Clover Health Reports 27% Growth in Medicare Advantage Membership, Surpassing 100,000 Lives After Strong Annual Election Period
Clover Health (CLOV) reported a significant 27% year-over-year growth in its Medicare Advantage membership, surpassing 100,000 members after the recent Annual Election Period. Approximately 95% of members are enrolled in the company's flagship 4-Star PPO plan.
The growth was primarily driven by members switching from other plans, attracted by Clover's robust plan benefits. The 4-Star rating positions the company for an anticipated 5% benchmark increase in payment year 2026. Clover emphasizes its technology-driven approach, using AI to improve clinical outcomes through early identification and management of chronic diseases.
The company plans to balance profitability with strategic investments in growth and technology, leveraging its strong market position and integrated care model. The 4-Star PPO plan has demonstrated top performance across key HEDIS measures, reflecting Clover's commitment to healthcare quality.
Clover Health (CLOV) ha riportato una significativa crescita del 27% anno su anno nella sua adesione al Medicare Advantage, superando i 100.000 membri dopo il recente Periodo di Elezione Annuale. Circa il 95% dei membri è iscritto al piano PPO principale dell'azienda, che ha un punteggio di 4 stelle.
La crescita è stata principalmente trainata dai membri che si sono trasferiti da altri piani, attratti dai vantaggi robusti del piano di Clover. Il punteggio di 4 stelle posiziona l'azienda per un previsto aumento del pagamento del 5% nel 2026. Clover sottolinea il suo approccio basato sulla tecnologia, utilizzando l'IA per migliorare i risultati clinici attraverso l'identificazione precoce e la gestione delle malattie croniche.
L'azienda prevede di bilanciare la redditività con investimenti strategici nella crescita e nella tecnologia, sfruttando la sua forte posizione di mercato e il modello di assistenza integrata. Il piano PPO a 4 stelle ha dimostrato prestazioni di alto livello in misure chiave HEDIS, riflettendo l'impegno di Clover per la qualità dell'assistenza sanitaria.
Clover Health (CLOV) reportó un crecimiento significativo del 27% interanual en su membresía de Medicare Advantage, superando los 100,000 miembros después del reciente Período de Elección Anual. Aproximadamente el 95% de los miembros está inscrito en el plan PPO de 4 estrellas de la empresa.
El crecimiento fue impulsado principalmente por miembros que cambiaron de otros planes, atraídos por los robustos beneficios del plan de Clover. La calificación de 4 estrellas posiciona a la empresa para un incremento de pago del 5% en el año 2026 que se anticipa. Clover enfatiza su enfoque impulsado por la tecnología, utilizando IA para mejorar los resultados clínicos a través de la identificación temprana y la gestión de enfermedades crónicas.
La empresa planea equilibrar la rentabilidad con inversiones estratégicas en crecimiento y tecnología, aprovechando su fuerte posición en el mercado y su modelo de atención integrada. El plan PPO de 4 estrellas ha demostrado un rendimiento superior en medidas clave de HEDIS, reflejando el compromiso de Clover con la calidad de la atención médica.
Clover Health (CLOV)는 최근 연간 선거 기간 이후 Medicare Advantage 회원 수가 전년 대비 27% 증가하여 100,000명을 넘었다고 보고했습니다. 약 95%의 회원이 회사의 주요 4성급 PPO 플랜에 가입되어 있습니다.
성장은 주로 다른 플랜에서 전환한 회원들에 의해 주도되었으며, Clover의 강력한 플랜 혜택에 끌린 결과입니다. 4성급 평가는 회사가 예상하는 2026년 지급 기준 5% 증가에 대비할 수 있게 합니다. Clover는 만성 질환의 조기 발견 및 관리를 통해 임상 결과를 개선하기 위해 AI를 활용한 기술 주도적 접근 방식을 강조합니다.
회사는 강력한 시장 위치와 통합 관리 모델을 활용하여 성장과 기술에 대한 전략적 투자를 통해 수익성과 균형을 맞출 계획입니다. 4성급 PPO 플랜은 HEDIS 주요 지표에서 뛰어난 성과를 보여주며, Clover의 헬스케어 품질에 대한 약속을 반영합니다.
