Over the past few years, there has been an added focus within the global healthcare industry to reduce costs and manage resources more efficiently while improving patient care. To meet these pressures, healthcare organizations including physicians and insurance service providers have become data driven. San Francisco-based Clover Health is a Billion Dollar Unicorn club member making big strides in the industry.
Clover Health’s Offerings
Clover Health was founded in 2014 by serial healthcare entrepreneur Vivek Garipalli and Yammer’s founding engineering team member Kris Gale. Prior to setting up Clover Health, Vivek had founded CarePoint Health, a fully integrated healthcare system in 2008. The two set up Clover Health with a mission to improve the quality of life of insurance members and physicians. Through his experiences at CarePoint Health, Vivek had realized that there existed significant friction between the doctors and insurers. Through Clover Health, he wanted to build an insurance model that aligned with physicians, reduced the doctor-insurer friction, increased visibility into the health of each patient, and thus ultimately led to improved care.
Today, Clover Health offers Medicare Advantage products and leverages technology to get better insights into members’ healthcare. Medicare Advantage, is a private HMO version of traditional Medicare, and had more than 18 million seniors and disabled people as its members in 2015. It paid out more than $170 billion in taxpayer-funded, capitated revenue to health plans in 2015.
Clover Health’s data and analytics platform uses continuous, real-time monitoring to drive preventive care to its members, thus reducing hospital admissions, avoidable spending, and better managing chronic diseases. It works by tracking inputs from a person’s medical history and identifying the highest-risk patients from insurance claims. Its platform then works with the members to help them become healthier by encouraging them to take prescription medication or manage their chronic diseases so that it can reduce its overall costs by reducing the rate of hospitalization.
