Results

Results

Counterpart Assistant (CA) was incubated by Clover Health as Clover Assistant, and has helped improve plan performance and clinical outcomes for Medicare members through proprietary AI technology.

Clinical Quality and HEDIS®

Counterpart Health has helped empower Clover Health's PPO plans to enhance care quality and achieve 4.94 out of 5 Stars on HEDIS measures for Star Rating year 2025 through a technology-driven approach to value-based care.¹

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Clinical Quality and HEDIS®

Medical Cost Ratio (MCR)

Double-digit MCR differential for returning members whose PCPs use Counterpart Assistant as compared to those who do not. ⁶

Medical Cost Ratio (MCR)

Chronic Obstructive Pulmonary Disease

A relationship with a PCP that uses CA is correlated with better outcomes for COPD patients, including fewer hospitalizations and readmissions, and better clinical management, such as more frequent outpatient pulmonology visits.

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Chronic Obstructive Pulmonary Disease

Heart Failure

A relationship with a PCP that uses CA is associated with better outcomes for CHF patients, including fewer hospitalizations and readmissions, and better clinical management, such as more frequent outpatient cardiologist visits and in-home care.

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Heart Failure

Diabetes

CA use is associated with early diagnosis, early treatment, improved blood sugar control, lower insulin use, and lower instances of Hypoglycemia.

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Diabetes

Chronic Kidney Disease (CKD)

CA use is associated with early diagnosis and improved disease trajectory.

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Chronic Kidney Disease (CKD)

Medication Adherence

CA use correlated with increased medication fills in previously non-adherent patients and higher performance on medication adherence quality measures.

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Medication Adherence
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).¹ 4.94 is the weighted average of the measure scores in the CMS star measure ratings for which the primary data source was HEDIS and for which Clover Health's PPO plans were eligible to be rated. The calculation uses the same weighting used by CMS for the measures in calculating the overall Star score.² Study analyzes HEDIS measure performance among eligible members of one MA plan who had at least one visit in 2023 from a primary care provider who used CA in connection with the visit (the “CA Cohort”) versus eligible members of the plan who received at least one primary care visit that year but none supported by CA (the “Non-CA Cohort”). To calculate the Hypothetical Full Plan Measure Rating Replacing Performance Rate for CA Cohort w/ Non-CA Cohort Rate, we: (1) calculated the full plan performance for each measure if the CA Cohort performed at the Non-CA Cohort Rate; and (2) applied the Stars cut points for the measure to the resulting data. Data analysis included only independent PCPs (i.e., the analysis excluded visits with clinicians employed by the MA plan or its affiliates).³ For more details, see the Clover Assistant Use and Diagnosis, Treatment, and Progression of Diabetes whitepaper⁴ For more details, see the Clover Assistant Use and Diagnosis, Treatment, and Progression of Chronic Kidney Disease whitepaper⁵ For more details, see Clover Assistant Medication Adherence whitepaper⁶ Experience of one MA plan⁷ Experience of one MA plan
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