Clover Health Reports Fourth Quarter and Full Year 2023 Financial Results; Delivers Continued Momentum in Financial Performance and Provides Full-Year 2024 Guidance
- Clover Health Investments, Corp. (CLOV) improved its full-year 2023 financial performance with Insurance MCR reaching 81.2% and fourth quarter MCR at 82.4%.
- The company reported a reduction of $126.2 million in net loss and an increase of $245.7 million in Adjusted EBITDA year-over-year.
- Clover issued 2024 guidance, forecasting an Insurance MCR range of 79% - 83% and potential Adjusted EBITDA profitability of up to $20 million at the high end of the range.
- CEO Andrew Toy highlighted the significant progress made in 2023 towards profitability, emphasizing the improvement in Adjusted EBITDA and Insurance MCR, positioning the company for future success in the Medicare Advantage program.
- Key financial metrics showed growth in Insurance revenue, a decline in Non-Insurance revenue, and improvements in Insurance MCR, reflecting the company's strategic focus on core business strengths.
- Clover's unique care management platform, including Clover Assistant and Clover Home Care, aims to empower clinicians for early chronic disease management, setting the stage for continued growth in 2024 and beyond.
- None.
Insights
The reported improvements in Insurance Medical Cost Ratio (MCR) and Adjusted EBITDA for Clover Health Investments, Corp. indicate a significant operational turnaround. A reduction in MCR from 91.8% to 81.2% year-over-year suggests enhanced efficiency in managing healthcare costs relative to premiums earned. This is a vital metric for investors as it reflects the company's ability to control expenses within its insurance operations, which is crucial for profitability in the insurance sector.
Furthermore, the reduction in net loss and the positive trajectory of Adjusted EBITDA, despite a reported net loss, suggest that the company is moving towards operational profitability. The focus on a 'benefit-rich, PPO-first model' and investments in care management platforms like Clover Assistant and Clover Home Care could be driving this improvement. These platforms may contribute to better health outcomes and cost management by facilitating early identification and management of chronic diseases.
The shift in Clover Health's business performance can be attributed to strategic initiatives aimed at improving unit economics within the Medicare Advantage program. The company's emphasis on a differentiated approach that leverages technology for clinician empowerment and chronic disease management is reflective of broader industry trends towards value-based care. This approach not only enhances patient care but also aligns with the financial incentives of reducing unnecessary healthcare spending.
While the reported decline in Non-Insurance revenue raises questions, the improved Insurance MCR and Adjusted EBITDA demonstrate a potential reallocation of resources towards more profitable and sustainable segments of the business. This realignment could be a response to market demands and regulatory environments that favor efficient, outcome-based healthcare delivery models.
The guidance for 2024, with an Insurance MCR range of 79% - 83% and up to $20 million of Adjusted EBITDA profitability, suggests management's confidence in maintaining the positive trend. However, it is important to note that the healthcare industry is subject to regulatory changes, competitive pressures and economic fluctuations that could impact these projections. The company's performance relative to competitors and the broader market will be crucial in assessing the sustainability of its growth trajectory and its ability to capitalize on the future of the Medicare Advantage program as projected by the CEO.
Investors should also consider the potential impact of the reported Non-Insurance revenue decline on overall business stability. While the focus on insurance operations seems to be yielding positive results, diversification of revenue streams remains an important factor in mitigating risks associated with market volatility.
Full-year 2023 Insurance MCR improved to
Company improves full-year 2023 Net Loss by
Issues 2024 guidance with Insurance MCR range of
FRANKLIN, Tenn., March 12, 2024 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (NASDAQ: CLOV) ("Clover," "Clover Health" or the "Company"), a managed care company focused on physician enablement, today reported financial results for the fourth quarter and full year 2023. Management will host a conference call today at 5:00 p.m. ET to discuss its operating results and other business highlights.
For the fourth quarter 2023, the Company reported revenue of
“We delivered remarkable progress in 2023 on our path to profitability, highlighted by an extraordinary improvement in Adjusted EBITDA since this time last year,” said Clover Health CEO Andrew Toy. “Driving this result is the strength and maturation of the core of our business, where we have been able to improve our Insurance MCR by more than 10 percentage points year-over-year. I believe that our ability to achieve industry-leading unit economics in 2023, within the context of a benefit-rich, PPO-first model, validates our differentiated approach, and positions our business to uniquely thrive in what we believe will be the future of the Medicare Advantage program. We expect to build upon this momentum in 2024 and beyond via our unique care management platform, underpinned by Clover Assistant and Clover Home Care, with a focus to empower clinicians to identify and manage chronic diseases earlier.”
