Counterpart Health 2025 Results: How Better Clinical Decisions at Scale Improve Outcomes, Quality, and Cost

Rhea-AI Summary

Counterpart Health (CLOV) reported 2025 highlights showing scaled clinical impact from its AI physician‑enablement platform, Counterpart Assistant (CA). Key outcomes include a >450% YoY increase in live third‑party customer clinicians, an approximate 1,500 basis point MCR differential for returning Clover members with CA PCPs, and the PPO Medicare Advantage plan achieving the #1 HEDIS score nationwide for a second year.

Retrospective analyses found earlier COPD diagnosis (new members 75% more likely in year one), higher outpatient pulmonology use (+18%), lower all‑cause hospitalizations (CHF −18%; COPD −15%), reduced 30‑day readmissions (CHF −25%; COPD −18%), and 70–89% higher diagnosis rates in high ADI neighborhoods. Product expansions included integrated ambient scribing, natural language chat, proactive visit summaries, and broader enterprise capabilities.

Positive

• Clinician adoption up >450% year‑over‑year, now hundreds of third‑party clinicians live
• Approximate 1,500 basis point MCR differential for returning Clover members with CA PCPs
• PPO Medicare Advantage plan achieved #1 HEDIS nationwide for a second consecutive year
• New member COPD diagnosis likelihood +75% in first year under CA PCPs
• All‑cause hospitalizations lower: CHF −18% and COPD −15%
• 30‑day readmissions reduced: CHF −25% and COPD −18%
• Diagnosis rates in high ADI neighborhoods higher by 70–89%

Negative

• Key clinical findings derive from retrospective analyses showing associations rather than randomized causal proof
• No company earnings, revenue, or guidance figures disclosed in the announcement

News Market Reaction

+1.54%

1 alert

+1.54% News Effect

On the day this news was published, CLOV gained 1.54%, reflecting a mild positive market reaction.

Data tracked by StockTitan Argus on the day of publication.

Key Figures

Clinician adoption growth: >450% YoY MCR differential: 1,500 basis points HEDIS ranking: #1 nationwide +5 more

8 metrics

Clinician adoption growth >450% YoY Increase in live third-party customer clinicians using Counterpart in 2025

MCR differential 1,500 basis points Approximate MCR gap for members whose PCPs use CA vs. those who do not

HEDIS ranking #1 nationwide HEDIS score for a PPO Medicare Advantage plan for second consecutive year

Earlier COPD diagnosis 75% more likely New members diagnosed with COPD in first year under CA PCPs

CHF hospitalizations 18% lower rate All-cause hospitalizations for CHF with a CA PCP relationship

COPD hospitalizations 15% lower rate All-cause hospitalizations for COPD with a CA PCP relationship

CHF readmissions 25% lower 30-day readmissions for CHF in CA-attributed patients

Chronic disease diagnosis rates 70–89% higher Diagnosis rates across four chronic diseases in high ADI neighborhoods with CA

Market Reality Check

Price: $2.26 Vol: Volume 4,125,625 vs 20-da...

normal vol

$2.26 Last Close

Volume Volume 4,125,625 vs 20-day average 4,396,944 (relative activity 0.94x). normal

Technical Price 2.6 trades below 200-day MA of 2.96, and is 46.61% under the 52-week high and 22.64% above the 52-week low.

Peers on Argus

CLOV is up 2.77% while key peers (e.g., OSCR, PGNY, ALHC, MOH, NEUE) show negati...

1 Down

CLOV is up 2.77% while key peers (e.g., OSCR, PGNY, ALHC, MOH, NEUE) show negative moves today, with OSCR in momentum scanners at about -4.17%. This divergence points to a stock-specific reaction tied to Counterpart’s outcomes update rather than a sector-wide move.

Common Catalyst Several peers reported conference participation and membership growth updates, but these headlines do not align with CLOV’s AI-enabled clinical outcomes focus.

