PayerIQ
Production
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Tier 2IACommercial

UCare

Active pursuit — access summits + value dossier

Composite
70.5
Rank
#33
Members
2.7M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
70
+17.5
Lives
20%
85
+17.0
Geography
20%
66
+13.2
Restrictions
15%
62
+9.3
Relationship
10%
76
+7.6
Financials
10%
59
+5.9
Composite Score70.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.5 + 17.0 + 13.2 + 9.3 + 7.6 + 5.9 = 70.5
Intelligence

Qualitative intelligence

Members
2.7M
Drug spend
$0.9B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
No policy defined
Avg reimbursement
26 days
Strategic notes

Restrictive formulary; outcomes-based arrangement may unlock Tier 2 placement

Peer set

Closest peers in Commercial

Paramount Health Care
MA · Tier 2
68.9
-1.6
Hennepin Health
ND · Tier 2
67.3
-3.3
CareOregon Managed Care
DC · Tier 2
67.3
-3.3
CareOregon
NH · Tier 2
67.2
-3.3
Sharp Health Plan
ND · Tier 1
75.0
+4.5
Playbook · Tier 2

Engagement timeline

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