PayerIQ
Production
Back to universe
Tier 2WAMedicaid

Washington Medicaid Health Plan

Active pursuit — access summits + value dossier

Composite
64.7
Rank
#79
Members
12.0M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
69
+17.3
Lives
20%
84
+16.8
Geography
20%
53
+10.6
Restrictions
15%
60
+9.0
Relationship
10%
51
+5.1
Financials
10%
59
+5.9
Composite Score64.7
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.3 + 16.8 + 10.6 + 9.0 + 5.1 + 5.9 = 64.7
Intelligence

Qualitative intelligence

Members
12.0M
Drug spend
$2.4B
Formulary
4-tier
PA / RA level
Low
Biosimilar policy
Preferred substitution
Avg reimbursement
27 days
Strategic notes

Active Medicaid contract renewal cycle; incumbent advantage can be leveraged

Peer set

Closest peers in Medicaid

Centene Medicaid Wyoming
WY · Tier 2
63.8
-0.9
WellCare of Alabama
AL · Tier 2
66.1
+1.4
Idaho Department of Medicaid
ID · Tier 2
60.9
-3.8
Medicaid Managed Care New Jersey
NJ · Tier 2
60.8
-3.9
WellCare of Alaska
AK · Tier 2
59.0
-5.7
Playbook · Tier 2

Engagement timeline

Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review