PayerIQ
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Tier 3MDMedicaid

Medicaid Managed Care Maryland

Monitor & nurture — quarterly touchpoints + data sharing

Composite
50.5
Rank
#204
Members
11.8M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
60
+15.0
Lives
20%
73
+14.6
Geography
20%
61
+12.2
Restrictions
15%
10
+1.5
Relationship
10%
10
+1.0
Financials
10%
62
+6.2
Composite Score50.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 15.0 + 14.6 + 12.2 + 1.5 + 1.0 + 6.2 = 50.5
Intelligence

Qualitative intelligence

Members
11.8M
Drug spend
$2.2B
Formulary
2-tier
PA / RA level
Very High
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
77 days
Strategic notes

Restrictive formulary; outcomes-based arrangement may unlock Tier 2 placement

Peer set

Closest peers in Medicaid

Amerigroup Alabama
AL · Tier 3
49.5
-1.0
Cenpatico Arizona
AZ · Tier 3
51.7
+1.2
WellCare of Texas
TX · Tier 3
48.8
-1.8
Wisconsin Community Health Alliance
WI · Tier 3
47.1
-3.4
Cenpatico Michigan
MI · Tier 3
47.0
-3.5
Playbook · Tier 3

Engagement timeline

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