Clover Health (CLOV) a annoncé une croissance significative de 27% d'une année sur l'autre de son adhésion au Medicare Advantage, dépassant les 100 000 membres après la récente Période d'Élection Annuelle. Environ 95% des membres sont inscrits au plan PPO phare de l'entreprise, qui a obtenu une note de 4 étoiles.
Cette croissance a été principalement influencée par des membres passant d'autres plans, attirés par les avantages solides du plan de Clover. La note de 4 étoiles positionne l'entreprise pour une augmentation prévue de 5% des paiements en 2026. Clover met en avant son approche technologique, utilisant l'IA pour améliorer les résultats cliniques grâce à une identification précoce et une gestion des maladies chroniques.
L'entreprise prévoit d'équilibrer rentabilité et investissements stratégiques dans la croissance et la technologie, en tirant parti de sa solide position sur le marché et de son modèle de soins intégrés. Le plan PPO à 4 étoiles a démontré des performances supérieures dans des mesures clés HEDIS, reflétant l'engagement de Clover envers la qualité des soins de santé.
Clover Health (CLOV) hat ein signifikantes Wachstum von 27% im Jahresvergleich in seiner Medicare Advantage Mitgliedschaft gemeldet und hat nach der kürzlichen jährlichen Wahlperiode die 100.000 Mitglieder überschritten. Etwa 95% der Mitglieder sind im führenden 4-Sterne PPO-Plan des Unternehmens eingeschrieben.
Das Wachstum wurde hauptsächlich durch Mitglieder, die von anderen Plänen gewechselt sind, angetrieben, die von den robusten Planleistungen von Clover angezogen wurden. Die 4-Sterne-Bewertung positioniert das Unternehmen für eine erwartete 5%ige Benchmark-Erhöhung der Zahlungen im Jahr 2026. Clover betont seinen technologiegetriebenen Ansatz und setzt KI ein, um klinische Ergebnisse durch frühzeitige Identifikation und Management chronischer Erkrankungen zu verbessern.
Das Unternehmen plant, Rentabilität mit strategischen Investitionen in Wachstum und Technologie in Einklang zu bringen, indem es seine starke Marktposition und das integrierte Versorgungsmodell nutzt. Der 4-Sterne-PPO-Plan hat in wichtigen HEDIS-Maßnahmen hervorragende Leistungen gezeigt, was Clover's Engagement für die Qualität der Gesundheitsversorgung unterstreicht.
- 27% year-over-year growth in Medicare Advantage membership
- Achieved 100,000+ member milestone
- 95% of members enrolled in 4-Star PPO plan
- Expected 5% benchmark payment increase in 2026 due to 4-Star rating
- Strong performance in HEDIS healthcare quality measures
- None.
Insights
The 27% year-over-year growth in Medicare Advantage membership positions Clover Health favorably in the competitive MA market. Surpassing 100,000 members represents a critical mass that enhances economies of scale and negotiating power with healthcare providers. The 4-Star rating achievement for their PPO plan covering 95% of membership is particularly noteworthy, as it unlocks a 5% benchmark payment increase for 2026, translating to approximately
The company's strategic focus on chronic disease management through AI technology creates a compelling competitive moat. In the Medicare Advantage space, where medical loss ratios typically range from 85-87%, improved clinical outcomes through earlier intervention can significantly impact profitability. The strong AEP performance, primarily driven by plan switchers, indicates effective market penetration and suggests Clover's value proposition is resonating with sophisticated Medicare beneficiaries who actively shop for better coverage.
The robust membership growth carries substantial financial implications. With average revenue per member of approximately
The focus on balancing profitability with strategic investments suggests a mature approach to scaling. The emphasis on technology investment, particularly in AI-powered solutions, indicates potential for improving medical cost ratios through better risk management and care coordination. The combination of accelerating membership growth, operational leverage from scale and upcoming payment enhancements creates a compelling financial trajectory for 2025-2026.
