PayerIQ
Production
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Tier 4FLMedicaid

WellCare of Florida

Deprioritize — minimal contact + revisit annually

Composite
45.4
Rank
#234
Members
2.2M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
43
+10.8
Lives
20%
15
+3.0
Geography
20%
70
+14.0
Restrictions
15%
41
+6.1
Relationship
10%
55
+5.5
Financials
10%
60
+6.0
Composite Score45.4
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 10.8 + 3.0 + 14.0 + 6.1 + 5.5 + 6.0 = 45.4
Intelligence

Qualitative intelligence

Members
2.2M
Drug spend
$0.4B
Formulary
5-tier
PA / RA level
Low
Biosimilar policy
No policy defined
Avg reimbursement
63 days
Strategic notes

Strong balance sheet; specialty pipeline access discussion underway

Peer set

Closest peers in Medicaid

Molina Medicaid Louisiana
LA · Tier 4
45.7
+0.3
Minnesota Medicaid Health Plan
MN · Tier 3
46.1
+0.7
Sunshine State Health Alaska
AK · Tier 4
44.4
-1.0
Cenpatico Michigan
MI · Tier 3
47.0
+1.6
Wisconsin Community Health Alliance
WI · Tier 3
47.1
+1.7
Playbook · Tier 4

Engagement timeline

Annually
Maintenance review · revisit tier