What You Should Know:
– Clover Health, a physician enablement company committed to bringing access to great healthcare to everyone on Medicare announced that it has delivered notice to the Centers for Medicare and Medicaid Services (“CMS”) that it will exit the CMS ACO REACH Program at the end of the 2023 performance year.
– Written notification will also be sent to all participating physicians in accordance with CMS requirements.
– The decision will have no impact on its ACO REACH beneficiaries, and Clover will continue to fulfill all of its obligations under the ACO REACH Program for the 2023 performance year.
Strategic Decision to Focus on Medicare Advantage
Clover Health’s CEO, Andrew Toy, explained the company’s decision to exit the ACO REACH Program:
“When we entered the ACO REACH business in 2021, we felt that expanding our platform to Original Medicare would have a number of benefits, including increasing the number of lives under Clover Assistant management and enabling us to rapidly increase the number of physicians we worked with directly. And, while we were successful in those goals, we have not seen a clear line to profitability in this business and it has also become quite clear that, over the same period of time, we have made far greater and swifter strides on our path to profitability in our Medicare Advantage insurance business.”