Historical Context

5 past events · Latest: Dec 16 (Neutral)

Pattern 5 events

Date	Event	Sentiment	Move	Catalyst
Dec 16	Conference participation	Neutral	+0.8%	Announcement of CEO presentation at J.P. Morgan 2026 Healthcare Conference.
Nov 17	Conference participation	Neutral	+0.0%	CFO participation in 2025 Citi Global Healthcare Conference with webcast access.
Nov 04	Earnings update	Neutral	-4.3%	Q3 2025 results with strong revenue and guidance but wider GAAP net loss and higher BER.
Oct 31	Board change	Neutral	+4.3%	Chelsea Clinton stepping down from Board after eight years of service.
Oct 30	Clinical outcomes	Positive	+1.7%	Whitepaper showing CA improved chronic disease detection and reduced hospital use.

Pattern Detected

Recent news shows mixed alignment: positive clinical/operational updates (like Counterpart outcomes and prior CA data) tended to coincide with modest gains, while neutral corporate or earnings items sometimes saw counterintuitive moves in both directions.

Recent Company History

Over the past few months, Clover Health reported Q3 2025 results with strong revenue and membership growth but wider losses, and filed its detailed 10‑Q. It highlighted Counterpart Assistant benefits in an Oct 30, 2025 whitepaper showing earlier chronic disease detection and lower hospital use. Governance news included Chelsea Clinton leaving the Board after eight years. The company also announced participation in major healthcare conferences. Today’s Counterpart outcomes update extends the prior CA evidence and supports its value-based care positioning.

Market Pulse Summary

This announcement highlights Counterpart’s 2025 progress as Clover’s AI-enabled platform, including ...

Analysis

This announcement highlights Counterpart’s 2025 progress as Clover’s AI-enabled platform, including >450% growth in live clinicians, a roughly 1,500-basis-point MCR differential, and lower hospitalizations and readmissions in chronic diseases. It builds on prior CA data disclosed in late 2025, reinforcing a value-based care narrative within Clover’s Medicare Advantage business. Investors may watch for how these clinical gains translate into sustained financial performance, while keeping an eye on future earnings, utilization trends, and ongoing insider activity in recent Form 4 filings.

Key Terms

hedis, ppo, medicare advantage, copd, +4 more

8 terms

hedis medical

"supported the #1 HEDIS score nationwide for a PPO Medicare Advantage plan"

HEDIS is a standardized set of measures used to evaluate how well health insurance plans deliver care and preventive services. Think of it like a report card that compares plans on things such as screenings, chronic-disease management and vaccination rates; investors monitor HEDIS scores because they affect plan reputation, consumer choice, quality-linked payments and regulatory scrutiny, all of which can influence membership, revenue and long-term growth.

ppo financial

"#1 HEDIS score nationwide for a PPO Medicare Advantage plan for the second"

A PPO, or preferred provider organization, is a type of health insurance plan that gives members a network of doctors and hospitals who agree to lower fees, while still allowing patients to see providers outside the network at higher cost. Investors care because PPOs influence how medical services are paid for and used, affecting revenue and margins for insurers, hospitals, drug makers and companies that serve employer health plans—think of it as a merchant discount program that shapes who customers choose and what they pay.

medicare advantage financial

"#1 HEDIS score nationwide for a PPO Medicare Advantage plan for the second"

Medicare Advantage is a type of health insurance plan offered by private companies that covers services traditionally provided by government-run Medicare. Think of it as a bundled package that combines hospital, doctor, and other medical care into one plan, often with added benefits. For investors, it matters because the popularity and profitability of these plans can influence healthcare companies and the broader health insurance industry.

copd medical

"members were 75% more likely to be diagnosed with COPD in their first year"

Chronic obstructive pulmonary disease (COPD) is a long-term lung condition that progressively narrows airways and reduces the ability to breathe, causing persistent cough, shortness of breath and fatigue. It matters to investors because a large and growing patient population creates steady demand for drugs, medical devices and care services, influences healthcare spending and regulatory decisions, and offers clear market opportunities—similar to a leaking engine that requires ongoing fixes and replacement parts.

congestive heart failure medical

"lower rate of all-cause hospitalizations for Congestive Heart Failure (CHF)"

A chronic condition in which the heart cannot pump blood efficiently enough to meet the body's needs, causing fluid buildup in the lungs and tissues; think of the heart as a weakened pump that lets pressure and fluid back up into pipes. It matters to investors because it drives demand for medications, medical devices, hospital services and long‑term care, influences healthcare spending and clinical trial activity, and can materially affect the revenue and regulatory risk for companies developing treatments.

area deprivation index medical

"resource-constrained, high Area Deprivation Index (ADI) neighborhoods."

