PayerIQ
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Tier 2ALMedicaid

WellCare of Alabama

Active pursuit — access summits + value dossier

Composite
66.1
Rank
#67
Members
12.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
52
+13.0
Lives
20%
92
+18.4
Geography
20%
100
+20.0
Restrictions
15%
28
+4.2
Relationship
10%
70
+7.0
Financials
10%
35
+3.5
Composite Score66.1
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 13.0 + 18.4 + 20.0 + 4.2 + 7.0 + 3.5 = 66.1
Intelligence

Qualitative intelligence

Members
12.4M
Drug spend
$2.3B
Formulary
5-tier
PA / RA level
Low
Biosimilar policy
Preferred substitution
Avg reimbursement
43 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in Medicaid

Washington Medicaid Health Plan
WA · Tier 2
64.7
-1.4
Centene Medicaid Wyoming
WY · Tier 2
63.8
-2.3
Idaho Department of Medicaid
ID · Tier 2
60.9
-5.2
Medicaid Managed Care New Jersey
NJ · Tier 2
60.8
-5.3
Cenpatico West Virginia
WV · Tier 2
71.7
+5.6
Playbook · Tier 2

Engagement timeline

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