Strong growth and success fueled by affordable plans, broad provider network, and doctor adoption of clinical software platform, ‘Clover Assistant’
Today Clover Health, an innovative technology company improving health outcomes for America’s seniors, announced robust membership growth of 37 percent in 2019. Clover began January 2019 with 39,400 members and starts January 2020 with 54,400 members. The company saw positive growth throughout the entire year, with a surge of new sign-ups during the recently ended Medicare Annual Election Period (AEP). One of the fastest-growing Medicare Advantage plans, Clover’s dramatic increase in membership is compared to the 5-year industry average of just 7 percent year-over-year growth.
Much of the growth in membership comes from New Jersey, a notoriously fragmented healthcare market where Clover continues to excel — thanks to affordable, high-quality Medicare Advantage plans that provide access to a wide network of primary care physicians, specialists, and hospitals. Clover’s approach differs from the narrow networks common with other Medicare Advantage plans, as its 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 an absolute minimum and allows members to pay the same low cost-sharing regardless of whether the doctor is in- or out-of-network.
Clover proudly serves many low-income and often overlooked communities, which is core to the company’s mission of bringing healthcare to people who are most in need and commonly ignored by other insurers. Clover analysis shows that this past AEP, approximately 50 percent of individuals in New Jersey choosing a Medicare Advantage plan for the first time selected Clover over the 7 other insurance companies offering plans. The company will take this successful formula to generate state-wide growth in its other markets in 2021.
In addition to expanding Clover’s membership base, the company is successfully providing significant clinical value to doctors through its Clover Assistant software platform. Acting like GPS for healthcare, Clover Assistant prioritizes care recommendations based on machine learning and the synthesis of each member’s healthcare history (including comorbid conditions, lab results, and medications). Clover Assistant also surfaces the latest evidence-based protocols to physicians, helping them select the most effective therapeutics and manage Clover members at the highest level of care.
For example, Clover members with diabetes receive customized management recommendations based on the presence of other conditions, such as cardiovascular or kidney disease, and are pointed to the most appropriate medication choices within the health plan formulary. Importantly, Clover Assistant is used at the point of care, during patient visits, when the recommendations are most actionable and relevant—supporting shared clinical decisions by providers and patients. Currently, over a thousand doctors in New Jersey are up and running with Clover Assistant.