PayerIQ
Production
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Tier 4NEBCBS

Anthem Blue Cross Blue Shield of Maine

Deprioritize — minimal contact + revisit annually

Composite
41.6
Rank
#244
Members
6.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
23
+5.8
Lives
20%
71
+14.2
Geography
20%
29
+5.8
Restrictions
15%
13
+1.9
Relationship
10%
86
+8.6
Financials
10%
53
+5.3
Composite Score41.6
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 5.8 + 14.2 + 5.8 + 1.9 + 8.6 + 5.3 = 41.6
Intelligence

Qualitative intelligence

Members
6.0M
Drug spend
$2.0B
Formulary
5-tier
PA / RA level
Low
Biosimilar policy
Step therapy required
Avg reimbursement
74 days
Strategic notes

Executive sponsor identified at VP of Pharmacy level; schedule quarterly touchpoint

Peer set

Closest peers in BCBS

Blue Cross Blue Shield of Massachusetts
LA · Tier 3
49.0
+7.4
Blue Cross Blue Shield of Texas
NY · Tier 3
50.7
+9.1
Blue Cross Blue Shield of Rhode Island
NM · Tier 3
53.0
+11.4
Regence BlueCross BlueShield Oregon
OR · Tier 3
53.8
+12.2
Blue Cross Blue Shield of Michigan
WV · Tier 3
54.6
+13.0
Playbook · Tier 4

Engagement timeline

Annually
Maintenance review · revisit tier