CMS Recalculates Star Ratings — Again
CMS is recalculating some 2026 Medicare Advantage Star Ratings after a court ruled it improperly calculated Clover Health's rating, a decision that could boost payments for a small number of insurers.
Have Insurtechs Truly Disrupted the Mainstream Health Insurance Industry?
Insurtechs like Bright Health Group, Clover Health and Oscar Health set out to disrupt health insurance — but have they actually done so? Not in a positive way, several experts say.
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Clover Therapeutics turns a new leaf as Character Bio to pursue dry AMD & more
Dry age-related macular degeneration currently has no FDA-approved treatments but the research of Clover Therapeutics has yielded two candidates. The biotech startup has made progress in the past two years under CEO Cheng Zhang and it’s now revealing more details about its approach, a new corporate identity, and a Series A financing that puts it on the path to the clinic.
Devoted Health raises $1.1B, sending valuation soaring past $12B
Though the Medicare Advantage-focused insurance technology startup is smaller than rivals like Clover Health in terms of membership and revenues, this latest financing round places it ahead of, or at least on par with, several larger competitors with regard to total funds raised.
CMS lowers MA premiums amid insurer plans to grow offerings
CMS is lowering the average premium for MA plans to $19 per month in 2022 from about $21 this year. The news comes as several insurers announce new MA plan offerings for 2022, including Humana, which said it will launch 72 plans.
In analyst call, Clover reveals it doesn’t have the customers it said it did during IPO
When it planned to go public through a SPAC merger, insurance startup Clover Health told investors that it already had 200,000 direct contracting lives under contract for 2021. But in new guidance shared on Monday, the company now plans to end the year just 70,000 to 100,000 covered lives from direct contracting.
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Clover Health, Roundtrip to offer MA members non-emergency transport services
The health insurance startup and transportation service company are joining forces to offer Medicare Advantage members access to non-emergency medical transportation. With transportation being a key social determinant of health, Clover Health and Roundtrip are aiming to improve member experience and outcomes through the partnership.
Short seller targets insurance startup Clover in scathing report
After a scathing report from short-seller Hindenburg claiming that Clover faced a False Claims Act investigation, the insurance startup’s stock plummeted. Clover went public last month after merging with a special-purpose acquisition company under billionaire investor Chamath Palihapitiya.
Clover’s growth projections reveal direct contracting pivot
When it announced plans to go public through a blank-check company, Clover Health shared ambitious projections for its future membership. Much of that growth is pinned on plans to launch a direct contracting business.
Clover Health goes public in $3.7B SPAC deal
Medicare Advantage startup Clover Health will go public in a blank-check acquisition led by billionaire Chamath Palihapitiya. The deal will value Clover at $3.7 billion.
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Medicare Advantage startup Clover Health plans big expansion
Clover Health said it plans to triple its footprint in the next year, pending CMS approval. But the insurer has also posted a net loss in recent years.
NJ legislators call for probe of insurance unicorn
New Jersey legislators called for state officials to investigate insurance startup Clover Health, as well as other entities created by the owners of for-profit hospital group CarePoint Health.
Clover Health touts membership growth after restructuring
Clover Health said it added 15,000 new members in the last year, primarily in New Jersey. The news comes after Clover restructured its workforce in March, affecting more than 100 employees.
Medicare Advantage startup Clover Health launches drug development arm
The company has signed an initial partnership with Genentech that will focus on understanding the genetic components that are related to a person's risk of developing ocular diseases like macular degeneration.
Clover Health is laying off a quarter of its workforce, two months after $500M fundraise
The Medicare Advantage startup positioned the layoffs as a way to focus more on developing specific expertise in Medicare Advantage and healthcare.