PayerIQ
Production
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Tier 2SDRegional

Florida Blue of South Dakota

Active pursuit — access summits + value dossier

Composite
60.5
Rank
#126
Members
1.8M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
94
+23.5
Lives
20%
29
+5.8
Geography
20%
60
+12.0
Restrictions
15%
37
+5.5
Relationship
10%
45
+4.5
Financials
10%
91
+9.1
Composite Score60.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 23.5 + 5.8 + 12.0 + 5.5 + 4.5 + 9.1 = 60.5
Intelligence

Qualitative intelligence

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

Prior collaboration on REMS program; account trust level high

Peer set

Closest peers in Regional

Gateway Health Plan of Maine
ME · Tier 2
60.4
-0.1
Martin's Point Health Care of Oklahoma
OK · Tier 2
60.5
+0.1
SCAN Health Plan of South Carolina
SC · Tier 2
60.3
-0.2
Hennepin Health of Colorado
CO · Tier 2
60.8
+0.3
EmblemHealth of Connecticut
CT · Tier 2
60.0
-0.5
Playbook · Tier 2

Engagement timeline

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