Key Company highlights are as follows:
| Dollars in Millions | Q4'23 | Q4'22 | FY'23 | FY'22 | ||||||||||||
| Insurance revenue | $ | 303.1 | $ | 270.3 | $ | 1,235.8 | $ | 1,084.9 | ||||||||
| Non-Insurance revenue | 197.9 | 622.6 | 773.2 | 2,380.1 | ||||||||||||
| Total revenue | 510.3 | 898.8 | 2,033.7 | 3,476.7 | ||||||||||||
| Insurance MCR | 82.4 | % | 92.4 | % | 81.2 | % | 91.8 | % | ||||||||
| Non-Insurance MCR | 100.2 | 103.6 | 99.8 | 103.4 | ||||||||||||
| Salaries and benefits plus General and administrative expenses ("SG&A") (1) | $ | 109.9 | $ | 124.3 | $ | 444.7 | $ | 486.6 | ||||||||
| Adjusted Salaries and benefits plus General and administrative expenses ("Adjusted SG&A") (non-GAAP) (1)(2) | 81.4 | 84.5 | 302.0 | 312.5 | ||||||||||||
| Net loss | (70.5 | ) | (84.2 | ) | (213.4 | ) | (339.6 | ) | ||||||||
| Adjusted EBITDA (non-GAAP) (2)(3) | (19.1 | ) | (80.0 | ) | (44.7 | ) | (290.4 | ) | ||||||||
(1) Salaries and benefits plus General and administrative expenses ("SG&A") is the sum of Salaries and benefits plus General and administrative expenses presented as the GAAP measure in the consolidated financial statements.
(2) Adjusted SG&A (non-GAAP) and Adjusted EBITDA (non-GAAP) are non-GAAP financial measures. Reconciliations of Adjusted SG&A (non-GAAP) to SG&A and Adjusted EBITDA (non-GAAP) to Net loss, respectively, the most directly comparable GAAP measures, are provided in the tables immediately following the consolidated financial statements below. Additional information about the Company's non-GAAP financial measures can be found under the caption "About Non-GAAP Financial Measures" below and in Appendix A.
(3) Beginning in the fourth quarter 2023, we updated our definition and presentation of Adjusted EBITDA (non-GAAP) to exclude impairment of goodwill and other intangible assets. Impairment of goodwill and other intangible assets is now being excluded because it is a new non-cash item, is customarily excluded from Adjusted EBITDA measures, and management believes that impairment of goodwill and other intangible assets does not reflect the Company's underlying fundamentals and it is not reflective of the Company’s operating expenses relating to its core businesses or its actual recurring cash expense. The prior period figure has been revised to conform to the updated definition and presentation. For additional information, see the definition of "Adjusted EBITDA (non-GAAP)" in Appendix A.
Financial Outlook
For full-year 2024, Clover Health is providing its guidance as follows:
| Guidance | |
| Insurance revenue | |
| Insurance MCR | |
| Adjusted SG&A (Non-GAAP)(1) | |
| Adjusted EBITDA (Non-GAAP)(1) | ( |
(1) Reconciliations of projected Adjusted SG&A (non-GAAP) to projected SG&A, and projected Adjusted EBITDA (non-GAAP) to Net loss, the most directly comparable GAAP measures, are not provided because Stock-based compensation expense, which is excluded from Adjusted SG&A (non-GAAP) and Adjusted EBITDA (non-GAAP), cannot be reasonably calculated or predicted at this time without unreasonable efforts. Additional information about the Company's non-GAAP financial measures can be found under the caption "About Non-GAAP Financial Measures" below and in Appendix A.
Lives under Clover Management
| December 31, 2023 | December 31, 2022 | ||
| Insurance members | 81,205 | 88,627 | |
| Non-Insurance beneficiaries(1) | 50,529 | 164,887 | |
(1) As a direct result of not participating in the ACO REACH Program in 2024, Lives under Clover Management will include only our Insurance members as of January 1, 2024.
