As with last year, Counterpart has enabled Clover Health to be the #1 performing PPO plan in the country for HEDIS clinical quality measures for plans over 2,000 members. Clover is again the only PPO amongst the Top 10 plans, demonstrating our AI platform\u2019s unique ability to drive both member outcomes and plan performance across a wide network of non-employed physicians, without capitation.<\/p>\n
Counterpart Health\u2019s flywheel for HEDIS excellence includes:<\/p>\n
CA-powered visits with clinical care gap closure: at the point of care, Counterpart Assistant (CA) surfaces actionable HEDIS clinical gaps for providers to close, whether by validating existing clinical evidence or ordering needed tests or referrals.Data ingestion: each CA visit triggers real-time clinical data collection from across the healthcare landscape, aggregating from more than 100 data sources to build a unified patient view.AI-powered HEDIS abstraction: Counterpart applies natural language processing (NLP) and large language model (LLM) technologies to identify suspect hits and exclusions for care coordination staff to review.HEDIS documentation gap closure: AI-augmented abstraction tooling closes documentation gaps across measures, allowing PCPs to focus on preventive care and clinical action rather than administrative tasks. <\/p>\n
This flywheel consistently powers superior results for Clover\u2019s Medicare Advantage population. From a patient outcomes perspective, those who see a CA-powered provider are more likely to meet quality benchmarks on a range of measures, including measures focused on colorectal cancer screening, breast cancer screening, and diabetic eye exams, as demonstrated in a previously published whitepaper<\/a>.<\/p>\n \u201cThis recognition for the second year running reinforces what we know: our technology doesn\u2019t just reduce administrative burden, it directly improves quality and outcomes,\u201d said Conrad Wai, CEO of Counterpart Health. \u201cBy opening our HEDIS excellence flywheel to third-party partners, we\u2019re enabling more organizations to benefit from the same proven processes that powered Clover\u2019s industry-leading results.\u201d<\/p>\n As Counterpart Health continues to expand its platform, the company is committed to scaling this model across more partners, driving better data, smarter AI, and higher-quality outcomes for value-based care at scale.<\/p>\n About Counterpart Health Investor Relations:<\/p>\n Ryan Schmidt<\/p>\n investors@cloverhealth.com<\/a><\/p>\n Press Inquiries:<\/p>\n
Counterpart Health<\/a>, a subsidiary of Clover Health Investments, Corp., or Clover Health, is a leading AI-powered physician enablement platform transforming care delivery. Born out of Clover Health as Clover Assistant, Counterpart Health\u2019s flagship software platform, Counterpart Assistant, provides clinically intuitive insights that help clinicians better manage chronic conditions and deliver high-quality care. Counterpart Health extends this powerful data-driven technology platform beyond Clover Health\u2019s Medicare Advantage plan, bringing its benefits to a wider audience to improve patient outcomes and reduce healthcare costs nationwide. Several published studies demonstrate the technology\u2019s impact on Diabetes<\/a>, Chronic Kidney Disease<\/a>, Congestive Heart Failure<\/a>, and Chronic Obstructive Pulmonary Disease<\/a> management, and Clinical Quality<\/a>.<\/p>\n
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