Clover Health Investments, Corp. (NASDAQ: CLOV) has announced that the Centers for Medicare and Medicaid Services (CMS) has increased the star rating of its PPO Medicare Advantage (MA) plans to 4 stars for 2025, which will impact payment year 2026. Additionally, CMS increased the rating of Clover’s HMO MA plan to 3.5 stars.
Currently, over 95% of Clover’s Medicare Advantage membership is served through its PPO plans.
For this measurement year, Clover’s overall star rating was driven by the company’s exceptional performance across a number of measures including medication adherence, the Healthcare Effectiveness Data and Information Set (HEDIS), and Consumer Assessment of Healthcare Providers and Systems (CAHPS).
Clover earned an impressive 4.94 out of 5 stars on HEDIS, which is a set of performance measures quantifying a plan’s ability to deliver preventative screenings and comprehensively manage a range of health issues including diabetes, cancer, and heart disease.
Andrew Toy, CEO of Clover Health, stated, “At Clover Health, our mission is centered around improving healthcare outcomes for our members, and our 4-star CMS rating reaffirms our commitment to this goal.”
Jamie Reynoso, CEO of Medicare Advantage at Clover Health, commented, “What we’ve been able to accomplish with this year’s star ratings is a manifestation of the foundational improvements we’ve built over the last several years. With a higher star rating, we are able to further reinvest in more competitive benefits, which we believe will deliver greater value to our members while fueling continued membership growth.”
In a demonstration of its commitment to care quality, 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. Following these announcements, the company's shares moved 3.0%, and are now trading at a price of $4.07. Check out the company's full 8-K submission here.
