PayerIQ
Production
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Tier 2IDBCBS

Blue Cross Blue Shield of Alabama

Active pursuit — access summits + value dossier

Composite
69.3
Rank
#38
Members
6.7M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
62
+15.5
Lives
20%
83
+16.6
Geography
20%
100
+20.0
Restrictions
15%
10
+1.5
Relationship
10%
97
+9.7
Financials
10%
60
+6.0
Composite Score69.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 15.5 + 16.6 + 20.0 + 1.5 + 9.7 + 6.0 = 69.3
Intelligence

Qualitative intelligence

Members
6.7M
Drug spend
$2.6B
Formulary
4-tier
PA / RA level
Very High
Biosimilar policy
Step therapy required
Avg reimbursement
75 days
Strategic notes

Geographic advantage in target region; growing Medicare Advantage enrollment

Peer set

Closest peers in BCBS

Blue Cross Blue Shield of Rhode Island Managed Care
KS · Tier 2
69.6
+0.3
Anthem Blue Cross Blue Shield of Maine HMO
IA · Tier 2
69.0
-0.3
CareFirst BlueCross BlueShield Managed Care
MA · Tier 2
68.7
-0.6
Florida Blue
ME · Tier 2
68.1
-1.2
Florida Blue MCO
DC · Tier 2
70.6
+1.3
Playbook · Tier 2

Engagement timeline

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