Medicare Advantage (MA) insurtech Clover Health promoted its financial improvement during a first quarter earnings call May 6.
Clover Health posted a quarterly revenue of $462 million, good for a 33% increase year over year, and a net loss of just $1 million. This time last year, Clover had a net loss of $19 million.
Its adjusted net income rose to $25 million, amounting to a 322% increase over the first quarter of 2024.
“That’s not just numbers on a page,” said CEO Andrew Toy. “That’s real momentum.”
Toy also pointed to a recently released white paper (PDF). When physicians use Counterpart Assistant, hospitalizations decrease by 18% and 30-day readmissions are reduced by one-fourth for congestive heart failure patients, it showed. Counterpart Assistant is an AI tool sold as a software-as-a-service to payers and providers under Clover’s business entity name Counterpart Health.
“And for areas where we don’t have an MA plan, we’re pushing forward with Counterpart Health,” he added, though fresh details about the newer business was limited. The focus right now, said Toy, is profitability in the insurance segment.
The company has about 97% of its 103,318 members enrolled in plans rated four stars or better under the MA star ratings system. Clover says it leads the country among insurance rivals on HEDIS scoring measures.
Executives on the call noted the MA final rate notice by CMS earlier this year was a positive development for the company, but merely was additive to the growth they already expected to see.
“I think what we’re seeing is that other have struggled a bit on the [Preferred Provider Organization (PPO)] and are pulling back on benefits, [and] are perhaps not really investing as much as they used to, cutting back on marketing, cutting back on commissions,” said Toy. “And that is just a natural cycle of the market. We are steadying the course. We feel good about where we are.
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