Clover Health Investments, Corp.

What they do

Clover Health operates Medicare Advantage plans as a Preferred Provider Organization (PPO, its flagship product) and Health Maintenance Organization (HMO), with 157,309 members at June 30, 2026. It also runs Clover Home Care, a longitudinal home-based primary care program for its highest-acuity members, and licenses its Clover Assistant software externally under the Counterpart Health brand. The proprietary cloud-based platform curates data from over 100 sources to deliver care recommendations at the point of care and is used across its PPO and HMO plans.

Revenue drivers

• Insurance segment (Medicare Advantage premiums) — The dominant revenue source: insurance revenue was $737.8 million of $743.2 million total revenues in Q2 2026, up 57.0% year-over-year on 48.7% average MA membership growth to 156,840.
• Total consolidated revenues — Reported at $743.2 million for Q2 2026 and $1,492.4 million for the first half of 2026, up 58.8% for the six-month period; the company does not break out Counterpart Health or Clover Home Care revenue separately in the excerpts provided.
• Insurance BER / net medical claims — Insurance net medical claims incurred were $615.4 million in Q2 2026, with an Insurance benefits expense ratio of 87.6%, down 80 basis points year-over-year, indicating the share of premium consumed by medical costs.

Recent performance

Q2 2026 total revenues were $743.2 million, up 55.6% year-over-year, and six-month revenues were $1,492.4 million, up 58.8%. GAAP net income was $28.0 million in Q2 2026, a $39 million year-over-year improvement, and $55.3 million for the six months. Consolidated gross profit rose 53.6% to $153.0 million in the quarter, and Adjusted EBITDA was $40.9 million, up 139.2%. Adjusted SG&A as a percent of revenue improved to 15.1% in Q2 2026 from 17.3% a year earlier. Cash, cash equivalents and investments totaled $443.0 million at June 30, 2026.

Strategy

Management's stated strategy is to improve care of MA members, develop wide physician networks, and provide technology to empower physicians. The core asset is Clover Assistant, licensed externally as Counterpart Assistant, which the company says improves clinical decision-making and plan performance; Counterpart Health was launched in 2024. Clover offers wide-network PPO plans with broad provider choice and often the same cost-sharing for in-network and out-of-network visits, and targets underserved markets, including members with at least two chronic diseases and those in the top five deciles of government-defined socioeconomic deprivation. Clover Home Care extends the model to the most medically complex members, and the company continues to invest in the platform and clinical programs.

Risks

• History of net losses — Clover reported net losses of $85.5 million in 2025, $46.3 million in 2024, and $210.1 million in 2023, with an accumulated deficit of approximately $2.3 billion as of December 31, 2025.
• Uncertain cash flow and financing need — Operating cash flow was negative in 2025 and 2023 and positive in 2024, and the company states it may seek additional financing that could be dilutive.
• Regulatory and Star Ratings dependence — Revenue depends on CMS Star Ratings and Medicare rules; the company's 2026 PPO contract H5141 rating was recalculated from 3.5 to 4.5 Stars for payment year 2027 following the Stars Litigation and CMS guidance.
• Medical cost and pricing risk — Because it operates at full risk, the company must accurately predict, price, and manage medical costs, and its Insurance BER was 87.6% in Q2 2026.

Outlook

Management raised full-year 2026 guidance across all metrics: average Medicare Advantage membership of 156,000 to 158,000 (about 47% growth at the midpoint), total revenues of $2.92 billion to $3.00 billion, consolidated gross profit of $525 million to $555 million, Adjusted EBITDA of $70 million to $85 million, and GAAP net income of $20 million to $35 million. The company cites improving cohort economics and a 4.5 Star payment year as support for its 2027 outlook, while noting the Star Ratings developments affect payment year 2027 rather than current-period results.