The next step in advancing Clover Health’s mission to improve every life

Vivek Garipalli
Jan 29, 2019 · 4 min read

Clover Health has always had an ambitious mission: to improve every life. Clover is the luckiest of companies that has complete alignment between the needs of our members and the success of our business. We grow and prosper financially when our members lead long, healthy lives.

Clover was created to fundamentally improve health outcomes for everyone and we knew the best way to do this was through Medicare Advantage (MA). Health is the top concern for America’s ever-growing ranks of seniors and as an MA insurer, Clover sits at the nexus of the health system for our members — bringing together information from primary care providers, specialists, hospitals and others to generate insights that no one else can.

But doing Medicare Advantage the right way is not easy. We are aiming to solve big problems and with that comes big challenges. We know we have made mistakes along the way, but we have learned from those missteps and that has helped us become smarter, stronger and provide better outcomes for our members.

Clover’s continuously improving economic fundamentals have allowed us to build sustainably, thoughtfully enter new markets and increase our overall membership by 35% during the last 12 months, compared with nationwide growth of 8% for Medicare Advantage overall. This has made Clover one of the fastest growing insurers in MA over the past three years. That said, there is much more to accomplish, which is why I am so excited about entering this next phase in our company’s history.

I am pleased to announce that Clover Health has raised a new round of funding — allowing us to bring our unique approach to improving lives and health outcomes to even more people.

Our latest funding round is led by Greenoaks Capital — who shares our vision for improving every life through better health outcomes. Our funding will close in the coming weeks, following standard regulatory approval.

This significant investment represents a recognition of Clover’s success in growing our core Medicare Advantage business as well as our ability to innovate and improve health outcomes for our members. The predictive technologies we are developing have shown meaningful results, including a machine learning model we call ‘QuickScore’ that has an 85 percent accuracy rate in identifying members at risk of being admitted to the hospital in the next 28 days. Knowing this allows Clover to prioritize and coordinate clinical resources to implement personalized care interventions, resulting in a 23% reduction in hospital admissions for those high-risk members.

We built Clover so that every decision we make is data-driven for the benefit of our members. We’ve developed tight feedback loops, so every action is fed back into our systems, helping us measure which actions most impact outcomes and iterate accordingly.

This is merely the tip of a very large iceberg that is Clover’s unequaled platform. A central challenge for healthcare today has been to devise a comprehensive, scalable system that gives physicians relevant, actionable data when they need it to help them make the best decisions possible at the point of care. Many have tried, but none have been able to create a tool that brings together the disparate information on a patient — information that is frequently scattered throughout different providers using a myriad of technology systems. Clover brings together this data and puts it at the fingertips of doctors. We will have more to share on our innovations in this area in the coming months.

This new round of funding isn’t just a strong vote of confidence in Clover Health. It also demonstrates our commitment to New Jersey residents and the innovation economy in the Garden State. We are part of the community in New Jersey, employing hundreds and providing popular insurance plans for the state’s most vulnerable inhabitants. As Clover continues to grow, so will our presence in New Jersey, as we reinvest back into the state with even more advanced care for our members.

In New Jersey, our provider network — comprised of health systems, doctors, and a full breadth of ancillary services — is arguably the broadest, strongest, and most comprehensive in the state. The hallmark of our partnership with providers goes far beyond routine insurance contracts; we support and offer the tools, data, and patient information necessary to ensure our clinical partners excel in providing the best possible care.

Medicare Advantage is widely considered to be the most stable and valuable segment of the U.S. healthcare system. With over 20 million enrollees and $200+ billion in annual revenue, Medicare Advantage is already a remarkably large market. By 2025, MA is expected to grow to more than $500 billion in annual revenue. And because Medicare is a government entitlement program, the MA space remains resilient year in and year out, regardless of the gyrations in the larger economy.

The Medicare Advantage space, however, is not easy — there are enormous barriers to entry. Clover’s approach has always been different from others who offer MA plans. Clover is committed to taking a long-term view — decades long — because we know healthcare is not for the faint of heart. This kind of determination is essential for making fundamental, positive change for patients.

We choose to offer our plans to underserved, minority populations, which far too often have been excluded from the benefits of Medicare Advantage plans. Clover proudly embraces serving a diverse population — 41% of our membership is African American or Hispanic, compared to the industry average of just 25%. We do this because we know it’s the right thing for our members and our business.

Clover also keeps adding new leadership, with our visionary Chief Technology Officer, Andrew Toy, being elevated to the role of President & CTO and joining the company’s board of directors.

This new investment in Clover provides us with additional capital to focus on growth, innovation, deepening our already strong ties with physicians, and improving the quality of care our members receive. Our goal has always been to improve every life; this is what drives our dedicated team of technologists and healthcare providers every day. We will keep our nose to the grindstone, focused on improving every single day and helping our members live long, healthy lives.

Clover: Off The Charts

Inspired to rethink how insurance works to better serve…

Clover: Off The Charts

Inspired to rethink how insurance works to better serve seniors and people with disabilities, Clover attracts empathetic and tenacious individuals dedicated to making a positive impact on the world. These are our stories.

Vivek Garipalli

Written by

Vivek Garipalli is a leading healthcare business expert who has founded a number of disruptive and innovative healthcare companies, including Clover Health

Clover: Off The Charts

Inspired to rethink how insurance works to better serve seniors and people with disabilities, Clover attracts empathetic and tenacious individuals dedicated to making a positive impact on the world. These are our stories.

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