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1 month ago
Clover Health Reports First Quarter 2025 Results and Improves Full Year 2025 Guidance
First quarter 2025 Medicare Advantage membership of 103,418, up 30% year-over-year
First quarter 2025 Total revenues of $462 million, up 33% year-over-year
Medicare Advantage medical costs are in line with expectations, underscoring the strength of Clover’s technology-first care management model
Meaningful improvement across first quarter 2025 profitability metrics: GAAP Net loss of $1 million, as compared to a GAAP Net loss of $19 million a year agoAdjusted EBITDA of $26 million, up 279% year-over-yearAdjusted Net income of $25 million, up 322% year-over-year
Improved Full Year 2025 Guidance:
Average Medicare Advantage membership of 103,000 - 107,000, representing 30% growth year-over-year at the midpoint
Insurance revenue between $1.800 billion and $1.875 billion, representing 37% growth year-over-year at the midpoint
Adjusted EBITDA profitability between $50 million and $70 million
Adjusted Net income between $50 million and $70 million
WILMINGTON, Del., May 06, 2025 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), today reported financial results for the first quarter 2025. Management will host a conference call today at 5:00 p.m. ET to discuss its operating results and other business highlights.
"I am very pleased with our strong start to the year, demonstrating our ability to meaningfully grow membership and expand profitability," said Clover Health CEO Andrew Toy. "Our differentiated model is designed to drive scalable growth and proactively manage our medical costs amidst regulatory changes, outperforming others in the industry, with Clover Assistant. Our recently published clinical whitepaper on Congestive Heart Failure shows that a relationship with a Clover Assistant provider was associated with lower average number of all-cause hospitalizations (18% lower) and 30-day readmissions (25% lower)."
"Our strong first quarter 2025 financial results reflect the execution of our strategic plan to grow revenue and membership above-market rates, while continuing to drive profitability. First quarter 2025 medical costs are in line with expectations," said Clover Health CFO Peter Kuipers. "Our results and strong underlying business fundamentals further reinforce our conviction in 2025, and we will continue to strategically invest into our growth model, manage our new and returning member cohorts, and expand Clover Assistant’s reach, to enhance our already strong competitive positioning in 2026 and beyond."
Key Company highlights are as follows:
Dollars in Millions 1Q25 1Q24 Change (%)
Insurance revenue $ 456.9 $ 341.7 33.7 %
Total revenues 462.3 346.9 33.3 %
Insurance net medical claims incurred 367.9 266.1 38.3 %
Salaries and benefits plus General and administrative expenses ("SG&A") 109.7 103.8 5.7 %
Adjusted Salaries and benefits plus General and administrative expenses ("Adjusted SG&A")(1) 83.1 74.9 10.9 %
Adjusted SG&A as a % of Total revenues 18.0 % 21.6 % (360 bps )
Net loss from continuing operations $ (1.3 ) $ (23.2 ) 94.4 %
Adjusted Net income from continuing operations(1)(2) 25.3 6.0 321.7 %
Adjusted EBITDA(1) 25.8 6.8 279.4 %
Average medicare advantage membership(5) 101,959 79,265 28.6 %
Insurance BER(3) 86.1 % 83.2 % 290 bps
Total cash, cash equivalents, and investments $ 390.8 $ 440.3 (11.2)%
Financial Outlook
For full-year 2025, Clover Health is improving its guidance as follows:
Current 2025 Guidance Previous 2025 Guidance
Insurance revenue $1.800 billion - $1.875 billion $1.800 billion - $1.875 billion
Adjusted SG&A(4) $355 million - $365 million $355 million - $365 million
Adjusted SG&A as a % of Total revenues 19% - 20% 19% - 20%
Adjusted EBITDA(4) $50 million - $70 million $45 million - $70 million
Adjusted Net income(2)(4) $50 million - $70 million $45 million - $70 million
Average Medicare Advantage membership 103,000 - 107,000 103,000 - 107,000
Insurance BER(4) 87% - 88% 87% - 88%
Lives under Clover Management
March 31, 2025 March 31, 2024
Insurance members 103,418 79,527
Earnings Conference Call Details
Clover Health’s management will host a conference call to discuss its financial results on Tuesday, May 6, at 5:00 PM Eastern Time. To access the call via telephone, please dial 800-274-8461 (for U.S. callers) or 203-518-9814 (for callers outside the U.S.) and enter the conference ID: CLOVQ125. A live audio webcast will also be available online at: https://event.on24.com/wcc/r/4907810/54258C9AF223D84ADCF625A1618CDA44 and related presentation materials will be available at Clover Health’s Investor Relations website at investors.cloverhealth.com. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link and at Clover Health’s Investor Relations website at investors.cloverhealth.com, and will remain available for approximately 12 months.
