PayerIQ
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Tier 3KYMedicaid

Meridian Health Plan of Kentucky

Monitor & nurture — quarterly touchpoints + data sharing

Composite
58.0
Rank
#156
Members
4.1M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
91
+22.8
Lives
20%
27
+5.4
Geography
20%
67
+13.4
Restrictions
15%
30
+4.5
Relationship
10%
42
+4.2
Financials
10%
77
+7.7
Composite Score58.0
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 22.8 + 5.4 + 13.4 + 4.5 + 4.2 + 7.7 = 58.0
Intelligence

Qualitative intelligence

Members
4.1M
Drug spend
$0.6B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Step therapy required
Avg reimbursement
40 days
Strategic notes

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

Peer set

Closest peers in Medicaid

Cenpatico California
CA · Tier 3
57.5
-0.5
Medicaid Managed Care Delaware
DE · Tier 2
58.9
+0.9
WellCare of Alaska
AK · Tier 2
59.0
+1.0
Molina Medicaid Iowa
IA · Tier 3
56.5
-1.5
Medicaid Managed Care Hawaii
HI · Tier 3
56.4
-1.6
Playbook · Tier 3

Engagement timeline

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