Clover Health

Clover CEO Andrew Toy recently sat down with Clover Co-founder and Executive Chairperson Vivek Garipalli to discuss the company Toy sold to Google before joining Clover, as well as his vision for the future of healthcare. One topic was the importance of moving away from the reactive model to focus on the early identification and management of disease. Take a listen here: https://lnkd.in/g_YAJjn8

A strong start to a big year! So proud of what this team has already accomplished, and incredibly excited for more to come.

Clover Health CEO Andrew Toy diverged from the traditional insurance opinion on Tuesday, choosing to defend the CMS rate notice that solidified a cut of 0.16% for MA benchmark payments

I’m getting a lot of pings about where we stand regarding the CMS rate notice that came out. In short, I think the CMS rate makes sense, is appropriate, and I feel good about what it means for Clover. As a quick summary, CMS set the rate at the same amount as the previous (advanced) rate notice, which is a relatively rare departure from the norm. Normally CMS is conservative in its initial notice then revises its rate upwards after that - they chose not to do this in this case. A few thoughts : Firstly, CMS noted that one of the reasons they did not increase the rate was because they did not see Fee-for-service trending in Q4 that was elevated. That was consistent with what we saw in our Q4 Clover results, though deviated from what Humana, United and others saw, where they said they saw elevated utilization in their MA plans. My view is that this corroborates our Clover view that other managed care orgs are seeing a challenge in managing care and cost on their PPO plans - an area they have pushed hard into in the last few years as they chased growth. For Clover - where we have always been PPO first - we have Clover Assistant and our Home-Care practice, which serve as the basis of our platform and we’ve demonstrated a differentiated ability to manage that PPO cost. Secondly, if you look at what this means for the future, you can see that starting in 2025 there will be an impedance mismatch between CMS’ rate setting (based on the secular trend in FFS) and the MA plans PPO-performance (which is loosely managed and trends upwards). This rate notice means CMS does not intend to adjust for this lack of PPO care management via its rates. That is fine for Clover but challenging for other plans, who will have to pull back on benefits even more if they’re not given grace via the rate. This impedance mismatch gives us a durable advantage in designing plan products that can lead to better growth. Ultimately, Clover’s advantage sits around believing the future of Medicare is hybridizing the benefits (Vision, dental, grocery etc) of MA with the wide network of Original Medicare. This rate notice emphasizes why we feel we’re in a good place to achieve that.

This morning we announced a new partnership with Quartet Health to provide Clover members suffering from serious mental illness additional support and resources. There are many great things about our work together, but as Noah Tong notes in his article for Fierce Healthcare, one thing we're most excited about is Clover Assistant's potential to drive enrollment in the program by using AI to identify members suffering from severe mental illness. https://lnkd.in/gFgRAU9N Press Release: https://lnkd.in/guqwxUnK -------------------- This document may contain forward-looking statements that are subject to risks and uncertainties. Actual results may differ materially from those expressed or implied including due to risk factors described in Clover Health’s most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) and Clover Health’s other filings with the SEC. We do not undertake to update any such statements.

Here at Clover Health, we just announced our 2023 results and 2024 guidance. I want to take a minute to call out the incredible progress we’ve made as a business since going public just a few short years ago. We’ve gone from an MCR of 106% in 2021, to 91.8% in 2022, to what we announced today, 81.2% for 2023. Furthermore, we continue to be confident that our business plan will take us to full year 2024 positive Adjusted EBITDA profitability — another major milestone in the progress of the company. While we are a company that most often focuses on the future, it’s helpful in these moments to recognize how hard work and focus can pay off. During 2023, our team stayed focused on our core mission of improving every life, and has put us well on the path to being able to do so as a sustainable public company. I could not be more proud of every member of the team, from our nurses, physicians, and MAs who provide quality care to member in their homes; to our operations team who work tirelessly to keep the health plan running; to our technology team, which has relentlessly focused on making Clover Assistant a key tool for Clover and its providers to ensure the best possible care for every member. Undoubtedly, challenges will arise in the future, as they do in any business. That said, I do hope that these excellent results in 2023, particularly in light of the difficulties faced by others in our industry, gives members, brokers, employees, and shareholders — both current and future — evidence-based confirmation that we’ve assembled a team and a business that can thrive and succeed. In the meantime, we will continue to keep our heads down, focused on the future, and let our numbers do the talking. ---- For more information on Adjusted EBITDA, a non-GAAP financial measure, please see our March 12, 2024 Earnings Release and Appendix A). https://lnkd.in/eYyvH6Nq ----

Starting the year strong! Today Clover released a new study examining how PCP use of Clover Assistant impacts medication adherence. We found that Clover Assistant use is correlated with (1) increased medication fills for medications to which the patient was previously non-adherent and (2) higher performance on medication adherence quality measures in the Medicare Advantage Stars program for members where Clover Assistant was used. Dr. Gnana Sunderam, who uses Clover Assistant in their practice in East Orange, New Jersey, says, “The Clover Assistant notification reminds me to re-prescribe medications. When I’m busy it’s easy to forget to send in a prescription because some patients have 30 day supplies and some have 90. Very few patients bring in their medications for me to review. And even our electronic medical record may not keep up with the newest medications patients are taking. As an added benefit, seeing that patients are not refilling medications helps me understand the reason a patient’s blood pressure or cholesterol is going up.” This report is continued validation of the current and future value Clover Assistant can bring to the healthcare system. So proud of the hard work and dedication of the entire team. 🍀🍀 https://lnkd.in/g-fFw5ds #CloverHealth #CloverAssistant #ImproveEveryLife

Clover Health HK had an awesome offsite last Friday! The highlight of the day was a thrilling rickshaw-building competition that we built using cardboards, followed by an exciting race among teams. The event was packed with engaging activities that not only provided a day of enjoyment but also promoted strong teamwork and collaboration among the participants. #Cloverhk

Mark your calendars! On Thursday, October 12th at 1pm ET, we’re thrilled to host our Virtual Clover Assistant Showcase. The event will feature informative product demonstrations, followed by a live Q&A session with Clover executives and key members of the Clover Assistant team. More information on how to join and submit questions here:  https://lnkd.in/gQ3AbEpk

Chronic kidney disease, or #CKD, is an underdiagnosed, undertreated, and progressively worsening chronic condition that can lead to high blood pressure, heart disease, stroke, dialysis dependence, and death. Today, we issued a retrospective data analysis exploring how clinician use of our technology platform, Clover Assistant, is associated with earlier diagnosis of CKD stage 3 and slower decline in kidney function. “Our findings demonstrate that use of Clover Assistant can support earlier diagnosis and treatment of chronic disease. Importantly, we’re seeing that when doctors use Clover Assistant, not only is CKD diagnosed earlier in its progression, but the rate of kidney decline decelerates after diagnosis. While chronic deterioration of kidney function cannot be reversed, any deceleration delays CKD complications like heart attacks and strokes, and reduces health costs. We’re using technology in a scalable way to positively influence physician behavior and improve lives.” – Kumar Dharmarajan, Chief Medical Officer of Clover Assistant. Read more here: https://lnkd.in/gH54S9CN