1
00:00:00,000 --> 00:00:02,740
Evernorth brings the power of wonder and relentless

2
00:00:02,799 --> 00:00:05,599
innovation to create world class pharmacy, care, and

3
00:00:05,599 --> 00:00:06,580
benefit solutions.

4
00:00:07,200 --> 00:00:08,960
Barriers to care can lead to gaps in

5
00:00:08,960 --> 00:00:10,719
care, which can drive up the total cost

6
00:00:10,719 --> 00:00:13,839
of care. Our capabilities work seamlessly together to

7
00:00:13,839 --> 00:00:17,245
create innovative pharmacy care and benefit solutions for

8
00:00:17,245 --> 00:00:18,225
today and tomorrow.

9
00:00:18,765 --> 00:00:21,565
Our connected health services make the treatment, prediction,

10
00:00:21,565 --> 00:00:24,225
and prevention of health care's most complex conditions

11
00:00:24,685 --> 00:00:27,265
easier and more accessible as we drive organizations

12
00:00:27,484 --> 00:00:28,464
and people forward.

13
00:00:29,079 --> 00:00:31,239
This is Haley Reitgard with the Becker's Payer

14
00:00:31,239 --> 00:00:33,240
Podcast, and we are recording live at the

15
00:00:33,240 --> 00:00:35,979
Becker's third annual spring payer issues roundtable.

16
00:00:36,520 --> 00:00:38,200
I am thrilled today to be joined by

17
00:00:38,200 --> 00:00:41,905
Peter Kuipers, CFO at Clover Health. Hi, Peter.

18
00:00:41,905 --> 00:00:43,664
Thank you so much for having this discussion

19
00:00:43,664 --> 00:00:45,344
with me today. Can you go ahead and

20
00:00:45,344 --> 00:00:47,104
introduce yourself and share a little bit about

21
00:00:47,104 --> 00:00:47,924
your background?

22
00:00:48,784 --> 00:00:50,704
It's great to be at the Beckers conference

23
00:00:50,704 --> 00:00:53,104
today. I'm Peter Kuipers, and I am the

24
00:00:53,104 --> 00:00:55,664
chief financial officer at Clover Health, and I'm

25
00:00:55,664 --> 00:00:56,725
happy to be here.

26
00:00:57,149 --> 00:00:59,890
My background before Clover Health is in technology

27
00:01:00,109 --> 00:01:01,570
and also in health care.

28
00:01:01,950 --> 00:01:03,570
Clover Health is a technology

29
00:01:03,950 --> 00:01:04,450
first

30
00:01:04,829 --> 00:01:07,890
health insurance plan with a differentiated approach.

31
00:01:09,234 --> 00:01:11,155
Alright. Well, to kick things off, I'd like

32
00:01:11,155 --> 00:01:14,454
to start with about, talking about balancing affordability

33
00:01:14,674 --> 00:01:16,914
and quality, which is a constant challenge for

34
00:01:16,914 --> 00:01:19,575
all health plans. So how is your organization

35
00:01:19,795 --> 00:01:22,114
innovating to manage the cost of care while

36
00:01:22,114 --> 00:01:23,974
maintaining or improving member outcome?

37
00:01:25,109 --> 00:01:27,030
That's really a great question. Clover is a

38
00:01:27,030 --> 00:01:29,049
technology first health insurance plan,

39
00:01:29,590 --> 00:01:32,010
like I said earlier, with a differentiated approach.

40
00:01:32,549 --> 00:01:35,370
Our technology platform called Clover Assistant

41
00:01:35,909 --> 00:01:39,210
helps physicians identify chronic diseases earlier,

42
00:01:40,135 --> 00:01:43,114
treat these diseases earlier with better care management,

43
00:01:43,974 --> 00:01:45,915
resulting in better health outcomes

44
00:01:46,454 --> 00:01:47,354
for our members

45
00:01:47,655 --> 00:01:49,754
with lower total cost of care.

46
00:01:50,534 --> 00:01:51,435
And we continually

47
00:01:51,894 --> 00:01:54,634
invest in the innovations on our technology platform,

48
00:01:55,189 --> 00:01:56,329
which is cloud based,

49
00:01:56,870 --> 00:01:58,969
powered by machine learning and AI.

