PayerIQ
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Tier 2AZMedicare Advantage

Commonwealth Care Alliance

Active pursuit — access summits + value dossier

Composite
63.9
Rank
#84
Members
3.3M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
56
+14.0
Lives
20%
76
+15.2
Geography
20%
67
+13.4
Restrictions
15%
47
+7.0
Relationship
10%
48
+4.8
Financials
10%
94
+9.4
Composite Score63.9
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 14.0 + 15.2 + 13.4 + 7.0 + 4.8 + 9.4 = 63.9
Intelligence

Qualitative intelligence

Members
3.3M
Drug spend
$1.5B
Formulary
3-tier
PA / RA level
Low
Biosimilar policy
No policy defined
Avg reimbursement
77 days
Strategic notes

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

Peer set

Closest peers in Medicare Advantage

Aetna Medicare Select
AR · Tier 2
64.3
+0.4
Blue Shield Medicare Advantage
AL · Tier 2
63.3
-0.6
Senior Whole Health
PA · Tier 2
64.6
+0.7
InnovAge PACE
AK · Tier 2
63.0
-0.9
United AARP MedicareComplete
KS · Tier 2
62.7
-1.1
Playbook · Tier 2

Engagement timeline

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