Upcoming Investor Events & Conferences
2025 Bank of America Healthcare Conference at 6:00 p.m. Eastern Time, Wednesday, May 14, 2025
22nd Annual Craig-Hallum Institutional Investor Conference, Wednesday, May 28, 2025
Any live and archived webcasts and presentations associated with the conferences listed above may be accessed on Clover Health’s Investor Relations website at: investors.cloverhealth.com/news-and-events/investor-events-presentations.
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 Guidance" and statements regarding expectations relating to potential improvements in operating expenses, Adjusted SG&A, Insurance BER, 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 updated guidance for full-year 2025). Statements regarding our Adjusted EBITDA profitability and Adjusted Net income profitability are also forward-looking, and are based on our current targets which are preliminary and are derived from our 2025 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 im
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4 months ago
Counterpart Health Partners with Google Cloud to Improve Clinical Data Access for Physicians
New functionality within Counterpart Assistant uses Google Cloud’s Vertex AI Search to give clinicians comprehensive insights across multiple sources of patient health data
WILMINGTON, Del., March 03, 2025 (GLOBE NEWSWIRE) -- Counterpart Health, Inc. (“Counterpart”), a leading AI-powered physician enablement platform, today announced it has partnered with Google Cloud to integrate Vertex AI Search into its flagship technology, Counterpart Assistant. This innovation gives providers on Counterpart Assistant a generative AI (gen AI) search experience across the breadth of a patient’s digital health record to provide contextualized insights, and to make it easier to deliver value-based care. Counterpart is a subsidiary of Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover Health”).
Physicians struggle to access and synthesize the vast amounts of data within patient health records. Fragmented EHR systems hinder a unified patient history view, slowing clinical decisions and consuming valuable time. The increasing volume of medical information further complicates effective patient care.
Unlike traditional siloed systems, Counterpart Assistant synthesizes data from more than 100 sources from across the healthcare landscape such as recent tests, hospital discharges, and medication adherence, to provide a single, comprehensive view of a patient’s history. With the integration of Vertex AI Search, physicians now benefit from Google Cloud’s leading large language models (LLMs) and AI platform, Vertex AI, all within the intuitive Counterpart Assistant platform.
Key features of Counterpart Assistant’s search functionality include:
Unified Search: Access all patient documents in one place, across multiple data sources.
AI-Generated Insights: Receive intelligent natural language answers to search queries powered by Google Cloud’s Vertex AI Search.
Clinical Evidence Citations and Verification: Expand citations to view supporting data for AI-generated responses.
Contextual Data Highlighting: Instantly locate specific phrases and keywords with highlighted snippets.
“Physicians are often under-resourced and lack access to cutting-edge technologies that can simplify care delivery,” said David Tsay, MD, chief medical officer at Counterpart. “Our goal with Counterpart Assistant is to bring all the leading edge tools under one roof, layer them over a single source of normalized data, and give clinicians what they need to make informed decisions—without the burden of fragmented solutions.”
This partnership with Google Cloud further solidifies Counterpart’s reputation as a leader in building technology-first, cloud-native solutions for physicians. Counterpart’s ability to seamlessly integrate best-in-breed technologies like Vertex AI Search within its proprietary platform demonstrates its commitment to equipping clinicians with the tools they need to provide exceptional care.
“Clinicians are spending nearly 28 hours a week on administrative tasks, and 82% are reporting burnout,” said Aashima Gupta, global director of Healthcare Strategy & Solutions, Google Cloud. “Gen AI-powered search can help alleviate some of this burden, and Counterpart Health's integration of Vertex AI Search will empower physicians to access critical patient information quickly and efficiently, helping them refocus on what matters most: better patient care."
Conrad Wai, CEO of Counterpart added, “At Counterpart, we believe practicing clinicians deserve technologies that help them focus on delivering exceptional patient care. This enhancement demonstrates Counterpart Assistant’s commitment to simplifying value-based care by presenting clinical insights in the context of care delivery, so patient outcomes naturally align with performance targets. With earlier diagnoses, better chronic disease management, and streamlined workflows, clinicians can focus on caring for their patients, while excelling in value-based care programs.”
To learn more about Counterpart Health, visit: www.counterparthealth.com.