Earnings Conference Call Details
Clover Health's management will host a conference call to discuss its financial results on Tuesday, March 12, at 5:00 PM Eastern Time. A live webcast of the call, together with the related materials, can be accessed from Clover Health's Investor Relations website at investors.cloverhealth.com, and an on-demand replay will be available on the same website following the call.
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 under "Financial Outlook" and statements regarding expectations relating to potential improvements in Insurance MCR, operating expenses, and the number of Clover Health's Insurance members, as well as the statements contained in the quotations of our executive officers, future capital needs and other expectations as to future performance, operations and results (including our guidance for 2024). Statements regarding our Adjusted EBITDA profitability are also forward-looking, and are based on our current targets which are preliminary and are derived from the upper end of the range for our 2024 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; 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; fluctuations in the price of our Class A common stock and our continued compliance with Nasdaq's listing requirements; 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"), 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.
About Non-GAAP Financial Measures
We use non-GAAP measures including Adjusted EBITDA, Adjusted SG&A, and Adjusted SG&A as a percentage of revenue. These non-GAAP financial measures are provided to enhance the reader's understanding of Clover Health's past financial performance and our prospects for the future. Clover Health's management team uses these non-GAAP financial measures in assessing Clover Health's performance, as well as in planning and forecasting future periods. These non-GAAP financial measures are not computed according to GAAP, and the methods we use to compute them may differ from the methods used by other companies. Non-GAAP financial measures are supplemental to and should not be considered a substitute for financial information presented in accordance with GAAP and should be read only in conjunction with our consolidated financial statements prepared in accordance with GAAP. Readers are encouraged to review the reconciliations of these non-GAAP financial measures to the comparable GAAP measures, which are attached to this release, together with other important financial information, including our filings with the SEC, on the Investor Relations page of our website at investors.cloverhealth.com.
For a description of these non-GAAP financial measures, including the reasons management uses each measure, please see Appendix A: "Explanation of Non-GAAP Financial Measures."
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 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.
Visit: www.cloverhealth.com
Investor Relations Contact:
Ryan Schmidt
Press Contact:
Andrew Still-Baxter
CLOVER HEALTH INVESTMENTS, CORP.
CONSOLIDATED BALANCE SHEETS: SELECTED METRICS
(in thousands)
| December 31, 2023 | December 31, 2022 | ||||
| Selected Balance Sheet Data: | |||||
| Cash, cash equivalents, restricted cash(1), and investments | $ | 417,317 | $ | 555,293 | |
| Total assets | 570,671 | 808,620 | |||
| Unpaid claims | 138,593 | 141,947 | |||
| Total liabilities | 284,277 | 451,733 | |||
| Total stockholders' equity | 286,394 | 356,887 | |||
(1) Restricted cash relates to
| CLOVER HEALTH INVESTMENTS, CORP. | |||||||||||||||
| CONSOLIDATED STATEMENTS OF OPERATIONS | |||||||||||||||
| (Dollars in thousands, except share amounts) | |||||||||||||||
| Three Months Ended December 31, | Years Ended December 31, | ||||||||||||||
| 2023 | 2022 | 2023 | 2022 | ||||||||||||
| Revenues: | |||||||||||||||
| Premiums earned, net (Net of ceded premiums of | $ | 303,070 | $ | 270,303 | $ | 1,235,769 | $ | 1,084,869 | |||||||
| Non-Insurance revenue | 197,866 | 622,556 | 773,177 | 2,380,135 | |||||||||||
| Other income | 9,315 | 5,932 | 24,774 | 11,683 | |||||||||||
