Oracle releases AI Database 26ai with built-in artificial intelligence
WILMINGTON, Del. - Clover Health Investments, Corp. (NASDAQ:CLOV) announced Thursday that the Centers for Medicare & Medicaid Services (CMS) has awarded its Medicare Advantage PPO plans 3.5 stars and its HMO plan 4.0 stars for 2026, affecting payment year 2027.
Despite the mixed ratings, the company expressed confidence in its ability to continue growing membership and increasing profitability regardless of star ratings. Through the first half of 2025, Clover grew revenue by 34% and membership by 32% year-over-year while maintaining Adjusted EBITDA profitability. InvestingPro analysis reveals the company is expected to achieve profitability this year, with analysts forecasting positive earnings per share of $0.11 for FY2025. The company maintains a healthy current ratio of 1.8 and holds more cash than debt on its balance sheet.
"Our technology centric care strategy fortunately puts us in a position where the Star rating does not dominate our results in the way it does for other plans," said Andrew Toy, Chief Executive Officer of Clover Health.
The company highlighted its strong performance in clinical measures, scoring 4.72 for its PPO plans on HEDIS clinical quality measures, which it attributes to its Clover Assistant platform.
Clover expressed concern that the current Star Ratings methodology places "disproportionate weight on non-outcomes measures" rather than actual clinical outcomes and health improvements. The company stated it is engaging with CMS to ensure its ratings appropriately reflect the quality of its Medicare Advantage offerings.
The company expects to continue delivering above-market Medicare Advantage growth and profitability expansion during 2026 and 2027, driven by its AI-powered Clover Assistant technology, increasing physician adoption, member retention, and operating leverage gains.
This information is based on a press release statement from Clover Health.
In other recent news, Clover Health Investments Corp reported its second-quarter 2025 earnings, revealing a revenue of $477.62 million. This figure surpassed the analysts’ forecast of $468.3 million, marking a 1.99% surprise in revenue. Despite the revenue beat, the company’s stock experienced a slight dip post-announcement. Additionally, Counterpart Health, a subsidiary of Clover Health, announced the appointment of two new executives to aid in scaling its AI-powered physician enablement platform. Blaine Lindsey has been named Vice President of Enterprise Growth and Partnerships, and Shannon Jacobs will serve as President of Market Operations for the Gulf Region. These strategic appointments are part of the company’s efforts to expand its platform’s reach and capabilities.
This article was generated with the support of AI and reviewed by an editor. For more information see our T&C.