Business
Clover Health Comments on 2026 Medicare Advantage Star Ratings and Trajectory for Increasing Profitability into 2027
Company underscores differentiated business model; reiterates confidence in its ability to drive above-market membership growth and increasing Adjusted EBITDA
About this update from Clover Health Investments, Corp.
[{"type":"text","content":"Company underscores differentiated business model; reiterates confidence in its ability to drive above-market membership growth and increasing Adjusted EBITDA profitability1 through 2027, independent of Star ratings WILMINGTON, Del., Oct. 09, 2025 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), a physician enablement company dedicated to bringing access to great healthcare to everyone on Medicare, today commented on the Centers for Medicare & Medicaid Services (“CMS”) release of the 2026 Star ratings for Clover Health’s Medicare Advantage (“MA”) plans. CMS has awarded the Clover PPO MA plans with 3.5 Stars and Clover’s HMO MA plan with 4.0 Stars. The 2026 Star ratings affect the payment year 2027. “Our technology centric care strategy fortunately puts us in a position where the Star rating does not dominate our results in the way it does for other plans,” said Andrew Toy, Chief Executive Officer of Clover Health. “With the year-over-year AI-driven improvements that we see in Clover Assistant and momentum in additional doctors signing up for our platform, we feel our business model can offset any effect from the Star rating. We are built to offer amazing wide-network benefits to our members independent of the rating, and we will drive growth and profitability while doing so.” Through the first half of 2025, which similar to 2027 is a 3.5 Star payment year, Clover grew revenue by 34% and membership by 32% year-over-year while delivering sustained Adjusted EBITDA profitability. Clover also emphasized that it continued to excel at clinical measures, once again scoring exceptionally high on the HEDIS clinical quality measures, with a score of 4.72 for its PPO plans, largely due to its Clover Assistant clinical platform. From a health policy perspective, Clover also notes that it does not believe the overall Star rating reflects the excellent health outcomes that it delivers to its members. The Company believes the Star Ratings methodology places disproportionate weight on non-outcomes measures (such as member experience surveys and administrative processes) rather than actual clinical outcomes and health improvements. Clover continues to actively engage with CMS to ensure that its assigned Star rating appropriately captures the strength and quality of its MA offerings....