| Total revenues | 510,251 | 898,791 | 2,033,720 | 3,476,687 | |||||||||||
| Operating expenses: | |||||||||||||||
| Net medical claims incurred | 447,985 | 893,645 | 1,776,388 | 3,453,952 | |||||||||||
| Salaries and benefits | 63,946 | 69,001 | 257,157 | 278,725 | |||||||||||
| General and administrative expenses | 45,983 | 55,348 | 187,571 | 207,917 | |||||||||||
| Impairment of goodwill and other intangible assets | 15,945 | — | 15,945 | — | |||||||||||
| Premium deficiency reserve benefit | (683 | ) | (11,089 | ) | (7,239 | ) | (93,517 | ) | |||||||
| Depreciation and amortization | 674 | (841 | ) | 2,509 | 1,187 | ||||||||||
| Restructuring costs | 2,061 | — | 9,931 | — | |||||||||||
| Other expense | — | 70 | — | 70 | |||||||||||
| Total operating expenses | 575,911 | 1,006,134 | 2,242,262 | 3,848,334 | |||||||||||
| Loss from operations | (65,660 | ) | (107,343 | ) | (208,542 | ) | (371,647 | ) | |||||||
| Change in fair value of warrants | 86 | (900 | ) | 86 | (900 | ) | |||||||||
| Interest expense | — | 136 | 7 | 1,333 | |||||||||||
| Amortization of notes and securities discounts | — | 3 | — | 30 | |||||||||||
| Loss (gain) on investment | 4,726 | 970 | 4,726 | (9,217 | ) | ||||||||||
| Gain on extinguishment of note payable | — | (23,326 | ) | — | (23,326 | ) | |||||||||
| Net loss | $ | (70,472 | ) | $ | (84,226 | ) | $ | (213,361 | ) | $ | (339,567 | ) | |||
| Basic and diluted weighted average number of Class A and Class B common shares and common share equivalents outstanding | 481,607,777 | 477,898,621 | 482,176,127 | 476,244,262 | |||||||||||
Operating Segments
| Insurance | Non-Insurance | Corporate/Other | Eliminations | Consolidated Total | ||||||||||||
| Three Months Ended December 31, 2023 | (in thousands) | |||||||||||||||
| Premiums earned, net (Net of ceded premiums of | $ | 303,070 | $ | — | $ | — | $ | — | $ | 303,070 | ||||||
| Non-Insurance revenue | — | 197,866 | — | — | 197,866 | |||||||||||
| Other income | 3,144 | 4,001 | 15,103 | (12,933 | ) | 9,315 | ||||||||||
| Intersegment revenues | — | — | 42,869 | (42,869 | ) | — | ||||||||||
| Net medical claims incurred | 249,806 | 198,232 | 5,611 | (5,664 | ) | 447,985 | ||||||||||
| Gross profit (loss) | $ | 56,408 | $ | 3,635 | $ | 52,361 | $ | (50,138 | ) | $ | 62,266 | |||||
| CLOVER HEALTH INVESTMENTS, CORP. | |||||||||||||||
| RECONCILIATION OF NON-GAAP FINANCIAL MEASURES | |||||||||||||||
| ADJUSTED EBITDA (NON-GAAP) RECONCILIATION | |||||||||||||||
| (in thousands)(1) | |||||||||||||||
| Three Months Ended December 31, | Years Ended December 31, | ||||||||||||||
| 2023 | 2022 | 2023 | 2022 | ||||||||||||
| Net loss: | $ | (70,472 | ) | $ | (84,226 | ) | $ | (213,361 | ) | $ | (339,567 | ) | |||
| Adjustments | |||||||||||||||
| Interest expense | — | 136 | 7 | 1,333 | |||||||||||
| Amortization of notes and securities discount | — | 3 | — | 30 | |||||||||||
| Depreciation and amortization | 674 | (841 | ) | 2,509 | 1,187 | ||||||||||
| Change in fair value of warrants | 86 | (900 | ) | 86 | (900 | ) | |||||||||
| Loss (gain) on investment | 4,726 | 970 | 4,726 | (9,217 | ) | ||||||||||
| Stock-based compensation expense | 33,136 | 39,097 | 140,931 | 164,305 | |||||||||||
| Premium deficiency reserve benefit | (683 | ) | (11,089 | ) | (7,239 | ) | (93,517 | ) | |||||||
| Restructuring costs | 2,061 | — | 9,931 | — | |||||||||||
| Non-recurring legal expenses and settlements | (4,565 | ) | 1,088 | 1,807 | 8,266 | ||||||||||
| Impairment of goodwill and other intangible assets | 15,945 | — | 15,945 | — | |||||||||||
| Expenses attributable to Seek Insurance Services, Inc. | — | (949 | ) | — | 655 | ||||||||||
| Expenses attributable to Character Biosciences, Inc. | — | — | — | 357 | |||||||||||
| Gain on extinguishment of note payable | $ | — | $ | (23,326 | ) | $ | — | $ | (23,326 | ) | |||||
| Adjusted EBITDA (non-GAAP) | $ | (19,092 | ) | $ | (80,037 | ) | $ | (44,658 | ) | $ | (290,394 | ) | |||
(1) The table above includes non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these non-GAAP measures, see Appendix A.
