Counterpart Health Expands Proven Flywheel for HEDIS Excellence to Third-Party Partners
Rhea-AI Summary
Counterpart Health (CLOV) said its AI-driven HEDIS flywheel again powered Clover Health Medicare Advantage plans to top-tier results and made the platform available to third-party partners on Oct 14, 2025. Clover was the #1 performing PPO for HEDIS clinical quality measures among plans over 2,000 members and the only PPO in the Top 10. The flywheel combines point-of-care Counterpart Assistant prompts, real-time ingestion from 100+ data sources, NLP/LLM abstraction, and AI-augmented documentation closure to raise quality and reduce administrative burden.
Counterpart cites improved benchmark rates for screenings and diabetic eye exams and plans to scale the platform to more partners.
Positive
- Clover ranked #1 PPO for HEDIS measures among plans >2,000 members
- Platform now offered to third-party partners, expanding addressable market
- Aggregates clinical data from 100+ sources for unified patient views
Negative
- None.
News Market Reaction 1 Alert
On the day this news was published, CLOV gained 6.08%, reflecting a notable positive market reaction.
Data tracked by StockTitan Argus on the day of publication.
Technology platform again powers top-tier HEDIS results for Clover Health Medicare Advantage plans
SAN FRANCISCO, Oct. 14, 2025 (GLOBE NEWSWIRE) -- Counterpart Health, Inc. (“Counterpart”), a wholly owned subsidiary of Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”) and a leading AI-powered value-based care enablement company, today announced that its technology platform has once again powered top-tier HEDIS results for Clover Health Medicare Advantage plans through its AI-driven flywheel. The company is now making this unparalleled HEDIS platform available to third-party partners for the first time.
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’s unique ability to drive both member outcomes and plan performance across a wide network of non-employed physicians, without capitation.
Counterpart Health’s flywheel for HEDIS excellence includes:
- 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.
This flywheel consistently powers superior results for Clover’s 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.
“This recognition for the second year running reinforces what we know: our technology doesn’t just reduce administrative burden, it directly improves quality and outcomes,” said Conrad Wai, CEO of Counterpart Health. “By opening our HEDIS excellence flywheel to third-party partners, we’re enabling more organizations to benefit from the same proven processes that powered Clover’s industry-leading results.”
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.
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.
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