CLOVNasdaqHospital & Medical Service PlansUS GAAP · USD

Clover Health Investments, Corp

Clover Health Investments, Corp. is a U.S. healthcare company focused on Medicare Advantage plans for seniors, with a particular emphasis on underserved markets and members with chronic conditions. Its core insurance business is built around PPO and HMO plans, while its Clover Assistant software platform is used to help providers identify, treat, and manage disease earlier through data-driven clinical insights. In 2024, the company launched Counterpart Health, a SaaS and tech-enabled services offering that commercializes Clover Assistant for external payors and providers serving Medicare-eligible populations. The business model combines managed care economics with a technology layer intended to improve care quality, lower medical costs, and create a higher-margin growth avenue over time.

Revenue1,924m USD
+40.3 %y/y
Operating profit (EBIT)-85.5m USD
−87.0 %y/y
EBIT margin-4.4%
−1.1 ppy/y
Net income-85.5m USD
−98.9 %y/y
Free cash flow-69.0m USD
−307.2 %y/y

Fiscal year 2025 · change from previous year

Development 2020–2025

-1,00001,0002,0003,0004,000m USD2020: 673 m USD2020: EBIT -93 m USD20202021: 1,472 m USD2021: EBIT -637 m USD20212022: 3,477 m USD2022: EBIT -287 m USD20222023: 1,261 m USD2023: EBIT -205 m USD20232024: 1,371 m USD2024: EBIT -46 m USD20242025: 1,924 m USD2025: EBIT -86 m USD20251,924-86
RevenueOperating profit (EBIT)

Business

Share of revenue
Medicare Advantage Insurance92 %

PPO and HMO Medicare Advantage plans sold to Medicare-eligible seniors through CMS-regulated channels.

Clinical Software Platform4 %

Clover Assistant and related provider workflow tools that deliver real-time clinical insights and care guidance.

Tech-Enabled Services2 %

Counterpart Health services that package Clover Assistant for external payors and providers.

Other Income2 %

Investment income and ancillary revenues that supplement insurance premiums.

Customers

Clover Health primarily serves Medicare-eligible seniors, especially those in underserved markets and those with multiple chronic diseases. Its insurance products are designed for members who want Medicare Advantage coverage, while its open-network and provider-enablement approach is meant to improve access and care coordination. On the provider side, the company sells Clover Assistant and Counterpart Health capabilities to clinicians, payors, and provider organizations that manage Medicare populations. The company also relies on brokers, field marketing organizations, and co-branding partners to acquire members, so distribution is a mix of direct-to-consumer and channel-led sales. Customer retention depends heavily on service quality, claims handling, and whether providers adopt the platform in their daily workflows.

Medicare Advantage members

Seniors enrolled in PPO and HMO MA plans who buy coverage for managed care, access, and coordinated benefits.

Underserved and high-need seniors

Members in socioeconomically deprived areas or with multiple chronic diseases who are targeted because Clover's care model is designed to improve outcomes and manage costs.

Primary care providers

Clinicians who use Clover Assistant to receive actionable insights and support earlier identification and treatment of disease.

External payors and provider organizations

Organizations purchasing Counterpart Health offerings to extend Clover Assistant capabilities to their own Medicare populations.

Distribution partners

Brokers, agents, and field marketing organizations that help sell MA plans and expand member acquisition.

Strategy

Clover's strategy is to use Clover Assistant to improve provider decision-making and lower medical costs, which supports both insurance economics and software commercialization. A key priority is selecting markets where its model can work in underserved areas that may not attract traditional MA competitors or large integrated provider systems. The company also aims to broaden distribution through brokers, field marketing organizations, co-branding, and open-network plan designs that make it easier for members to access care and for Clover to build provider relationships. Counterpart Health is a strategic extension of the platform, intended to create a higher-margin external revenue stream while leveraging existing technology and clinical workflows.

Expand MA membership in underserved marketsMedium term

These markets fit Clover's model and may be less contested by large integrated competitors.

Increase Clover Assistant adoptionShort term

Provider usage is central to the company's care model and to lowering medical costs.

Commercialize Counterpart HealthMedium term

External SaaS and tech-enabled services could diversify revenue and improve margins.

Geography

Clover Health is primarily a U.S. business and its Medicare Advantage plans are available in several states. Management stated that beginning in 2026 the MA plans will be available in 203 counties across five states, indicating a geographically selective but expanding footprint. The company emphasizes underserved markets rather than broad national scale, so local market selection and provider relationships are central to growth. Counterpart Health is being commercialized nationwide, which could broaden the company's geographic reach beyond its insurance footprint over time.

Risks

Clover faces the core managed-care risk that it may not accurately predict, price, and manage medical costs, which can quickly pressure margins in Medicare Advantage. The company also depends on provider adoption of Clover Assistant, and clinicians may resist changing workflows or may view the platform as more complex or less effective than traditional approaches. Because the business relies on customer service, claims processing, and third-party vendors, service failures can hurt retention and reputation. More broadly, the company is exposed to CMS regulation, Star Ratings changes, competitive pressure in MA, and the need for additional capital if growth or losses outpace internal funding capacity.

Sorted by severity
LowMediumHighLowMediumHighImpact →Likelihood →Medical cost trend and pricing risk1Financing and liquidity risk2Provider adoption risk for Clover Assistant3CMS and Star Ratings risk4Customer service and vendor dependency risk5
Impact is the risk’s severity and likelihood how probable it is over the next few years, both assessed from the company’s reports. Numbers match the list.
  1. Medical cost trend and pricing riskImpact: HighLikelihood: High

    MA profitability depends on accurately forecasting claims and risk adjustment; underestimation can materially hurt results.

    Exposure: Insurance segment

  2. Financing and liquidity riskImpact: HighLikelihood: High

    The company may need external capital if operating losses or growth investments exceed available resources.

    Exposure: Corporate liquidity

  3. Provider adoption risk for Clover AssistantImpact: HighLikelihood: Medium

    The platform's value depends on clinicians changing workflows and using the software consistently.

    Exposure: Technology and care model

  4. CMS and Star Ratings riskImpact: HighLikelihood: Medium

    Medicare Advantage is highly regulated and rating changes can affect payment and enrollment appeal.

    Exposure: Medicare Advantage plans

  5. Customer service and vendor dependency riskImpact: MediumLikelihood: Medium

    Retention depends on call center, claims, and service quality, some of which are outsourced.

    Exposure: Member operations

Accounting

Judgemental items
Risk adjustment revenue

Medicare Advantage revenue depends on CMS risk scores and related estimates, which can change as data is finalized.

Impact: Can materially affect premiums earned and reported revenue

Net claims and claims adjustment expense reserves

Medical claims are incurred before fully settled, requiring actuarial estimates that may later prove too high or too low.

Impact: Can materially affect benefits expense and earnings

Revenue recognition over coverage periods

Insurance premiums are earned over time, so membership changes and seasonality affect quarterly comparability.

Impact: Creates timing differences between cash collections and GAAP revenue

Non-GAAP adjustments

Adjusted EBITDA and related measures exclude items such as stock compensation and certain non-recurring costs.

Impact: May improve trend visibility but can obscure full economic cost

Publicly listed companies with a comparable business focus.

Last updated: 24/09/2026

Clover Health Investments, Corp (CLOV) Revenue, Earnings & Financials 2025 – Clarifo