Earnings Labs

Clover Health Investments, Corp. (CLOV)

Q3 2024 Earnings Call· Wed, Nov 6, 2024

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Transcript

Operator

Operator

Ladies and gentlemen, good afternoon, and welcome to the Clover Health Third Quarter 2024 Earnings Conference Call. At this time, all participants are in a listen-only mode. A question-and-answer session will follow the prepared remarks. [Operator Instructions] As a reminder, today’s call is being recorded. I would now like to turn the call over to Ryan Schmidt, Investor Relations for Clover Health. Please go ahead.

Ryan Schmidt

Analyst

Good afternoon, everyone. Joining me on our call today to discuss the company’s third quarter 2024 results are Andrew Toy, Clover Health’s Chief Executive Officer; and Peter Kuipers, the company’s Chief Financial Officer. You can find today’s press release in the accompanying supplemental slides, as well as the company’s most recent investor deck in the Investor Events and Presentation section of our website at investors.cloverhealth.com. This webcast is being recorded and a replay will be available in the Investor Relations section of the Clover Health website. I’d also like to caution you that we may make forward-looking statements during today’s call that are subject to risks and uncertainties, including expectations about future performance. Factors that may cause actual results to differ materially from expectations are detailed in our SEC filings, including in the risk factors section of our most recent annual report on Form 10-K and other SEC filings. Information about non-GAAP financial measures referenced, including a reconciliation of those measures to GAAP measures, can be found in the earnings materials available on our website. With that, I’ll now turn the call over to Andrew.

Andrew Toy

Analyst · UBS

Thanks, Ryan, and thank you, everyone, for joining us today. We have had a tremendous amount of progress at Clover that we’re excited to talk through. Firstly, we delivered another quarter of meaningful adjusted EBITDA profitability and positive operating cash flow. As such, we are improving our full year adjusted EBITDA guidance. We have always emphasized our focus on delivering a profitable Clover and I feel that we have executed very well here. Secondly, we achieved another quarter of industry-leading loss ratios, driven by continued strong performance on both PMPM revenue, as well as medical expense management. We’re particularly proud of this because we see this value being driven largely by the technology-powered performance of the independent fee-for-service position in our wide network. This is the part of the network where a lot of other Medicare Advantage plans are struggling to manage total cost of care. Thirdly, we are proud to have received upgraded Star Ratings for our plans, most notably a 4-Star Rating for our flagship PPO for plan year 2025, impacting payment year 2026. In fact, for plans with over 2,000 members, our PPO received the highest score in the entire country on core HEDIS measures, with a score of 4.94, even edging out high-performing HMOs. Over 95% of our members are in this 4-Star plan. The key differentiator with Clover is that these results are driven by physicians using our technology, Clover Assistant. Unlike almost every other high-performing MA plan, Clover’s plans have almost no traditional value-based contracts or delegated risk. We do not pay traditional quality incentives around gap closure. Instead, what we focus on is having physicians use Clover Assistant, which acts as a GPS for physicians to better manage Medicare Advantage, total cost of care and quality. Between our network position and our internal…

Peter Kuipers

Analyst · UBS

Thanks, Andrew. I’m continually impressed with our ability to execute, deliver upon our goals and drive strong business performance and momentum during this year while managing the total cost of care. I will begin by covering the third quarter and year-to-date financial highlights and then review our updated guidance for the full year 2024. Clover fundamentals are strong. GAAP net loss in continuing operations for the third quarter improved significantly by $25 million to a loss of $9 million as compared to the same quarter last year. Similarly, adjusted EBITDA meaningfully improved to a profit of $19 million this quarter, compared to $3 million in the third quarter of 2023. On a year-to-date basis, we have significantly improved our adjusted EBITDA profitability by $87 million, as compared to the same year-to-date period for 2023, delivering $62 million of adjusted EBITDA so far this year, driven by continued durable MA plan momentum and further SG&A optimization. We have continued to deliver industry-leading benefit ratios for insurance business driven by our ability to control total cost of care. During the third quarter 2024, our Insurance Benefits Expense Ratio or BER improved to 82.8%, compared to 82.2% in the same period of 2023. Similarly, Insurance MCR improved to 78% in the third quarter this year from 78.5% last year. Specifically, within our medical costs and patient supplemental benefits and Part D costs came in favorably as compared to last quarter and are generally in line with our expectations. Our strong market performance was accompanied by insurance revenue of $323 million representing year-to-year growth of 7% in the quarter. On a year-to-date basis, revenue was $1.14 billion or 9% growth year-to-year. On a year-to-date basis, BER was 80.6% and MCR was 75.6%, both of which represent strong improvements of over 500 basis points year-over-year.…

