PayerIQ
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Tier 2ARMedicare Advantage

Aetna Medicare Select

Active pursuit — access summits + value dossier

Composite
64.3
Rank
#82
Members
3.8M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
91
+22.8
Lives
20%
83
+16.6
Geography
20%
34
+6.8
Restrictions
15%
39
+5.8
Relationship
10%
23
+2.3
Financials
10%
100
+10.0
Composite Score64.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 22.8 + 16.6 + 6.8 + 5.8 + 2.3 + 10.0 = 64.3
Intelligence

Qualitative intelligence

Members
3.8M
Drug spend
$2.0B
Formulary
5-tier
PA / RA level
None
Biosimilar policy
Step therapy required
Avg reimbursement
67 days
Strategic notes

BCBS plan with regional flexibility; negotiation via BlueCard network possible

Peer set

Closest peers in Medicare Advantage

Senior Whole Health
PA · Tier 2
64.6
+0.3
Commonwealth Care Alliance
AZ · Tier 2
63.9
-0.4
Blue Shield Medicare Advantage
AL · Tier 2
63.3
-1.0
Alignment Healthcare
IA · Tier 2
65.6
+1.3
InnovAge PACE
AK · Tier 2
63.0
-1.3
Playbook · Tier 2

Engagement timeline

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