PayerIQ
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Tier 2TXMedicare Advantage

AARP Medicare Complete

Active pursuit — access summits + value dossier

Composite
68.7
Rank
#44
Members
4.7M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
48
+12.0
Lives
20%
100
+20.0
Geography
20%
82
+16.4
Restrictions
15%
39
+5.8
Relationship
10%
70
+7.0
Financials
10%
74
+7.4
Composite Score68.7
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 12.0 + 20.0 + 16.4 + 5.8 + 7.0 + 7.4 = 68.7
Intelligence

Qualitative intelligence

Members
4.7M
Drug spend
$2.3B
Formulary
5-tier
PA / RA level
Moderate
Biosimilar policy
Mandatory substitution
Avg reimbursement
49 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in Medicare Advantage

Imperial Health Holdings
WY · Tier 2
68.7
0.0
Cigna-HealthSpring PPO
DE · Tier 2
69.5
+0.9
Imperial Health Holdings HMO
GA · Tier 2
70.3
+1.7
Friday Health Plans
CA · Tier 2
70.5
+1.9
Clover Health
NY · Tier 2
71.0
+2.4
Playbook · Tier 2

Engagement timeline

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