50
00:01:59,510 --> 00:02:01,189
I'd like to go a little bit deeper

51
00:02:01,189 --> 00:02:03,349
there. So what are some best practices or

52
00:02:03,349 --> 00:02:05,750
tools that your organization relies on to keep

53
00:02:05,750 --> 00:02:07,290
quality of care at the forefront?

54
00:02:08,574 --> 00:02:10,915
First, we're focused on using technology,

55
00:02:11,455 --> 00:02:12,915
our Clover system platform,

56
00:02:13,534 --> 00:02:14,835
to empower physicians

57
00:02:15,135 --> 00:02:16,435
at the point of care,

58
00:02:16,974 --> 00:02:18,354
at the time of care,

59
00:02:18,735 --> 00:02:21,455
to deliver earlier and better quality care management

60
00:02:21,455 --> 00:02:22,275
for our members.

61
00:02:23,099 --> 00:02:24,879
We continually invest in quality

62
00:02:25,340 --> 00:02:26,400
and our tech platform.

63
00:02:27,019 --> 00:02:28,459
This has been a focal point in our

64
00:02:28,459 --> 00:02:28,959
strategy,

65
00:02:29,259 --> 00:02:31,039
and we've communicated this publicly

66
00:02:31,580 --> 00:02:32,799
during earnings calls.

67
00:02:33,099 --> 00:02:34,159
We have a multiyear

68
00:02:35,019 --> 00:02:37,680
technology road map to further enhance the clinical

69
00:02:38,125 --> 00:02:41,185
and predictive capabilities of the Clover system platform.

70
00:02:42,604 --> 00:02:44,864
We demonstrated our ability to do so

71
00:02:45,324 --> 00:02:47,745
via industry leading HEDIS scores,

72
00:02:48,044 --> 00:02:50,384
which is the quality measure within the star

73
00:02:50,444 --> 00:02:51,425
rating system.

74
00:02:52,349 --> 00:02:55,229
We also have an exceptional compliance team with

75
00:02:55,229 --> 00:02:57,969
an extensive background in health care and compliance

76
00:02:58,030 --> 00:02:58,530
leadership.

77
00:02:59,870 --> 00:03:01,949
Well, we've talked a lot about quality of

78
00:03:01,949 --> 00:03:04,049
care, and I'd love to pivot the conversation

79
00:03:04,189 --> 00:03:05,729
a little bit to member satisfaction,

80
00:03:06,485 --> 00:03:09,044
which is essential to thrive in today's competitive

81
00:03:09,044 --> 00:03:10,025
health care landscape.

82
00:03:10,485 --> 00:03:13,444
So what experience or engagement strategies have proven

83
00:03:13,444 --> 00:03:15,764
effective for your organization, and how are you

84
00:03:15,764 --> 00:03:16,745
measuring success?

85
00:03:18,004 --> 00:03:21,444
So we measure member satisfaction success via two

86
00:03:21,444 --> 00:03:22,379
main measures.

87
00:03:23,659 --> 00:03:26,960
First, we focus on and measure member retention.

88
00:03:27,659 --> 00:03:29,680
We have very high retention rates

89
00:03:30,060 --> 00:03:31,200
both in AEP

90
00:03:31,659 --> 00:03:32,400
and also

91
00:03:32,700 --> 00:03:33,439
in OEP.

92
00:03:34,794 --> 00:03:37,694
Second, we focus on empowering physicians to deliver

93
00:03:38,314 --> 00:03:39,615
superior health outcomes

94
00:03:39,995 --> 00:03:41,694
using the Clover Assistant technology.

95
00:03:42,875 --> 00:03:45,594
Using this platform, physicians are able to diagnose

96
00:03:45,594 --> 00:03:47,455
and treat chronic diseases earlier.

97
00:03:48,635 --> 00:03:49,455
For example,

98
00:03:50,319 --> 00:03:51,539
using our technology,

99
00:03:53,120 --> 00:03:53,620
physicians

100
00:03:54,000 --> 00:03:56,180
are able to diagnose diabetes

101
00:03:57,039 --> 00:03:58,259
three years earlier

102
00:03:58,719 --> 00:04:01,780
and chronic kidney disease eighteen months earlier.

