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Tier 3DCMedicare Advantage

Wellcare Medicare Advantage

Monitor & nurture — quarterly touchpoints + data sharing

Composite
46.5
Rank
#226
Members
2.9M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
56
+14.0
Lives
20%
65
+13.0
Geography
20%
38
+7.6
Restrictions
15%
10
+1.5
Relationship
10%
23
+2.3
Financials
10%
81
+8.1
Composite Score46.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 14.0 + 13.0 + 7.6 + 1.5 + 2.3 + 8.1 = 46.5
Intelligence

Qualitative intelligence

Members
2.9M
Drug spend
$1.7B
Formulary
6-tier
PA / RA level
High
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
76 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in Medicare Advantage

Humana Gold Plus
ME · Tier 3
47.8
+1.3
Humana Gold Plus PPO
MI · Tier 4
44.9
-1.6
Bright Health
MS · Tier 3
50.5
+4.0
Highmark Freedom Blue
ND · Tier 3
57.7
+11.2
Cigna-HealthSpring
MS · Tier 2
60.5
+14.0
Playbook · Tier 3

Engagement timeline

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