Health Care Startups 2020

By pjain      Published Jan. 11, 2021, 5:04 a.m. in blog Invest   

Health Care Markets

Medicare Advantage market Key Factors

  • Overall Medicare Market - Aging population - more seniors are entering that market, anyone over 65 or who's disabled.
  • 30% range of all Medicare eligibles get enrolled in Medicare Advantage plans.
  • Medicare Advantage has a huge potential for growth - projections are for half a trillion dollar market by 2025
  • People allowed to drop MA or switch to another Jan 1 - Mar 31st every year

Clover Health

Medicare plan provider

- we are one of the fastest growing Medicare plans already in the United States,
- to accelerate innovation in Medicare.
  • As of Dec end'20 had 57,000 members - much smaller than Medicare Advantage market

Direct recontracting of Original Medicare

CMS is allowing companies to look at how we can manage both Medicare Advantage and original Medicare folks under the same umbrella.

It now allows providers like Clover to access the remainder, the people who are not in MA plans. The people basically making up the bulk of the market right now can now also be managed by our software on our care model by Clover Assistant. They will remain in original Medicare.

They hope dramatic growth in subscribers, and Clover Assist will give an advantage in pulling MA from others, but even more from the remaining 70% on regular Medicare.

Direct plans with Medicare/PCPs

With direct contracting, we can take that close partnership with primary care physicians, and what happens is, when they partner with us under direct contracting, they're-- seniors, the people who are already going to use them as their PCP, come under our management as well. So from our perspective, we're now always partnering with the PCP, but with MA, we partner with the PCP, and we enroll new members and they come into our MA plan.

Technology Enabled Software for Better Care and Satisfied Seniors

  • Patients full lifecycle can be managed by our software on our care model by Clover Assistant.

  • Giving software to primary care physicians to look after America's seniors

    • better care

Timeline, About

  • President, Andrew Toy

  • 2015 $1b - focus on senior-health

  • 2020 SPAC IPO social capital Hedosophia Holdings Corp. III is completed. It valued the company at about $3.7 b
  • Will use public capital to open up NEW MARKETS, Growth


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