PayerIQ
Sun, May 24, 2026
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Tier 3DCFederal
Veterans Affairs Pharmacy Benefits
Monitor & nurture — quarterly touchpoints + data sharing
Composite
49.6
Rank
#208
Members
15.3M
Scoring profile
Six-criterion radar
Breakdown
Weighted score contribution
Claims
25%
54
+13.5
Lives
20%
43
+8.6
Geography
20%
66
+13.2
Restrictions
15%
19
+2.9
Relationship
10%
40
+4.0
Financials
10%
75
+7.5
Composite Score49.6
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 13.5 + 8.6 + 13.2 + 2.9 + 4.0 + 7.5 = 49.6
Intelligence
Qualitative intelligence
Members
15.3M
Drug spend
$3.3B
Formulary
3-tier
PA / RA level
High
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
83 days
Strategic notes
Executive sponsor identified at VP of Pharmacy level; schedule quarterly touchpoint
Peer set
Closest peers in Federal
CHAMPVA (Civilian Health and Medical Program of VA) Managed Care
DC · Tier 3
54.3
+4.6
Centers for Medicare & Medicaid Services (CMS) Insurance
MD · Tier 2
58.2
+8.6
TRICARE (Defense Health Agency)
DC · Tier 2
58.3
+8.6
Centers for Medicare & Medicaid Services (CMS)
VA · Tier 2
58.8
+9.1
Centers for Medicare & Medicaid Services (CMS) Health Plan
DC · Tier 2
59.8
+10.1
Playbook · Tier 3
Engagement timeline
Week 2
Account manager check-in
Bi-annually
Formulary monitoring report