A measure that scores neighborhoods by levels of economic hardship and resource shortages—such as poverty, unemployment, low education, and substandard housing—so areas can be compared on how deprived they are. Investors use it like a neighborhood compatibility map: it signals local demand, health risks, workforce stability and policy needs that affect property values, consumer spending, insurance costs and longer-term business performance.

value-based care medical

"operating system for value-based care, with capabilities spanning the exam"

A health-care delivery approach that rewards providers for keeping patients healthy and improving outcomes instead of charging for each test or visit. For investors, it matters because it shifts where profits and losses come from—favoring providers and technologies that lower long-term costs, prevent complications, and demonstrate measurable results; think of it like paying a contractor only when the house stays sound, which changes who wins and loses financially.

ambient scribing technical

"Integrated Ambient Scribing: A fully integrated solution that listens to visits"

Ambient scribing is an automated system that listens to real-world conversations—such as doctor visits, earnings calls, or meetings—and creates written records and summaries without manual note-taking. Like a silent assistant that fills out forms and highlights key points, it can speed workflows, reduce labor costs and improve accuracy, but it also raises questions about data privacy, security and regulatory compliance that investors must weigh when assessing risks and potential savings.

AI-generated analysis. Not financial advice.

Counterpart continues to demonstrate that unified data and real-time insights, delivered directly into the clinician’s workflow, drive measurable clinical and financial outcomes

SAN FRANCISCO, Jan. 12, 2026 (GLOBE NEWSWIRE) -- Counterpart Health, Inc. (“Counterpart” or the “Company”), a leading AI-powered physician-enablement platform and subsidiary of Clover Health Investments, Corp. (Nasdaq: CLOV), today released key 2025 highlights. The past year was defined by continued publication of research demonstrating the platform's impact on chronic disease management, meaningful product expansion, and the scaled adoption of Counterpart Assistant (CA) by hundreds of live third-party customer clinicians across diverse practice settings.

Clinical Quality and Financial Performance Outcomes

Data released in 2025 highlights the scale and consistency of the platform's impact. These outcomes reflect the cumulative effect of thousands of better clinical decisions made during real patient visits:

• Clinician Adoption: Counterpart recorded a >450% Year-over-Year increase in live third-party customer clinicians, now representing hundreds of third-party customer clinicians live on the platform across multiple states.
• MCR Differential: Returning Clover Health members whose primary care physicians (PCPs) use CA demonstrated an approximate 1,500 basis point MCR differential compared to those whose PCPs do not, with performance differentials compounding as member cohorts mature.
• Quality Metrics: Counterpart’s technology supported the #1 HEDIS score nationwide for a PPO Medicare Advantage plan for the second consecutive year—achieved across a wide network of non-employed physicians without capitation.
  
  

Evidence-Based Clinical Impact

Throughout 2025, Counterpart released three new retrospective data analyses validating CA’s ability to help improve chronic disease management. These studies use real-world data to quantify how CA supports proactive, longitudinal care by equipping PCPs at the point-of-care:

• Earlier Disease Identification: Data indicated that new members were 75% more likely to be diagnosed with COPD in their first year when under the care of a CA PCP. Additionally, COPD patients recorded an 18% higher average number of outpatient pulmonology visits, reflecting better coordination of specialty care.
• Reductions in Acute Care Utilization: Research showed that a relationship with a CA PCP was associated with an 18% lower rate of all-cause hospitalizations for Congestive Heart Failure (CHF) and a 15% lower rate for COPD. The studies also recorded meaningful reductions in 30-day readmissions (25% lower for CHF; 18% lower for COPD).
• Support for Patients in Socioeconomically Disadvantaged Neighborhoods: Data demonstrated how CA supports PCPs in resource-constrained, high Area Deprivation Index (ADI) neighborhoods. In these settings, CA attribution was associated with 70–89% higher diagnosis rates across four major chronic diseases, with patients identified at significantly earlier clinical stages.
  
