Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover
Health” or the “Company”), today announced that the Centers for
Medicare and Medicaid Services (“CMS”) has increased the Star
rating of its PPO Medicare Advantage (“MA”) plans to 4 Stars for
2025, which will affect payment year 2026. Additionally, CMS
increased the rating of Clover’s HMO MA plan to 3.5 Stars.
Currently, over 95% of Clover’s Medicare Advantage membership is
served through its PPO plans.
Each year CMS rates every plan on its healthcare quality and
drug plan, and issues a Star rating on a scale of 1 to 5 Stars. For
this measurement year, Clover’s overall Star rating was driven by
the Company’s exceptional performance across a number of measures
including Medication Adherence, the Healthcare Effectiveness Data
and Information Set (“HEDIS”), and Consumer Assessment of
Healthcare Providers and Systems (“CAHPS”). Clover earned an
impressive 4.94 out of 5 Stars on HEDIS in particular, which is a
set of performance measures quantifying a plan’s ability to deliver
preventative screenings and comprehensively manage a range of
health issues including diabetes, cancer, and heart disease.
"At Clover Health, our mission is centered around improving
healthcare outcomes for our members, and our 4-Star CMS rating
reaffirms our commitment to this goal,” said Andrew Toy,
CEO of Clover Health. “Our investment in quality far
exceeds industry standards, as demonstrated by our exceptional
HEDIS score. By leveraging the power of Clover Assistant
technology, we’re empowering physicians with real-time insights
that directly enhance the quality of care through better preventive
services and care coordination. We will continue prioritizing these
efforts to drive impactful, long-term health improvements for our
members."
"What we’ve been able to accomplish with this year’s Star
ratings is a manifestation of the foundational improvements we’ve
built over the last several years," said Jamie Reynoso, CEO
of Medicare Advantage, Clover Health. "With a higher Star
rating, we are able to further reinvest in more competitive
benefits, which we believe will deliver greater value to our
members while fueling continued membership growth. This milestone
allows us to scale our impact to more people on Medicare without
compromising our financial strength or commitment to care
quality.”
To learn more about Clover Health and its Medicare Advantage
plans visit www.cloverhealth.com. For providers, health systems and
plans interested in learning about how they can use Clover’s
proprietary technology stack to succeed in value based care, visit
www.counterparthealth.com.
Federal Contracting Disclaimer: Clover Health is a Preferred
Provider Organization (PPO) and a Health Maintenance Organization
(HMO) with a Medicare contract. Enrollment in Clover Health depends
on contract renewal.
The statements contained in this document are solely those of
the authors and do not necessarily reflect the views or policies of
CMS. The authors assume responsibility for the accuracy and
completeness of the information contained in this document.
About Clover Health:Clover Health (Nasdaq:
CLOV) is a physician enablement technology company committed to
bringing access to great healthcare to everyone on Medicare. This
includes a health equity-based focus on seniors who have
historically lacked access to affordable, high-quality healthcare.
Our strategy is powered by our software platform, Clover Assistant,
which is designed to aggregate patient data from across the
healthcare ecosystem to support clinical decision-making and
improve health outcomes through the early identification and
management of chronic disease. For our members, we provide PPO and
HMO Medicare Advantage plans in several states, with a
differentiated focus on our flagship wide-network, high-choice PPO
plans. For healthcare providers outside Clover Health's Medicare
Advantage plan, we aim to extend the benefits of our data-driven
technology platform to a wider audience via our subsidiary,
Counterpart Health, and to enable enhanced patient outcomes and
reduced healthcare costs on a nationwide scale. Clover Health has
published data demonstrating the technology’s impact on Medication
Adherence, as well as the earlier identification and management of
Diabetes and Chronic Kidney Disease.
Forward-Looking Statements:Please note that
this press release contains forward-looking statements within the
meaning of Section 27A of the Securities Act of 1933, as amended,
and Section 21E of the Securities Exchange Act of 1934, as amended.
Forward-looking statements include statements regarding future
events and Clover Health’s future results of operations, financial
position, business strategy and future plans. Forward-looking
statements are not guarantees of future performance, and you are
cautioned not to place undue reliance on such statements. In some
cases, you can identify forward looking statements because they
contain words such as “may,” “will,” “should,” “expects,” “plans,”
“anticipates,” “going to,” “can,” “could,” “should,” “would,”
“intends,” “target,” “projects,” “contemplates,” “believes,”
“estimates,” “predicts,” “potential,” “outlook,” “forecast,”
“guidance,” “objective,” “plan,” “seek,” “grow,” “target,” “if,”
“continue” or the negative of these words or other similar terms or
expressions that concern Clover Health’s expectations, strategy,
priorities, plans or intentions. Forward-looking statements in this
press release include, but are not limited to, the anticipated
benefits associated with CMS’s 2025 Star rating of 4 for Clover
Health’s PPO MA plans, as well as our expectations related to
Clover Health’s profitability, liquidity, future performance,
future operations and future results. These statements are subject
to known and unknown risks, uncertainties and other factors that
may cause Clover Health’s actual results, levels of activity,
performance or achievements to differ materially from results
expressed or implied in this press release. Additional information
concerning these and other risk factors is contained in Clover
Health’s most recent Annual Report on Form 10-K, filed with the
Securities and Exchange Commission (the “SEC”) on March 14, 2024,
and in our subsequent filings with the SEC, in each case where
relevant, including the Risk Factors sections therein, and in its
other filings with the SEC. The forward-looking statements included
in this press release are made as of the date hereof. Except as
required by law, Clover Health undertakes no obligation to update
any of these forward-looking statements after the date of this
press release or to conform these statements to actual results or
revised expectations.
Press Contact:Andrew
Still-Baxterpress@cloverhealth.com
Investor Relations Contact:Ryan
Schmidtinvestors@cloverhealth.com
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