · Tier 2
58.5
+2.0
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report