regulatory
confidence high
sentiment positive
materiality 0.75
Clover Health's 2026 MA Star Ratings: PPO 3.5 Stars, HMO 4.0 Stars; Company confident in offsetting impact
CLOVER HEALTH INVESTMENTS, CORP. /DE
- CMS awarded Clover's PPO plans 3.5 Stars and HMO plan 4.0 Stars for 2026 ratings, affecting payment year 2027.
- CEO Andrew Toy states the Star rating does not dominate results due to Clover Assistant's AI-driven care improvements and platform momentum.
- H1 2025 results: revenue up 34% YoY, membership up 32% YoY, sustained Adjusted EBITDA profitability.
- Clover's PPO plans achieved HEDIS clinical quality score of 4.72, attributed to Clover Assistant platform.
- Company actively engaging with CMS, believes Star methodology overweighs non-outcomes measures.