Andrew Toy

Analyst · UBS

Thanks, Peter. I’m proud of the achievements the Clover team has delivered over the first three quarters of the year. First, we have been increasing our adjusted EBITDA profitability and demonstrating our ability to care for our membership cohorts profitably. Second, we are delivering industry-leading loss ratios and Medicare Advantage performance on a wide network of providers, almost all of whom are still on fee-for-service arrangements. Third, we have achieved strong Star Rating performance on this same network, fueling our go-forward financial momentum and positioning us with a strong multiyear growth opportunity. All of this is enabled by our differentiated care platform and technology, Clover Assistance. We continue to be very excited about the progress and long-term opportunity to bring our technology to other value-based providers and MA plans via our Counterpart Health SaaS and tech-enabled services offering. As a reminder of our core strategy, we plan to grow our own MA plan significantly and profitably within our current markets, and we plan to also expand to new geographies. For markets where we don’t have an MA plan, Counterpart Health allows us to bring in our model of Medicare Advantage Managed Care via partnerships with local providers and plans. Since we launched the offering earlier this year, we have had significant interest in the platform, and this interest has accelerated since we announced our Stars results, particularly the fact that our PPO plan received the highest HEDIS score for core HEDIS measures for plans over 2,000 members. Not only do we offer strong performance, but what others find particularly compelling is that we specialize in improving the performance of wide-network, fee-for-service, independent physicians. Most managed care entities have no real solution for this component of the care ecosystem, and so the fact that we are able to drive excellent results in this area gives us unparalleled product market fit. While this is exciting, we’re still in the early innings. We believe that demand for Counterpart Assistance will only increase as more and more industry players face the market pressures that many insurers and healthcare providers have signaled this year. As we engage with prospective partners, we do expect the larger health organizations to have longer sales cycles and the smaller groups to have shorter sales cycles. That said, we’re looking to onboard more partners in both 2025 and 2026 when the industry Stars headwinds will come to fruition. Stay tuned for more updates about Counterpart, including us signing up additional partners in the future. Clover is truly at an exciting inflection point, making it a great time to be along for the ride. With that, let’s go to questions.

Operator

Operator

[Operator Instructions] Thank you. We’ll take our first question from Jonathan Yong of UBS.

Jonathan Yong

Analyst · UBS

Hey, guys. Thanks for taking the question. It sounds like you’re feeling pretty good about how AEP is shaping up for 2025. Just any color you could provide there on what you’re seeing and what stands out and if the STARS rating improvement is helping you attract more members?

Andrew Toy

Analyst · UBS

Yeah. Hey, Jonathan, thanks for the question. Definitely in AEP, a couple of different things. As a reminder, our 4-Star Rating does affect payment year 2026, but it does affect plan year 2025, so we are appearing as a 4-star plan in the Plan Finder right now. What that means is because we have also maintained our general product richness between the 2, 4 stars and the product richness, and some of our competitors going down in Stars Ratings, we are positioned very well in the overall comparison between our plans and everyone else due to the retreat of others. So we feel good about where we sit from a product richness perspective. We feel good about the relative Stars Rating, and I would even note that even before this AEP, we did have material growth lead up to AEP on an intra-year basis, so we’re carrying some of that momentum through as well. So overall, excited to go back to growth, feel really good about how we manage our cohorts as well.

Jonathan Yong

Analyst · UBS

Great, thanks. And then just in relation to the investments you’re doing, I guess, in this fourth quarter here, can you talk about what those investments are and how much of it will be kind of one-time in nature versus permanent? And also, how much was the PPD benefit in the quarter? Thanks.

Peter Kuipers

Analyst · UBS

Hey, Jonathan, it’s Peter. How are you doing? Good to meet you here as well. So as far as the investments in the fourth quarter in SG&A, you should think about a big portion of that is go-to-market -- marketing, given the fact that Andrew just discussed as well, we feel strong and we’ll disclose more on how AEP is going later on. And then another good chunk of the increased investments is really quality, quality initiatives. I think in the prepared remarks, we also talked about the HEDIS clinical score, right? So we’ll continue to invest and improve our platform. And as far as PPD, we don’t disclose that on the call here the specifics of PPD, but it’s a smaller impact than it was in prior quarters.

Jonathan Yong

Analyst · UBS

Thanks.

Peter Kuipers

Analyst · UBS

And of course, we’re normalizing also, as you know, IBNR over time, giving change, and then also our new ecosystem.

Operator

Operator

We’ll take our next question from John French of Leerink Partners.

John French

Analyst · Leerink Partners

Hey, thanks for taking my question. I was wondering if you could talk about how you were factoring in the IRA and its change on plan liability into or on drug costs into your bids? Thanks.

Andrew Toy

Analyst · Leerink Partners

Yeah. So basically, the way we looked at this is that while we’re not disclosing exactly the mechanics of the bid, we, like everyone else in the industry, had to react a little bit as that more of the IRA was being phased in, how much of the subsidy is coming in, the direct subsidy, how much it affects the amount of revenue that we’re going to be getting versus the amount of benefit we provide. Overall, I think we feel pretty good about where we bid against that. We feel that it’s probably going to be something we need to test going into next year versus actual claims experience, but where it netted out, given the amount of variability, we think we should be in pretty good shape. What you’ll also see is that in our actual plan products, we were able to maintain quite a bit of strength in our Part D offering, whereas we did see a bit of a retreat from those competitors in our markets. So we expect our Plan D offering to actually be quite favorable for the purposes of plan richness.

John French

Analyst · Leerink Partners

Great. Thanks.

Operator

Operator

[Operator Instructions] And it appears that we have no further questions at this time. I’d be happy to return the call to Mr. Toy for any concluding remarks.

Andrew Toy

Analyst · UBS

All right. Thanks, everyone. Thank you for joining us today. Thank you all for your questions. As I said earlier, I’m very proud of the team and of the results that we’ve had this quarter and year-to-date. I feel really good about the care platform and the results that we’re generating on our cohorts. I feel very much that our investments in quality, startup performance is excellent. And now the phase in front of us is looking forward to the growth opportunity ahead of us that we’ve outlined today. So we look to maintain and continue our strength and our performance on the financial side and to be adding to top line growth, membership growth. Thanks again for joining our call and we’re looking forward to sharing our full year results and the results of our AEP during our next earnings call. Thanks so much, everyone.

Operator

Operator

This concludes today’s Clover Health’s third quarter 2024 earnings call and webcast. You may now disconnect your line at this time. Have a wonderful day.