About Counterpart Health
Counterpart Health, a subsidiary of Clover Health Investments, Corp., or Clover Health, is a leading AI powered physician enablement platform. Counterpart Health’s flagship software platform, Counterpart Assistant, was incubated by Clover Health as Clover Assistant and has helped improve plan performance and clinical outcomes for Medicare members through proprietary AI technology. Counterpart Health extends the benefits of the data-driven technology platform outside of Clover Health’s Medicare Advantage plan to a wider audience, to enable enhanced patient outcomes and reduced healthcare costs nationwide. Clover Health has published data demonstrating the technology’s impact on Medication Adherence, as well as
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4 months ago
Counterpart Health Signs Multi-Year Agreement with Southern Illinois Healthcare
WILMINGTON, Del., Feb. 05, 2025 (GLOBE NEWSWIRE) -- Counterpart Health, Inc. (“Counterpart”), an AI-powered physician enablement platform, today announced a strategic, multi-year agreement with Southern Illinois Healthcare (SIH), a regional leader in healthcare delivery and the largest health system in Southern Illinois. Counterpart is a subsidiary of Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover Health”).
This partnership will enable SIH’s care teams to excel in value-based care arrangements by equipping them with Counterpart Assistant, a cloud-based AI platform seamlessly integrated into their existing EPIC electronic health record (EHR) system. Counterpart Assistant delivers real-time, patient-specific insights directly within physicians’ workflows, ensuring clinical decisions are guided by actionable, data-driven insights that prioritize patient outcomes. By focusing on improving care delivery, physicians can naturally achieve the key metrics required for success in value-based agreements without added complexity or administrative burden.
“Southern Illinois Healthcare has always been committed to providing exceptional care, particularly in the rural communities we serve,” said SIH President and CEO John Antes. “Counterpart Assistant’s ability to deliver insights at the point of care helps us achieve better outcomes for our patients while enabling success in value-based arrangements. This partnership reinforces our mission to deliver top-quality care in the most efficient, patient-centered way possible.”
Value-based care agreements require meeting specific health plan metrics, which are often tedious to manage alongside direct patient care. Counterpart Assistant simplifies this process by presenting relevant clinical insights in the context of care delivery, ensuring that improved patient outcomes naturally align with performance targets. With earlier diagnoses, better chronic disease management, and streamlined workflows, SIH’s clinicians can focus on caring for their patients, while seamlessly excelling in value-based care programs.
“Southern Illinois Healthcare’s reputation for clinical excellence makes them an ideal partner as we work to enhance value-based care delivery,” said Aric Sharp, CEO of Value-Based Care for Clover Health. “Counterpart Assistant enables providers to focus on improving patient outcomes, and the resulting performance in value-based metrics becomes a natural byproduct of this patient-first approach.”
By leveraging Counterpart Health’s proprietary AI and machine learning capabilities, SIH is advancing its ability to deliver superior patient outcomes while navigating the increasing complexity of value-based care agreements with confidence and ease.
For more information on how Counterpart Health supports physicians in value-based care arrangements, visit www.counterparthealth.com.
About Counterpart Health
Counterpart Health, a subsidiary of Clover Health Investments, Corp. (Nasdaq: CLOV), or Clover Health, is a leading AI powered physician enablement platform. Counterpart Health’s flagship software platform, Counterpart Assistant, was incubated by Clover Health as Clover Assistant and has helped improve plan performance and clinical outcomes for Medicare members through proprietary AI technology. Counterpart Health extends the benefits of the data-driven technology platform outside of Clover Health’s Medicare Advantage plan to a wider audience, to enable enhanced patient outcomes and reduced healthcare costs nationwide. Clover Health has published data demonstrating the technology’s impact on Medication Adherence, as well as the earlier identification and management of Diabetes and Chronic Kidney Disease.
About Southern Illinois Healthcare
Based in Carbondale, Ill., Southern Illinois Healthcare (SIH) is a not-for-profit health system serving the southernmost 16 counties with four hospitals and the region’s only comprehensive cancer center, Level II Trauma Center, open heart surgery program, birthing center, special care nursery and pediatric unit. The organization is also home to the SIH Mulberry Center in Harrisburg, the only non-state operated inpatient behavioral health unit south of Interstate 64. With over 670 employed and affiliated physicians and advanced practice providers in 60 specialties and subspecialties, SIH also operates more than 30 clinic
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5 months ago
Clover Health Reports 27% Growth in Medicare Advantage Membership, Surpassing 100,000 Lives After Strong Annual Election Period
Robust plan benefits powered member growth, mainly driven by switchers from other plans
Company will focus on balancing profitability with strategic investments in growth and technology to take advantage of strong market opportunity
~95% of Clover’s January 1, 2025 membership is in its flagship 4 Star PPO plan
WILMINGTON, Del., Jan. 13, 2025 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), today announced a 27% year-over-year growth of its Medicare Advantage (MA) membership during the most recent Annual Election Period (AEP). The Company enters 2025 with over 100,000 members, approximately 95% of whom are enrolled in Clover’s flagship 4-Star PPO plan.
