PayerIQ
Production
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Tier 3MSCommercial

Excellus BlueCross BlueShield

Monitor & nurture — quarterly touchpoints + data sharing

Composite
56.0
Rank
#179
Members
2.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
61
+15.3
Lives
20%
66
+13.2
Geography
20%
62
+12.4
Restrictions
15%
22
+3.3
Relationship
10%
63
+6.3
Financials
10%
55
+5.5
Composite Score56.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 15.3 + 13.2 + 12.4 + 3.3 + 6.3 + 5.5 = 56.0
Intelligence

Qualitative intelligence

Members
2.1M
Drug spend
$0.5B
Formulary
4-tier
PA / RA level
Moderate
Biosimilar policy
Step therapy required
Avg reimbursement
60 days
Strategic notes

Medicare Part D plan with stable formulary; step edit removal is key ask

Peer set

Closest peers in Commercial

Sutter Health Plus
OH · Tier 3
57.2
+1.3
ConnectiCare
DE · Tier 3
54.7
-1.3
SilverSummit Healthplan
MD · Tier 3
54.5
-1.5
PreferredOne
RI · Tier 3
58.0
+2.0
Superior HealthPlan
LA · Tier 2
58.3
+2.3
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report