Evernorth brings the power of wonder and relentless
innovation to create world class pharmacy, care, and
benefit solutions.
Barriers to care can lead to gaps in
care, which can drive up the total cost
of care. Our capabilities work seamlessly together to
create innovative pharmacy care and benefit solutions for
today and tomorrow.
Our connected health services make the treatment, prediction,
and prevention of health care's most complex conditions
easier and more accessible as we drive organizations
and people forward.
This is Haley Reitgard with the Becker's Payer
Podcast, and we are recording live at the
Becker's third annual spring payer issues roundtable.
I am thrilled today to be joined by
Peter Kuipers, CFO at Clover Health. Hi, Peter.
Thank you so much for having this discussion
with me today. Can you go ahead and
introduce yourself and share a little bit about
your background?
It's great to be at the Beckers conference
today. I'm Peter Kuipers, and I am the
chief financial officer at Clover Health, and I'm
happy to be here.
My background before Clover Health is in technology
and also in health care.
Clover Health is a technology
first
health insurance plan with a differentiated approach.
Alright. Well, to kick things off, I'd like
to start with about, talking about balancing affordability
and quality, which is a constant challenge for
all health plans. So how is your organization
innovating to manage the cost of care while
maintaining or improving member outcome?
That's really a great question. Clover is a
technology first health insurance plan,
like I said earlier, with a differentiated approach.
Our technology platform called Clover Assistant
helps physicians identify chronic diseases earlier,
treat these diseases earlier with better care management,
resulting in better health outcomes
for our members
with lower total cost of care.
And we continually
invest in the innovations on our technology platform,
which is cloud based,
powered by machine learning and AI.
I'd like to go a little bit deeper
there. So what are some best practices or
tools that your organization relies on to keep
quality of care at the forefront?
First, we're focused on using technology,
our Clover system platform,
to empower physicians
at the point of care,
at the time of care,
to deliver earlier and better quality care management
for our members.
We continually invest in quality
and our tech platform.
This has been a focal point in our
strategy,
and we've communicated this publicly
during earnings calls.
We have a multiyear
technology road map to further enhance the clinical
and predictive capabilities of the Clover system platform.
We demonstrated our ability to do so
via industry leading HEDIS scores,
which is the quality measure within the star
rating system.
We also have an exceptional compliance team with
an extensive background in health care and compliance
leadership.
Well, we've talked a lot about quality of
care, and I'd love to pivot the conversation
a little bit to member satisfaction,
which is essential to thrive in today's competitive
health care landscape.
So what experience or engagement strategies have proven
effective for your organization, and how are you
measuring success?
So we measure member satisfaction success via two
main measures.
First, we focus on and measure member retention.
We have very high retention rates
both in AEP
and also
in OEP.
Second, we focus on empowering physicians to deliver
superior health outcomes
using the Clover Assistant technology.
Using this platform, physicians are able to diagnose
and treat chronic diseases earlier.
For example,
using our technology,
physicians
are able to diagnose diabetes
three years earlier
and chronic kidney disease eighteen months earlier.
Also, from a plan design perspective,
we are also a premium free PPO first
plan
offering
where our members
are free to choose their physician.
Also, our home care services
uses the same technology
and is led by MDs.
In total, despite industry headwinds,
because of this technology first approach,
we are actually able to keep plan benefits
steady this year while we are growing 30%
in members and balancing profitability.
Looking ahead, what do you see as the
biggest opportunity for payers to lead the charge
in transforming care delivery and driving better outcomes
for all stakeholders?
How can leaders take a step in this
direction now?
At Clover, we believe that the most transformative
opportunity to improve care delivery and health outcomes
is actually to empower physicians
with leading clinical
technology
to deliver preventive and earlier high quality care
at the point of care.
Now since the middle of last year,
we are also offering the same technology
branded now
counterpart assistance
also to other
Medicare Advantage plans
and risk bearing or value based care providers
so that these plan supervisors
also can identify
chronic diseases
earlier
with better care management,
resulting in better health outcomes
for their members with total with lower total
cost of care.
In summary, our mission really is to help
improve health care for as many Medicare Advantage
members as possible.
Peter, thank you so much for joining me
today. Again, this is Haley Recker with the
Becker's Payer podcast recorded live at the Becker's
third annual spring payer issues roundtable. Thank you
so much. Thank you. My pleasure.