HIMSSCast: Why a Google vet started a next-gen health insurer

Clover Health wants to improve physicians’ performance by giving them access to cutting-edge AI technology. But the company chose to enter the market, not as a technology vendor, but as an insurer, disrupting traditional payment structures and care-navigation technology in one fell swoop.

On today’s HIMSSCast, Clover Health’s Andrew Toy joins host Jonah Comstock to talk about his story and his own particular take on solving the healthcare cost crisis in America.

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Talking points:

• What Clover does and how it’s different from other payers and other startups.
• Clover Assistant, Clover’s provider-facing tech stack, and how it fits into their model.
• Getting away from the idea of networks.
• What does value-based care mean for Clover?
• Who holds the risk? And why it should be the insurers?
• Why the incentive-alignment argument for value-based care is more complicated than people think.
• Incentivizing doctors by giving them more powerful tools.
• How health systems should fit into the value-based care landscape.
• Why Clover launched as a payer, and not a technology vendor.
• Why Clover built its Assistant outside of the EHR.
• Fixing healthcare means doing so for everyone.
• How can innovation in insurance push through incumbent players?

More about this episode:

Medicare Advantage insurtech startup Clover Health raises $500M

Clover Health will join the public market by merging with Social Capital SPAC

Clover Health’s new subsidiary will rely on members, machine learning to fuel drug development

Clover Health laying off 25 percent of staff as it seeks new healthcare expertise

Clover Health gets $130M from Greenoaks, Google Ventures, others

Clover Health planning expansion into 101 new markets

Clover Health taps MedArrive to vaccinate its homebound MA members

Walmart partners with Clover Health to offer Medicare Advantage plans