Clover Health Applauds White House and CMS' Push to "Tear Down Digital Walls," Accelerating and Simplifying Access to Health Data for Patients and Their Clinicians
WILMINGTON, Del., July 31, 2025 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (NASDAQ:CLOV) ("Clover Health"), a physician enablement company bringing access to great healthcare to everyone on Medicare, strongly supports the White House and Centers for Medicare & Medicaid Services' (CMS) announcement calling on the healthcare industry to "tear down digital walls" and build a truly patient-centric, interoperable ecosystem. The Administration's leadership is a strong step toward a truly unified healthcare data ecosystem. Clover Health is proud to advance this goal. For years, Clover Health has worked with most of the networks pledging support for the CMS' Health Tech Ecosystem initiative, to exchange rich patient data and make it available to doctors wherever and whenever they see patients.
"These initiatives are perfectly aligned with our playbook," said Conrad Wai, CEO of Counterpart Health, Clover's technology-enabled value based care subsidiary. "Counterpart Assistant has unified more than a hundred different data sources – including leading Health Information Exchanges, Electronic Health Records, labs, pharmacies, and claims feeds – so doctors don't have to deal with the typical patchwork of healthcare data. Instead, they see a complete longitudinal record for every patient, right when it matters. We're excited to collaborate on these efforts and accelerate our progress."
Tearing down digital walls - Counterpart Assistant's unified data platform synthesizes clinical data from the majority of CMS-aligned networks named in the pledge, delivering true interoperability today. By making real-time lab, pharmacy, hospital, claims, clinical notes, and other health data easily available to physicians as actionable insights at the point of care, Counterpart Assistant tears down the digital walls that historically left clinicians "flying blind." The result: earlier diagnosis and treatment, fewer duplicative tests, smoother care transitions, and better health outcomes for our seniors.
Supporting independent clinicians caring for patients in rural and other underserved areas - Much of the care delivered via Counterpart Assistant occurs in small, independent practices. These are precisely the groups that are typically shut out of data-sharing initiatives, leading to even more fragmented care, poor patient experiences, and worse health outcomes.
Better health outcomes across chronic conditions - Using proprietary machine learning models, Counterpart Assistant technology improves care coordination for doctors and is correlated with improved patient health, including:
- Diabetes: earlier diagnosis, leading to earlier treatment (an average of 36 months earlier), reduced reliance on insulin, and lower incidence of hypoglycemia at later stages of type 2 diabetes.1
- Congestive Heart Failure (CHF): lower all-cause hospitalizations (18% lower) and 30-day readmissions (25% lower).2
- Chronic Kidney Disease (CKD): earlier diagnosis of CKD stage 3 and higher. This finding was even more significant for seniors in areas of higher deprivation, including rural America, where CKD disproportionately impacts seniors.3
- Medication Adherence: Non-adherence to medications for diabetes, high blood pressure, and high cholesterol is common and associated with worse chronic disease control, increased disease-related complications, and higher healthcare costs. Counterpart Assistant alerting PCPs to patients' medication non-adherence led to increased medication fills on the day of the Counterpart Assistant visit, with adherence remaining higher 90 days after the visit.4
Outcomes like these, from earlier diagnosis and management of chronic conditions to better medication adherence, contributed to Clover Health PPO plans' 4 Star rating for 2025, including achieving 4.94 out of 5 Stars on HEDIS measures, the top-performing score on core HEDIS measures for Medicare Advantage plans with over 2,000 members nationwide.5
Looking ahead
Clover Health looks forward to working with CMS, industry networks, and technology partners to expand data-sharing pathways, providing every doctor, and the patients they care for, the same digital access and care coordination as the largest health systems.
About Clover Health:
Clover Health (NASDAQ:CLOV) is a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare. This includes a focus on seniors who have historically lacked access to affordable, high-quality healthcare. Our strategy is powered by our software platform, Clover Assistant, which is designed to aggregate patient data from across the healthcare ecosystem to support clinical decision-making and improve health outcomes through the early identification and management of chronic disease. For our members, we provide PPO and HMO Medicare Advantage plans in several states, with a differentiated focus on our flagship wide-network, high-choice PPO plans. For healthcare providers outside Clover Health's Medicare Advantage plan, we extend the benefits of our data-driven technology platform to a wider audience via our subsidiary, Counterpart Health, and aim to enable enhanced patient outcomes and reduced healthcare costs on a nationwide scale. Clover Health has published data demonstrating the technology's impact on Medication Adherence and Congestive Heart Failure, as well as the earlier identification and management of Diabetes and Chronic Kidney Disease.
About Counterpart Health
Counterpart Health, a subsidiary of Clover Health Investments, Corp., or Clover Health, is a leading AI powered physician enablement platform. Counterpart Health's flagship software platform, Counterpart Assistant, was incubated by Clover Health as Clover Assistant and has helped improve plan performance and clinical outcomes for Medicare members through proprietary AI technology. Counterpart Health extends the benefits of the data-driven technology platform outside of Clover Health's Medicare Advantage plan to a wider audience, to enable enhanced patient outcomes and reduced healthcare costs nationwide. Clover Health has published data demonstrating the technology's impact on Medication Adherence and Congestive Heart Failure, as well as the earlier identification and management of Diabetes and Chronic Kidney Disease.
Visit: www.cloverhealth.com
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5 4.94 is the weighted average of the measure scores in the CMS Star Ratings for which the primary data source was HEDIS and for which Clover was eligible to be rated. The calculation uses the same weighting used by CMS for the measures in calculating the overall Star score. The analysis targets non-SNP (Special Needs Plan) HEDIS measures for plans with more than 2,000 contracted lives. Exclusions include measures like C06 (Medication Review) and C07 (Pain Assessment), which are only relevant to SNP plans. Not all contracts offer SNPs, therefore those measures were excluded to enhance the accuracy of comparison across contracts. For detailed methodology and the HEDIS performance of the broader industry visit, please see here.
