PayerIQ
Production
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Tier 3HIMedicaid

Medicaid Managed Care Hawaii

Monitor & nurture — quarterly touchpoints + data sharing

Composite
56.4
Rank
#173
Members
8.8M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
56
+14.0
Lives
20%
53
+10.6
Geography
20%
67
+13.4
Restrictions
15%
43
+6.5
Relationship
10%
55
+5.5
Financials
10%
64
+6.4
Composite Score56.4
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 14.0 + 10.6 + 13.4 + 6.5 + 5.5 + 6.4 = 56.4
Intelligence

Qualitative intelligence

Members
8.8M
Drug spend
$1.2B
Formulary
4-tier
PA / RA level
High
Biosimilar policy
Case-by-case review
Avg reimbursement
41 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in Medicaid

Molina Medicaid Iowa
IA · Tier 3
56.5
+0.1
Meridian Health Plan of Louisiana
LA · Tier 3
56.0
-0.3
New Mexico Medicaid Health Plan
NM · Tier 3
55.9
-0.5
Community Care Alliance Vermont Health Plan
VT · Tier 3
55.8
-0.6
Cenpatico California
CA · Tier 3
57.5
+1.1
Playbook · Tier 3

Engagement timeline

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