PayerIQ
Production
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Tier 2AKMedicaid

WellCare of Alaska

Active pursuit — access summits + value dossier

Composite
59.0
Rank
#142
Members
8.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
78
+19.5
Lives
20%
61
+12.2
Geography
20%
56
+11.2
Restrictions
15%
53
+7.9
Relationship
10%
36
+3.6
Financials
10%
45
+4.5
Composite Score59.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 19.5 + 12.2 + 11.2 + 7.9 + 3.6 + 4.5 = 59.0
Intelligence

Qualitative intelligence

Members
8.0M
Drug spend
$1.2B
Formulary
3-tier
PA / RA level
Very High
Biosimilar policy
No policy defined
Avg reimbursement
73 days
Strategic notes

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

Peer set

Closest peers in Medicaid

Medicaid Managed Care Delaware
DE · Tier 2
58.9
-0.1
Meridian Health Plan of Kentucky
KY · Tier 3
58.0
-1.0
Cenpatico California
CA · Tier 3
57.5
-1.5
Medicaid Managed Care New Jersey
NJ · Tier 2
60.8
+1.8
Idaho Department of Medicaid
ID · Tier 2
60.9
+1.9
Playbook · Tier 2

Engagement timeline

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