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Clover Health is leaving the ACO REACH program at the end of the 2023 performance year, the company recently announced.
While the insurer said that Clover will continue to fulfill all its ACO Reach obligations for the rest of this year, including sending a written notification to participating physicians as required by Centers for Medicare and Medicaid Services, CEO Andrew Toy said continuing in ACO Reach does not make sound business sense.
“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,” said Toy in a statement. “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.”