  

Technological Innovation and Enterprise Scaling

Unlike retrospective analytics or documentation-only tools, Counterpart delivers support inside the clinical encounter where decisions are made and outcomes are shaped. In 2025, Counterpart expanded beyond the point of care to support clinicians and organizations across the full arc of care. This evolution marks Counterpart’s transition into an end-to-end clinical operating system for value-based care, with capabilities spanning the exam room and the enterprise:

• Integrated Ambient Scribing: A fully integrated solution that listens to visits in real time, allowing physicians to focus on patients and bringing enterprise-grade technology to every practice.
• Natural Language Chat: Next-generation capabilities that allow clinicians to ask questions about a patient’s medical history in natural language and receive immediate responses and source documents, all within a PHI-safe environment.
• Proactive Visit Summaries: Automated synthesis of longitudinal data that flags potential care opportunities before clinicians enter the exam room.
• Enterprise-Level Capabilities: Expanded capabilities across quality operations, population health, and data services.
  
  

“When we connect the dots across the healthcare ecosystem, better care moves from a possibility to the norm,” said Conrad Wai, CEO of Counterpart Health. “In 2025, we showed that better outcomes and lower costs are driven by thousands of better clinical decisions made during real patient visits. When clinicians are supported in the moment with timely, high-fidelity insights, proactive value-based care becomes repeatable at scale. Our focus is on building a clinical operating system that works for any clinician, in any setting—setting a new standard for how care is delivered.”

The idea is brought to life in Counterpart’s latest video (watch the video here), highlighting how every condition detected, prescription filled, or conversation in the exam room shapes a patient’s life. Informed by complete data and timely, individualized insights, these moments compound into earlier diagnoses, better management, lower costs, and healthier lives.

This is the future of value-based care Counterpart is building, one where thousands of small, better-informed decisions create extraordinary outcomes for patients, clinicians, and communities.

About Counterpart Health
Counterpart Health, 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’s 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’s 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’s impact on Diabetes, Chronic Kidney Disease, Congestive Heart Failure, and Chronic Obstructive Pulmonary Disease management, and Clinical Quality.

Investor Relations:
Ryan Schmidt
investors@cloverhealth.com

Press Inquiries:
press@cloverhealth.com

FAQ

What clinician adoption growth did Counterpart report for 2025 for CLOV?

Counterpart reported a >b450% year‑over‑year increase in live third‑party customer clinicians, now totaling hundreds of clinicians.

How large was the MCR differential for Clover members served by CA PCPs (CLOV)?

Returning Clover members with CA primary care physicians showed an approximate 1,500 basis point MCR differential versus non‑CA PCPs.

What clinical outcome improvements did Counterpart (CLOV) report for CHF and COPD in 2025?

Analyses found lower all‑cause hospitalizations (CHF −18%; COPD −15%) and reduced 30‑day readmissions (CHF −25%; COPD −18%).

Did Counterpart (CLOV) report any quality recognition in 2025?

Yes; Counterpart’s technology supported the #1 HEDIS score nationwide for a PPO Medicare Advantage plan for a second consecutive year.

What product expansions did Counterpart announce in 2025 for clinicians and enterprises?

New capabilities included integrated ambient scribing, natural language chat within a PHI‑safe environment, proactive visit summaries, and expanded enterprise quality/population health tools.

How did Counterpart (CLOV) perform in disadvantaged neighborhoods in 2025 analyses?

CA attribution was associated with 70–89% higher diagnosis rates across four major chronic diseases and earlier clinical stage identification in high ADI areas.