Home Health Medicare Advantage startup Clover Health plans big expansion – MedCity News

Medicare Advantage startup Clover Health plans big expansion – MedCity News

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Medicare Advantage startup Clover Health plans big expansion – MedCity News

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Medicare Advantage startup Clover Health is planning a big expansion that would nearly triple its footprint, despite financial losses in recent years. The company said it would expand to 108 counties in eight states, up from the 34 counties where it currently operates — pending approval from the Centers for Medicare and Medicaid Services.

Clover currently operates in seven states, though most of its 57,000 members are in the New Jersey area. After seeing its membership grow by 37% last year, it will begin offering its plans in Mississippi, and expand to additional counties in the states where it currently operates.

In an email, a Clover spokesman said the planned expansion is still awaiting CMS approval, but the company fully expects it to be approved next month.

The San Francisco-based startup currently offers Medicare Advantage plans that are structured as wide PPO networks, and it also has a smaller HMO business. Like other insurance startups, it touts its technology platform, which it says uses health data to lower costs and improve outcomes for its members.

That said, technology alone won’t make or break a company.

Months after raising $500 million from Greenoaks Capital last year, Clover Health cut roughly a quarter of its workforce. Clover said the layoffs were not financially motivated, but instead because the company needed to to bring in more healthcare experts.

Clover has been operating at a net loss in recent years. In 2019, its PPO business, Clover Insurance Company, posted a net loss of $60.57 million, up from $40.9 million in 2018. It brought in revenues of $427.4 million, up from $290 million the prior year, according to its annual statement.

Photo credit: designer491, Getty Images

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