Clover Health (NASDAQ: CLOV) recently released their third quarter 2025 supplemental Q&A, providing insight into their performance and strategic focus. Here are some key takeaways from the Q&A:
Medical Cost Pressures: The incurred part C medical cost trend for the third quarter of 2025 was 4% year-over-year, excluding pharmacy, while absorbing 35% new membership growth. This cost trend was higher than initial expectations but is viewed as a solid result relative to the broader market and the company's growth rate.
Outlook for 2026: Clover Health expects 2026 to be fundamentally different from 2025, with various favorable factors contributing to a larger base of profitable returning members and greater ability to increase adjusted EBITDA profitability.
Growth Discipline and Market Expansion: The company plans to enter 2026 with a focus on disciplined growth, improved cohort performance, and a refined growth strategy targeting markets where Clover Assistant coverage and physician engagement are strong.
Pharmacy Management and Star Ratings: Clover Health is implementing enhancements in pharmacy management to improve pharmacy-related star measures and strengthen their overall quality profile.
Membership Growth and Retention: Despite a recent star ratings downgrade, Clover Health anticipates continued growth and retention, citing mid-90% voluntary retention and a focus on affordability, choice, and broad PPO access as key drivers for membership growth.
Clover Assistant's Moat: The company believes that Clover Assistant's competitive advantage has strengthened over the past two years, citing expanded capabilities and strong real-time clinical recommendation engine.
Counterpart Health Success: Early feedback and outcome data for Counterpart Health have been positive, demonstrating clinical impact, market fit, and commercial scalability.
Expansion and Hiring: Clover Health has brought in top leaders to support the scaling and growth of Counterpart Health, aiming to meet the growing demand for their technology.
Future of AI in Healthcare: The company sees AI as a tool to empower physicians rather than replace them, emphasizing the augmentation of human expertise.
Enterprise Offering: Clover Health has developed an enterprise offering for Counterpart Health, designed for larger-scale health plan payors and systems, addressing the broader needs of enterprise partners focused on improving HEDIS performance.
Following these announcements, the company's shares moved -0.59%, and are now trading at a price of $2.535. For more information, read the company's full 8-K submission here.
