News Briefs

March 4

✦ In its first earnings report released as a publicly traded company, Clover Health on March 1 said it ended 2020 with more than 58,000 Medicare members, generated more than $670 million in revenue for the full year and reported a net loss of $91.6 million. The latter was an improvement over a net loss of $363.7 million in 2019, resulting from “year-over-year improvement of derivative valuation, offset by an unfavorable change in the fair value of warrant expenses,” the company explained in a March 1 press release. Its medical loss ratio for the year was 88.7%, compared with 98.6% for 2019; excluding the estimated net effect of COVID-19, its full-year normalized MLR was 90.5%, an improvement that was “driven by operational efficiency and the increase in the number of members managed by PCPs that use the Clover Assistant,” said the company. The Medicare-focused technology and health care company said it anticipates Medicare Advantage membership to be between 68,000 and 70,000 by Dec. 31, 2021. Visit https://bit.ly/2NSEArD.

✦ The American Rescue Plan Act of 2021 (H.R. 1319), passed by the House on Feb. 27, includes additional federal funding for states that newly adopt Medicaid expansion and creates a new option for states to extend pregnancy-related Medicaid and CHIP coverage to new mothers for 12 months, according to a summary from the Georgetown University Center for Children & Families. The bill would also require drug manufacturers to pay higher rebates to Medicaid on drugs that have had excessive price increases by eliminating a cap on total drug rebates that manufacturers must pay state Medicaid programs. However, Senate Democrats at press time reportedly agreed to delay that change, which is estimated to generate about $23.5 billion in savings to the federal government and states over 10 years, until 2024. Senate Democrats are likely to push the bill through via budget reconciliation (see story, p. 1), aiming for the March 14 deadline when emergency unemployment benefits expire. Visit https://bit.ly/3uOkyiw.

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Radar on Medicare Advantage

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.