Better Health for All

Clover Health's core business, Medicare Advantage plans, and its Clover Assistant platform deliver substantial health benefits. The platform is associated with earlier identification and treatment of diabetes for 44,000 patients and over 8,000 primary care practitioners, leading to lower blood sugar, reduced insulin use, and fewer hypoglycemia cases.

The company uses machine learning models to identify undiagnosed conditions and refine them through physician feedback. Clover Health's mission is to improve the lives of all members, including those in high-deprivation areas, and it specifically targets Medicare-eligible seniors, minorities, and low-income individuals in historically excluded communities. However, the company's report notes that medication co-pays and physical access to pharmacies are barriers to medication adherence for low-income members, despite Clover's plans including zero-cost PCPs and low specialist copays. Clover Health uses member data, including medications, procedures, lab results, and diagnoses, to create holistic health profiles and identify undiagnosed conditions.

Fair Money & Economic Opportunity

66% of Clover members live in communities that fall within the top five deciles of socioeconomic deprivation.

Additionally, 49% of Clover Medicare Advantage members identify as people of color, compared to an industry average of 34%. The majority of Clover’s plans have no premiums, and many offer $0 copays for primary care visits. Clover members save an average of 41% over the lifetime cost of membership in Original Medicare. The company's PPO plan has in- and out-of-network cost sharing parity for physicians. Clover emphasizes making comprehensive, affordable Medicare plans widely available in communities with more people of color, and provides pre-programmed, internet-enabled tablets to members lacking video-enabled devices. Clover supports three APIs: Formulary, Provider Directory, and Patient Access, but requires registration and review, and disables access if member data hasn't been actively used within three months. In 2016, CMS issued a notice regarding Clover's misleading marketing activities, which incorrectly stated that out-of-network providers were obligated to accept Clover enrollees, and imposed a fine. Clover Home Care members saw a 17% reduction in hospitalizations and a $325 average reduction in medical expenses per member per month. The company states its intent is to reinvest savings back into the system to make plans more affordable. Clover helps doctors understand medication costs and assists members in applying for programs to reduce medication costs. Clover's planned expansion in 2021 increased coverage to 108 counties across eight states, up from 34 counties. Clover Assistant is designed to gather and sort large amounts of data and present it to doctors in a simple, personalized view, flagging potential care gaps.

Fair Trade & Ethical Sourcing

Clover Health operates as a technology company providing Medicare Advantage plans, with revenue primarily derived from premiums.

Its business model does not involve the procurement or trade of physical commodities or materials typically associated with a traditional supply chain for goods. Therefore, all KPIs related to fair trade certifications, supplier audits, forced/child labor incidents, supply chain traceability, remediation processes, ethical sourcing clauses in supplier contracts, high-risk materials, and supplier diversity spend are not applicable to the company's core operations based on the provided information. Article 3, which discusses a Supplier Code of Conduct and conflict minerals, pertains to Cencora, not Clover Health.

Honest & Fair Business

Clover Health has not incurred any ethics-related regulatory fines in the past three years.

An SEC investigation concluded in February 2021 with no enforcement action recommended. However, the company has faced allegations from Hindenburg Research regarding undisclosed DOJ inquiries and potential 'upcoding' of Medicare claims, which Clover denies. The existence of these inquiries, even without explicit fines or warning letters, indicates regulatory scrutiny.

Kind to Animals

Clover Health's research subsidiary, Character Biosciences (formerly Clover Therapeutics), has used animal testing for its dry AMD approach.

The company does not mention a specific animal testing policy.

No War, No Weapons

The provided articles, which include corporate governance overviews, ESG risk ratings, lobbying data, and details on AI in healthcare, do not contain any information regarding Clover Health Investments, Corp.'s involvement in arms manufacturing, military contracts, dual-use technology, or any other defense-related activities. One article about 'Clover Imaging' and conflict minerals was identified, but it explicitly states that 'Clover Imaging is not a publicly traded company'

and the information is not relevant to CLOV.US. Therefore, no specific data points were found to assess the company against the 'No War, No Weapons' value.

Respect for Cultures & Communities

Clover Health follows Culturally and Linguistically Appropriate Service (CLAS) standards, issued by the US Department of Health and Human Services Office of Minority Health.

Cultural competency is also included as a component of the company's Quality Improvement Program. Given Clover Health's business model, its operations do not appear to directly impact cultural contexts in a way that would necessitate a specific cultural impact assessment protocol beyond these service delivery standards. There is no specific assessment score provided for language inclusivity, but adherence to CLAS standards suggests basic, industry-standard inclusivity. No evidence was found for other KPIs related to formal partnerships, community reinvestment, cultural appropriation incidents, local employment, community-specific grievance mechanisms, FPIC processes, community governance inclusion, cultural preservation investment, local procurement, indigenous suppliers, cultural site protection, social license, charitable giving, community fund allocation, cultural incident response, or cultural sensitivity training completion.

Safe & Smart Tech

Clover Health states that AI should be used responsibly and ethically, not to deny care or replace clinicians, but to empower physicians, and that it designs, validates, and monitors technologies to improve outcomes for everyone.

The company mentions compliance with HIPAA when data is shared directly with healthcare providers or the health plan, and that standalone third-party apps are regulated by the Federal Trade Commission Act. Clover Health also aims to obey laws and prevent fraud and abuse, and discloses personal information as necessary to respond to legal or regulatory processes. Users can manage data sharing settings with third-party applications via a member portal, request access, modification, or deletion of their personal information, and opt out of certain communications. However, deleting an application from a device does not prevent it from receiving data, and each app has its own method for data deletion. The company employs "reasonable security measures" and mentions secured email or text communications in some locations, but also acknowledges unencrypted email and SMS text messaging as a risk. Identity verification and account authentication are used. Clover Health has a bug bounty program that supports developers and security engineers, offering rewards for detailed reports, but it was last updated 3 years ago. The program aims to harden CLV against potential attack vectors, with specific vulnerabilities considered out of scope. The company considers restrictions requested by users regarding treatment, payment, and healthcare operations activities, and users can submit a request to delete specified information, such as Blue Button data, consistent with applicable law or policy. Medical information is maintained and made available for up to 10 years, or longer if required by law.