PayerIQ
Production
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Tier 2PABCBS

Arkansas Blue Cross and Blue Shield

Active pursuit — access summits + value dossier

Composite
65.5
Rank
#73
Members
7.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
66
+16.5
Lives
20%
79
+15.8
Geography
20%
53
+10.6
Restrictions
15%
46
+6.9
Relationship
10%
84
+8.4
Financials
10%
73
+7.3
Composite Score65.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 16.5 + 15.8 + 10.6 + 6.9 + 8.4 + 7.3 = 65.5
Intelligence

Qualitative intelligence

Members
7.1M
Drug spend
$2.6B
Formulary
4-tier
PA / RA level
Moderate
Biosimilar policy
Case-by-case review
Avg reimbursement
18 days
Strategic notes

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

Peer set

Closest peers in BCBS

Wellmark Blue Cross Blue Shield Iowa
WY · Tier 2
66.8
+1.3
Blue Cross Blue Shield Nebraska
ND · Tier 2
63.8
-1.8
Hawaii Medical Service Association
SC · Tier 2
67.5
+2.0
Blue Cross Blue Shield of Louisiana
VT · Tier 2
63.4
-2.1
Blue Cross Blue Shield of Rhode Island Health Plan
TN · Tier 2
67.7
+2.2
Playbook · Tier 2

Engagement timeline

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