PayerIQ
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Tier 3IAMedicaid

Molina Medicaid Iowa

Monitor & nurture — quarterly touchpoints + data sharing

Composite
56.5
Rank
#172
Members
9.6M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
18
+4.5
Lives
20%
70
+14.0
Geography
20%
67
+13.4
Restrictions
15%
75
+11.3
Relationship
10%
50
+5.0
Financials
10%
83
+8.3
Composite Score56.5
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 4.5 + 14.0 + 13.4 + 11.3 + 5.0 + 8.3 = 56.5
Intelligence

Qualitative intelligence

Members
9.6M
Drug spend
$2.1B
Formulary
4-tier
PA / RA level
Moderate
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
39 days
Strategic notes

Formulary restructure Q3 creates new placement window; timing is critical

Peer set

Closest peers in Medicaid

Medicaid Managed Care Hawaii
HI · Tier 3
56.4
-0.1
Meridian Health Plan of Louisiana
LA · Tier 3
56.0
-0.4
New Mexico Medicaid Health Plan
NM · Tier 3
55.9
-0.6
Community Care Alliance Vermont Health Plan
VT · Tier 3
55.8
-0.7
Cenpatico California
CA · Tier 3
57.5
+1.0
Playbook · Tier 3

Engagement timeline

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