- Robust plan benefits powered member growth, mainly driven by switchers from other plans
- Company will focus on balancing profitability with strategic investments in growth and technology to take advantage of strong market opportunity
- ~
95% of Clover’s January 1, 2025 membership is in its flagship 4 Star PPO plan
WILMINGTON, Del., Jan. 13, 2025 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), today announced a
“Driven by robust plan benefits and our 4 Star rating, we’ve delivered exceptional member growth, and I feel honored to bring so many new people into our unique model of care,” said Andrew Toy, CEO of Clover Health. “We invest deeply in using technology to improve clinical outcomes through the earlier identification, management and treatment of chronic disease, a clear differentiator from our peers. Looking forward, we will take advantage of the strong market opportunity in front of us, by making strategic investments in growth as well as continuing to widen our AI-powered technology moat.”
Clover’s 4-Star rating PPO plan reflects the Company’s deep investment in care quality, with top performance across key HEDIS measures—an industry standard for healthcare quality. This achievement also positions Clover for an anticipated
Jamie Reynoso, CEO of Medicare Advantage at Clover Health, added: “Our foundational investments over the last few years—ranging from enhanced care management to operational efficiencies—are paying off. Keeping a keen focus on improving the health of our members, by being an active participant in their care management, Clover is in an incredibly strong position to continue this above-market growth trajectory while of course maintaining profitability. Our strong membership growth, coupled with the expected 2026 tailwinds of our 4-Star rating and increasing impact of our integrated care model, positions Clover for long-term Medicare Advantage success. We’re excited to keep pushing forward.”
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 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 extend the benefits of our data-driven technology platform to a wider audience via our subsidiary, Counterpart Health, and aim 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
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 condition, market size and opportunity, business strategy and plans, and the factors affecting our performance and our objectives for future operations. 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," "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 following: statements regarding the Company’s Annual Election Period results and 2025 market growth and their anticipated effects on the Company’s financial performance, the anticipated number of Clover Health Insurance members, Adjusted EBITDA profitability, and the Company’s Star Ratings and its affect on future membership growth and profitability, as well as the statements contained in the quotations of our executive officers and other expectations as to future performance, operations and results. Forward-looking statements regarding our Adjusted EBITDA profitability are based on our current targets which are preliminary and are derived from our 2025 financial outlook. These statements are subject to known and unknown risks, uncertainties and other factors that may cause our actual results, levels of activity, performance or achievements to differ materially from results expressed or implied by forward-looking statements in this press release. Forward-looking statements involve a number of judgments, risks and uncertainties, including, without limitation, risks related to: our expectations regarding results of operations, financial condition, and cash flows; our expectations regarding the development and management of our Insurance business; our ability to successfully enter new service markets and manage our operations; anticipated trends and challenges in our business and in the markets in which we operate; our ability to effectively manage our beneficiary base and provider network; our ability to maintain and increase adoption and use of Clover Assistant, including the expansion of Clover Assistant for external payors and providers under the brand name Counterpart Assistant; the anticipated benefits associated with the use of Clover Assistant, including our ability to utilize the platform to manage our medical care ratios; our ability to maintain or improve our Star Ratings or otherwise continue to improve the financial performance of our business; our ability to develop new features and functionality that meet market needs and achieve market acceptance; our ability to retain and hire necessary employees and staff our operations appropriately; the timing and amount of certain investments in growth; the outcome of any known and unknown litigation and regulatory proceedings; any current, pending, or future legislation, regulations or policies that could have a negative effect on our revenue and businesses, including rules, regulations, and policies relating to healthcare and Medicare; our ability to maintain, protect, and enhance our intellectual property; general economic conditions and uncertainty; persistent high inflation and interest rates; and geopolitical uncertainty and instability. Additional information concerning these and other risk factors is contained under Item 1A. “Risk Factors” in our most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission (the "SEC") on March 14, 2024, as such risks may be updated in our subsequent 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-Baxter
press@cloverhealth.com
Investor Relations Contact:
Ryan Schmidt
investors@cloverhealth.com
FAQ
What was CLOV's Medicare Advantage membership growth rate in 2024?
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What percentage of CLOV members are enrolled in the 4-Star PPO plan?
What is the expected payment increase for CLOV in 2026 due to its 4-Star rating?
What drove CLOV's membership growth in the recent Annual Election Period?
