PayerIQ
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Tier 4AKMedicaid

Sunshine State Health Alaska

Deprioritize — minimal contact + revisit annually

Composite
44.4
Rank
#237
Members
6.3M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
45
+11.3
Lives
20%
35
+7.0
Geography
20%
38
+7.6
Restrictions
15%
53
+7.9
Relationship
10%
53
+5.3
Financials
10%
53
+5.3
Composite Score44.4
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 11.3 + 7.0 + 7.6 + 7.9 + 5.3 + 5.3 = 44.4
Intelligence

Qualitative intelligence

Members
6.3M
Drug spend
$0.9B
Formulary
6-tier
PA / RA level
Moderate
Biosimilar policy
Preferred substitution
Avg reimbursement
30 days
Strategic notes

PBM-managed rebate structure; volume-based rebate negotiation is primary lever

Peer set

Closest peers in Medicaid

Pennsylvania Department of Medicaid
PA · Tier 4
43.4
-1.0
WellCare of Florida
FL · Tier 4
45.4
+1.0
Molina Medicaid Louisiana
LA · Tier 4
45.7
+1.3
Minnesota Medicaid Health Plan
MN · Tier 3
46.1
+1.7
Cenpatico Michigan
MI · Tier 3
47.0
+2.6
Playbook · Tier 4

Engagement timeline

Annually
Maintenance review · revisit tier