PayerIQ
Production
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Tier 2AKMedicare Advantage

InnovAge PACE

Active pursuit — access summits + value dossier

Composite
63.0
Rank
#92
Members
4.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
50
+12.5
Lives
20%
100
+20.0
Geography
20%
67
+13.4
Restrictions
15%
10
+1.5
Relationship
10%
77
+7.7
Financials
10%
79
+7.9
Composite Score63.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 12.5 + 20.0 + 13.4 + 1.5 + 7.7 + 7.9 = 63.0
Intelligence

Qualitative intelligence

Members
4.5M
Drug spend
$2.5B
Formulary
4-tier
PA / RA level
Very High
Biosimilar policy
No policy defined
Avg reimbursement
40 days
Strategic notes

CMS Star Rating above 4.0; quality bonus payments create room for contract flexibility

Peer set

Closest peers in Medicare Advantage

Blue Shield Medicare Advantage
AL · Tier 2
63.3
+0.3
United AARP MedicareComplete
KS · Tier 2
62.7
-0.3
Humana Gold Plus HMO
GA · Tier 2
62.4
-0.6
United AARP MedicareComplete Managed Care
IL · Tier 2
62.4
-0.6
Commonwealth Care Alliance
AZ · Tier 2
63.9
+0.9
Playbook · Tier 2

Engagement timeline

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