Clover Health will triple geographic footprint

Clover Health , an innovative technology company improving health outcomes for America’s seniors, announced plans to triple its geographic footprint. The expansion, pending CMS approval, increases Clover’s coverage to 108 counties in eight states.

Clover currently offers Medicare Advantage (MA) plans in 34 counties across seven states where it cares for 57,000 members. The planned expansion will bring coverage to a total of 74 additional counties with 69 of the additional counties being in Clover’s existing markets of Arizona, Georgia, New Jersey, Pennsylvania, South Carolina, Tennessee, and Texas, as well as 5 counties in Mississippi—a new market for the company. The expansion increases Clover’s market opportunity to nearly 5 million Medicare eligibles. The expansion comes on the heels of Clover’s most significant year of customer growth to date. In 2019, Clover grew membership by 37 percent and was recognized by Deft Research as the fastest-growing Medicare Advantage plan with over 50,000 members.

Unlike other Medicare Advantage plans with narrow networks, Clover’s PPO provider networks are broad and open, enabling its members to see any doctor participating in Medicare willing to accept them. Clover also focuses on keeping out-of-pocket costs for its members to a minimum and many plans allow members to pay the same low cost-sharing regardless of whether a doctor is in- or out-of-network.

Serving low-income and often overlooked communities is core to Clover’s mission to bring healthcare to people who are most in need. Clover can succeed in underserved and fragmented healthcare markets thanks to the significant clinical value provided to physicians through its Clover Assistant software. Acting like a GPS for healthcare, Clover Assistant uses machine learning to prioritize care recommendations and surface the latest evidence-based protocols to primary care providers, thereby raising the level of care of every provider.

“We knew that if we wanted to successfully bring great healthcare to every senior, including those in traditionally underserved communities, it was essential for us to actively provide value to the system, and we couldn’t play the same games as other insurers who shuffle risk and exploit flaws in the MA program. Through our unique ability to power two-way conversations with clinicians at the point of care, Clover Assistant gathers and shares the most accurate data on a member’s disease burden, which is critical to developing and validating care plans.” – Andrew Toy, President and Chief Technology Officer of Clover Health.

“The information delivered through Clover Assistant is incredibly valuable for providing our patients with the highest level of care. Clover’s technology is easy to use. It provides timely information to support care coordination, medication adherence, and offers clinical insights which empower me to produce better outcomes for my patients in rural Georgia.” – Dr. Lawrence Adjei, a primary care physician in Rincon, GA.

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, 2021.