PayerIQ
Production
Back to universe
Tier 4AKCommercial

MDwise

Deprioritize — minimal contact + revisit annually

Composite
45.5
Rank
#233
Members
1.8M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
41
+10.3
Lives
20%
51
+10.2
Geography
20%
43
+8.6
Restrictions
15%
21
+3.1
Relationship
10%
54
+5.4
Financials
10%
79
+7.9
Composite Score45.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 10.3 + 10.2 + 8.6 + 3.1 + 5.4 + 7.9 = 45.5
Intelligence

Qualitative intelligence

Members
1.8M
Drug spend
$0.5B
Formulary
4-tier
PA / RA level
Moderate
Biosimilar policy
No policy defined
Avg reimbursement
58 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in Commercial

Sunshine Health
WI · Tier 3
46.8
+1.3
Excellus BlueCross BlueShield HMO
TX · Tier 3
47.4
+1.9
WellStar Health
WI · Tier 3
48.6
+3.1
UPMC Health Plan
AK · Tier 3
49.6
+4.1
Physicians Plus
VT · Tier 4
40.6
-4.9
Playbook · Tier 4

Engagement timeline

Annually
Maintenance review · revisit tier