Clover Health Strengthens Presence Across Georgia with New Medicare Advantage Network Contracts
Clover Health (Nasdaq: CLOV) has expanded its provider network in Georgia, adding approximately 5,000 primary care physicians and specialists. This growth complements Clover's existing network and provides in-network access to nearly 15,000 providers statewide. The Centers for Medicare and Medicaid Services authorized Clover to operate in 78 additional counties in Georgia starting January 1, 2022, potentially serving over 600,000 new eligible Medicare members. Clover's Medicare Advantage plans will promote cost-sharing parity, allowing members to see their preferred providers regardless of network status.
- Expansion of provider network by adding 5,000 primary care physicians and specialists.
- Access to nearly 15,000 providers statewide for Clover members.
- CMS approval for expansion into 78 additional counties in Georgia, increasing potential member base to over 600,000.
- None.
- 5,000 primary care physicians and specialists in network
- Facilitates ease and access to local care for GA members
NASHVILLE, Tenn., Nov. 10, 2021 (GLOBE NEWSWIRE) -- Clover Health (Nasdaq: CLOV) (“Clover”), a technology company committed to improving health equity for America’s underserved seniors, today announced it has significantly increased the breadth and depth of its provider network throughout Georgia with the addition of dozens of hospitals, health systems and key provider partners across the region.
These contracts align approximately 5,000 new primary care physicians (PCPs) and specialists with Clover’s Medicare Advantage PPO network and complement the strong existing network in the Atlanta, Savannah, and Macon markets, offering Clover members in-network access to nearly 15,000 providers statewide.
Recently, the Centers for Medicare and Medicaid Services (CMS) approved Clover’s service area expansion to operate in 78 additional counties in Georgia. With this approved service area expansion beginning January 1, 2022, Clover’s Medicare Advantage (MA) plans will be available to more than 600,000 eligible individuals in 146 of Georgia’s 159 counties.
Individuals eligible for Medicare in these new counties can sign up for Clover’s plans during the Annual Election Period, which runs from October 15 to December 7, with coverage starting on January 1, 2022.
Such significant network growth with local hospitals and health systems in Georgia demonstrates Clover’s deep investment in serving the state’s local Medicare population as well as the potential of Clover’s technology-driven approach. Importantly, while Clover offers a strong network, the company also prides itself on the open nature of its MA plans. Clover's MA plans in Georgia have in- and out-of-network cost-sharing parity, which means that seeing a PCP costs the same for Clover members in the state regardless of whether their PCP is in Clover’s network or not. One important advantage of this approach is that it often allows people to continue seeing their existing PCP rather than switching to a new one with whom they do not have an existing relationship.
“With our wide network we strive to empower members to see the physician they choose and trust, whereas HMOs tend to dictate that choice through narrow networks. It’s essential as an insurer to foster the trusting relationships seniors already have in place with their doctors, because we believe it encourages them to engage more regularly with the healthcare system and that it can ultimately lead to improved health outcomes,” said Andrew Toy, President of Clover. “By strengthening our provider network with thousands of clinicians across Georgia and providing them with our clinical support technology, we believe we can make quality, data-driven care more accessible to the local Medicare population.”
The key agreements supporting Clover’s 2022 expansion counties in Georgia and neighboring states serving Georgia-based patients include:
- Aiken Regional Medical Centers in Aiken, SC
- Archbold Medical Center in Thomasville, GA
- Augusta University Health in Augusta, GA
- Crisp Regional Health Services in Cordele, GA
- Emory Healthcare in Atlanta, GA with hospitals and physicians across the state, including Columbus, GA
- Grady Health in Atlanta, GA
- HCA Healthcare in Savannah, GA with hospitals and physicians across the state, including Augusta, Dublin, Vidalia, and Waycross, GA
- Navicent Health in Macon, GA
- Northside Hospital in Atlanta, GA
- Phoebe Putney Health System in Albany, GA
- Piedmont Healthcare in Atlanta, GA, with hospitals and physicians across the state, including Athens, Augusta, Columbus, and Macon, GA
- Southeast Georgia Health System in Brunswick, GA
- St. Joseph’s/Candler Health System in Savannah, GA
- Tanner Health System in Carrollton, GA
- Wellstar Health System in Marietta, GA, with hospitals and physicians across the state
These providers may also contract with other Plans/Part D sponsors.
About Clover Health:
Clover Health (Nasdaq: CLOV) is a next-generation risk-bearing organization aiming to achieve health equity for all Americans. While our mission is to improve every life, we particularly focus on seniors who have historically lacked access to affordable high quality healthcare.
We aim to provide great care, in a sustainable way, by having a business model built around improving medical outcomes while lowering avoidable costs. We do this while taking a holistic approach to understanding the health needs and social risk factors of those under our care. This strategy is underpinned by the company’s proprietary software platform, the Clover Assistant, which is designed to aggregate patient data from across the health ecosystem to support clinical decision-making by presenting physicians and other providers with real-time, personalized recommendations at the point of care.
Making care more accessible is at the heart of our business, and we believe patients should have the freedom to choose their doctors. We offer affordable Medicare Advantage plans with extensive benefits, provide primary care physicians with the Clover Assistant, and also make comprehensive home-based care available via the Clover Home Care program.
With its corporate headquarters in Nashville, Clover’s workforce is distributed around the U.S. and also includes a team of world-class technologists based in Hong Kong. The company manages care for Medicare beneficiaries in Arizona, Georgia, Mississippi, New Jersey, New York, Pennsylvania, South Carolina, Tennessee, and Texas.
Press Contact:
Andrew Still-Baxter
press@cloverhealth.com
FAQ
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