103
00:04:02,879 --> 00:04:04,739
Also, from a plan design perspective,

104
00:04:06,055 --> 00:04:09,254
we are also a premium free PPO first

105
00:04:09,254 --> 00:04:09,754
plan

106
00:04:10,135 --> 00:04:10,635
offering

107
00:04:11,175 --> 00:04:12,235
where our members

108
00:04:12,775 --> 00:04:14,395
are free to choose their physician.

109
00:04:15,415 --> 00:04:16,714
Also, our home care services

110
00:04:17,495 --> 00:04:18,875
uses the same technology

111
00:04:19,415 --> 00:04:20,795
and is led by MDs.

112
00:04:21,790 --> 00:04:23,970
In total, despite industry headwinds,

113
00:04:24,509 --> 00:04:26,770
because of this technology first approach,

114
00:04:27,310 --> 00:04:29,629
we are actually able to keep plan benefits

115
00:04:29,629 --> 00:04:32,670
steady this year while we are growing 30%

116
00:04:32,670 --> 00:04:35,009
in members and balancing profitability.

117
00:04:36,644 --> 00:04:38,485
Looking ahead, what do you see as the

118
00:04:38,485 --> 00:04:41,044
biggest opportunity for payers to lead the charge

119
00:04:41,044 --> 00:04:43,845
in transforming care delivery and driving better outcomes

120
00:04:43,845 --> 00:04:44,824
for all stakeholders?

121
00:04:45,284 --> 00:04:46,805
How can leaders take a step in this

122
00:04:46,805 --> 00:04:47,704
direction now?

123
00:04:48,729 --> 00:04:50,990
At Clover, we believe that the most transformative

124
00:04:51,050 --> 00:04:53,870
opportunity to improve care delivery and health outcomes

125
00:04:54,409 --> 00:04:56,189
is actually to empower physicians

126
00:04:56,810 --> 00:04:58,189
with leading clinical

127
00:04:59,129 --> 00:04:59,629
technology

128
00:05:00,250 --> 00:05:03,149
to deliver preventive and earlier high quality care

129
00:05:03,365 --> 00:05:04,504
at the point of care.

130
00:05:05,764 --> 00:05:08,105
Now since the middle of last year,

131
00:05:08,725 --> 00:05:10,985
we are also offering the same technology

132
00:05:11,845 --> 00:05:12,824
branded now

133
00:05:13,205 --> 00:05:14,264
counterpart assistance

134
00:05:14,725 --> 00:05:15,865
also to other

135
00:05:16,165 --> 00:05:17,625
Medicare Advantage plans

136
00:05:18,310 --> 00:05:20,889
and risk bearing or value based care providers

137
00:05:21,669 --> 00:05:23,050
so that these plan supervisors

138
00:05:23,509 --> 00:05:24,649
also can identify

139
00:05:25,430 --> 00:05:26,329
chronic diseases

140
00:05:27,110 --> 00:05:27,610
earlier

141
00:05:27,990 --> 00:05:29,289
with better care management,

142
00:05:29,829 --> 00:05:31,370
resulting in better health outcomes

143
00:05:32,425 --> 00:05:35,305
for their members with total with lower total

144
00:05:35,305 --> 00:05:36,285
cost of care.

145
00:05:37,225 --> 00:05:40,504
In summary, our mission really is to help

146
00:05:40,504 --> 00:05:43,384
improve health care for as many Medicare Advantage

147
00:05:43,384 --> 00:05:44,524
members as possible.

148
00:05:45,819 --> 00:05:47,660
Peter, thank you so much for joining me

149
00:05:47,660 --> 00:05:49,740
today. Again, this is Haley Recker with the

150
00:05:49,740 --> 00:05:52,540
Becker's Payer podcast recorded live at the Becker's

151
00:05:52,540 --> 00:05:55,339
third annual spring payer issues roundtable. Thank you

152
00:05:55,339 --> 00:05:57,120
so much. Thank you. My pleasure.