Clover Health Investments, Corp. announced on October 10, 2024, that its PPO Medicare Advantage (MA) plans received an increased Star rating of 4 Stars from the Centers for Medicare and Medicaid Services (CMS) for 2025, which will affect payment year 2026. Additionally, Clover’s HMO MA plan rating increased to 3.5 Stars.
Over 95% of Clover’s Medicare Advantage membership is currently served through its PPO plans. The 4-Star rating was driven by the company’s performance across measures including Medication Adherence, the Healthcare Effectiveness Data and Information Set (HEDIS), where Clover earned 4.94 out of 5 Stars, and Consumer Assessment of Healthcare Providers and Systems (CAHPS).
This achievement provides a 5% quality bonus to benchmark rates for the 2026 payment year, strengthening Clover's ability to offer more competitive benefits. This is expected to deliver greater value to members and fuel continued membership growth, without compromising financial strength or care quality.
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