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Tier 1VTMedicaid

Community Care Alliance Vermont

Priority engagement — executive meetings + contract acceleration

Composite
76.9
Rank
#9
Members
10.6M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
100
+25.0
Lives
20%
74
+14.8
Geography
20%
56
+11.2
Restrictions
15%
64
+9.6
Relationship
10%
100
+10.0
Financials
10%
63
+6.3
Composite Score76.9
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 25.0 + 14.8 + 11.2 + 9.6 + 10.0 + 6.3 = 76.9
Intelligence

Qualitative intelligence

Members
10.6M
Drug spend
$1.4B
Formulary
3-tier
PA / RA level
Low
Biosimilar policy
Preferred substitution
Avg reimbursement
21 days
Strategic notes

Large dual-eligible population; PA/RA process requires clinical evidence package

Peer set

Closest peers in Medicaid

Cenpatico West Virginia
WV · Tier 2
71.7
-5.3
WellCare of Alabama
AL · Tier 2
66.1
-10.8
Washington Medicaid Health Plan
WA · Tier 2
64.7
-12.3
Centene Medicaid Wyoming
WY · Tier 2
63.8
-13.1
Idaho Department of Medicaid
ID · Tier 2
60.9
-16.0
Playbook · Tier 1

Engagement timeline

Week 1
Executive sponsor outreach · contract review
Week 2
Account team alignment · data sharing MoU
Week 4
Strategic roadmap session
Quarterly
C-suite QBR · joint planning