“Driven by robust plan benefits and our 4 Star rating, we’ve delivered exceptional member growth, and I feel honored to bring so many new people into our unique model of care,” said Andrew Toy, CEO of Clover Health. “We invest deeply in using technology to improve clinical outcomes through the earlier identification, management and treatment of chronic disease, a clear differentiator from our peers. Looking forward, we will take advantage of the strong market opportunity in front of us, by making strategic investments in growth as well as continuing to widen our AI-powered technology moat.”
Clover’s 4-Star rating PPO plan reflects the Company’s deep investment in care quality, with top performance across key HEDIS measures—an industry standard for healthcare quality. This achievement also positions Clover for an anticipated 5% benchmark increase in payment year 2026 (PY26), strengthening the company’s ability to reinvest in improving benefits and further accelerating membership growth.
Jamie Reynoso, CEO of Medicare Advantage at Clover Health, added: “Our foundational investments over the last few years—ranging from enhanced care management to operational efficiencies—are paying off. Keeping a keen focus on improving the health of our members, by being an active participant in their care management, Clover is in an incredibly strong position to continue this above-market growth trajectory while of course maintaining profitability. Our strong membership growth, coupled with the expected 2026 tailwinds of our 4-Star rating and increasing impact of our integrated care model, positions Clover for long-term Medicare Advantage success. We’re excited to keep pushing forward.”
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5 months ago
Counterpart Health Deploys Counterpart Assistant with Leading Accountable Care Organization
WILLMINGTON, Del., Jan. 07, 2025 (GLOBE NEWSWIRE) -- Counterpart Health, Inc. (“Counterpart”), an AI-powered physician enablement platform, today announced it has successfully deployed its Counterpart Assistant technology within Duke Connected Care (DCC), a recognized leader in accountable care and part of the prestigious Duke University Health System. Counterpart is a subsidiary of Clover Health Investments, Corp. (NASDAQ: CLOV) (“Clover Health”).
Based in Durham, North Carolina, DCC is a physician-led accountable care organization and integral component of one of the nation’s top academic medical centers, Duke University Health System, known for its groundbreaking research, world-class medical education, and exceptional patient care. As a premier provider of healthcare services, DCC encompasses a broad network of physicians and facilities focused on value-based healthcare.
Following a successful implementation, primary care physicians across DCC’s network of non-employed physicians now have access to Counterpart Health's technology to enable advanced decision support at the point of care. Leveraging Counterpart Assistant, a cloud-based AI platform designed to seamlessly integrate with existing electronic health record (EHR) systems, clinicians receive real-time, actionable insights to help improve chronic disease management and enhance patient outcomes while maintaining their established workflows.
“DCC supports Duke Health’s strategies of delivering exceptional health outcomes and cost- effective health care in a way that fully engages patients and their loved ones with dignity and compassion,” said John Yeatts, MD, MPH, and Executive Director of DCC. “One of our goals is to unify and optimize performance across our disparate network of non-employed community practices. By leveraging cutting-edge AI technology, we are empowering our physicians with actionable insights and driving improved health outcomes.”
Conrad Wai, CEO of Counterpart Health, added, “Duke Connected Care’s reputation as a global leader in academic medicine and healthcare innovation makes this partnership especially meaningful. Our technology is purpose-built to support clinicians by delivering personalized, data-driven insights, and we’re excited to see the transformative impact it is already having across Duke’s broad and diverse network of clinicians.”
Dr. Francis Aniekwensi, a Henderson, NC-based family physician who participates in DCC’s Accountable Care Organization (ACO) stated, "I think you guys are doing a great job reducing the burden on PCPs. Especially bringing data we don't have as a small rural practice. We can't afford a fancy EHR where we might be able to get some of that automatically. The better data we have, the better job we can do of taking care of our patients.”
For more information about Counterpart Health’s AI-powered solutions and their role in transforming healthcare delivery, visit www.counterparthealth.com.