Clover expands Medicare Advantage plans to 6 more markets

Clover Health
The expansion includes three states where Clover hasn't previously offered plans: South Carolina, Tennessee and Arizona. (Clover Health)

Clover Health will expand its Medicare Advantage offerings into six new cities beginning next year.

The new markets include Camden, New Jersey; Charleston, South Carolina; El Paso, Texas; Nashville, Tennessee; Philadelphia; and Tucson, Arizona. 

The startup Medicare Advantage (MA) insurer believes it will be able to attract customers and deliver quality services through local providers in those locations, according to an announcement on Friday.

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The South and Southwest have seen considerable population growth in recent years, and Philadelphia and Nashville are known as hubs for healthcare.

The expansions await regulatory approval, but once approved, consumers in those cities will be able to enroll in Clover’s MA plans between Oct. 15 and Dec. 7, 2018. Clover currently offers plans in Georgia, New Jersey, Pennsylvania and Texas.

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Clover hopes to be "a different kind of insurance company," according to Chief Technology Officer Andrew Toy. 

"We are there to look after [our customers], we’re there to have a relationship with them that no other plan has, and we are in it for their long-term health, happiness, and longevity," he told FierceHealthcare. 

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Clover has recently battled some unfavorable publicity. A report earlier this year revealed some strategic missteps, including a spat with Lab Corp and Quest Diagnostics in which it delayed paying bills for its members' lab tests. The company was fined by CMS in 2016 for "misleading" marketing tactics. 

In addition, the insurer has been digging its way out of a financial slump. In 2016, it earned $184 million and lost $35 million; in 2017, it earned $267 million with $22 million in losses, despite a major investment from Alphabet, Inc., Google’s parent company.

But Toy said those problems were "growing pains" and Clover has "largely moved past a lot of those issues." 

Clover also touts its ability to move "beyond just actuarial tables” using technology and data science "on a personalized basis," Toy said. 

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Clover’s artificial intelligence (AI) platform predicts whether vulnerable patients will be admitted to the hospital within 28 days with 85% accuracy, which it described in a release as “an unmatched level of precision.”

In the same announcement, Clover said it will provide its AI technology to Taiwan’s Cathay Life Insurance—its first international partnership. The American company said this platform can provide Cathay “actionable, data-driven insights.”

IT tools like this have allowed Clover to put a "laser focus on chronic care management," and now Cathay can "bring that to their members as well," said Toy. 

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