CLOVER HEALTH INVESTMENTS, CORP.
RECONCILIATION OF NON-GAAP FINANCIAL MEASURES
ADJUSTED SG&A (NON-GAAP) RECONCILIATION
(in thousands)(1)
| Three Months Ended December 31, | Years Ended December 31, | ||||||||||||||
| 2023 | 2022 | 2023 | 2022 | ||||||||||||
| Salaries and benefits | $ | 63,946 | $ | 69,001 | $ | 257,157 | $ | 278,725 | |||||||
| General and administrative expenses | 45,983 | 55,348 | 187,571 | 207,917 | |||||||||||
| Total SG&A | 109,929 | 124,349 | 444,728 | 486,642 | |||||||||||
| Adjustments | |||||||||||||||
| Stock-based compensation expense | (33,136 | ) | (39,097 | ) | (140,931 | ) | (164,305 | ) | |||||||
| Non-recurring legal expenses and settlements | 4,565 | (1,088 | ) | (1,807 | ) | (8,266 | ) | ||||||||
| Expenses attributable to Seek Insurance Services, Inc. | — | 364 | — | (1,240 | ) | ||||||||||
| Expenses attributable to Character Biosciences, Inc. | — | — | — | (357 | ) | ||||||||||
| Adjusted SG&A (non-GAAP) | $ | 81,358 | $ | 84,528 | $ | 301,990 | $ | 312,474 | |||||||
| Total revenues | $ | 510,251 | $ | 898,791 | $ | 2,033,720 | $ | 3,476,687 | |||||||
| Adjusted SG&A (non-GAAP) as a percentage of revenue | 16 | % | 9 | % | 15 | % | 9 | % | |||||||
(1) The table above includes non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these non-GAAP measures, see Appendix A.
CLOVER HEALTH INVESTMENTS, CORP.
Appendix A
Explanation of Non-GAAP Financial Measures
Non-GAAP Definitions
Adjusted EBITDA - A non-GAAP financial measure defined by us as net loss before interest expense, amortization of notes and securities discount, depreciation and amortization, change in fair value of warrants, gain on investment, stock-based compensation expense, premium deficiency reserve benefit, restructuring costs, non-recurring legal expenses and settlements, impairment of goodwill and other intangible assets, expenses attributable to Seek Insurance Services, Inc., expenses attributable to Character Biosciences, Inc., and gain on extinguishment of note payable. Adjusted EBITDA is a key measure used by our management team and the board of directors to understand and evaluate our operating performance and trends, to prepare and approve our annual budget and to develop short and long-term operating plans. In particular, we believe that the exclusion of the amounts eliminated in calculating Adjusted EBITDA provide useful measures for period-to-period comparisons of our business. Accordingly, we believe that Adjusted EBITDA provides investors and others useful information to understand and evaluate our operating results in the same manner as our management and our board of directors.
Adjusted SG&A - A non-GAAP financial measure defined by us as total SG&A less Stock-based compensation expense, less non-recurring legal expenses and settlements, less expenses attributable to Seek Insurance Services, Inc., and Character Biosciences, Inc. We believe that Adjusted SG&A provides management, investors, and others a useful view of our operating spend as it excludes non-cash, stock-based compensation and expenses related to investments that management believes do not reflect the Company's core operating expenses. We believe that Adjusted SG&A as a percentage of revenue is useful to management, investors, and others because it allows us to measure our operational leverage as revenue scales.
FAQ
What is Clover Health's (CLOV) Insurance MCR for full-year 2023?
How much did Clover Health's (CLOV) net loss reduce by in full-year 2023?
What was the increase in Clover Health's (CLOV) Adjusted EBITDA year-over-year?
What is the 2024 guidance range for Clover Health's (CLOV) Insurance MCR?
What is the potential Adjusted EBITDA profitability at the high end of the 2024 guidance for Clover Health (CLOV)?
Which CEO of Clover Health (CLOV) commented on the company's progress in 2023?
What are the key components of Clover Health's unique care management platform?
What metrics showed growth in Clover Health's (CLOV) financial performance?
