PayerIQ
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Tier 3TXMedicaid

WellCare of Texas

Monitor & nurture — quarterly touchpoints + data sharing

Composite
48.8
Rank
#214
Members
8.2M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
48
+12.0
Lives
20%
58
+11.6
Geography
20%
53
+10.6
Restrictions
15%
19
+2.9
Relationship
10%
55
+5.5
Financials
10%
62
+6.2
Composite Score48.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 12.0 + 11.6 + 10.6 + 2.9 + 5.5 + 6.2 = 48.8
Intelligence

Qualitative intelligence

Members
8.2M
Drug spend
$1.4B
Formulary
4-tier
PA / RA level
High
Biosimilar policy
Mandatory substitution
Avg reimbursement
63 days
Strategic notes

Large covered lives base; formulary team open to outcomes-based contracts

Peer set

Closest peers in Medicaid

Amerigroup Alabama
AL · Tier 3
49.5
+0.7
Wisconsin Community Health Alliance
WI · Tier 3
47.1
-1.6
Cenpatico Michigan
MI · Tier 3
47.0
-1.7
Medicaid Managed Care Maryland
MD · Tier 3
50.5
+1.8
Minnesota Medicaid Health Plan
MN · Tier 3
46.1
-2.6
Playbook · Tier 3

Engagement timeline

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