A great price on a quality business, or are cost pressures revealing structural cracks?In 2025, UnitedHealth Group (UNH +1.19%) faced a notable increase in medical costs amid other challenges, forcing management to cut its earnings guidance in April before withdrawing it completely a month later. As a result, the stock fell nearly 45% from peak to trough as profit margins shrank. The once-steady healthcare insurance giant looked anything but reliable last year.NYSE : UNHUnitedHealth GroupToday's Change( 1.1 ...

PresentationGood morning, everyone, and welcome again to the 44th Annual JPMorgan Healthcare Conference. My name is Matt Mckean, and I'm an associate here at JPM, and it's my pleasure to introduce our next presenting company, Clover Health. Joining us today from Clover is CEO, Andrew Toy; and CFO, Peter Kuipers. They'll be running us through a brief set of materials, and we ask that you hold off on any Q&A until the end.Andrew ToyCo-Founder, CEO & Director All right. Thank you very much for joining us today ...

Key Takeaways CLOV delivered 53% YoY growth in Medicare Advantage PPO membership during the 2026 AEP.CLOV retained over 95% of members by keeping plan benefits stable and expanding presence across core markets.CLOV expects GAAP net income profitability in 2026, supported by retention, CA use and SG&A efficiency.Clover Health Investments(CLOV) has reported strong results from the 2026 Annual Enrollment Period (AEP), delivering 53% year-over-year growth in Medicare Advantage PPO membership. After a strong enr ...

Clover Health Investments FY Conference Summary Company Overview - **Company**: Clover Health Investments (NasdaqGS:CLOV) - **Industry**: Medicare Advantage Key Points and Arguments Financial Performance - Clover Health achieved **Adjusted EBITDA profitability** last year and aims for **GAAP net income profitability** in the current year [2][3] - The company reported a **53% year-on-year growth** in membership, increasing from approximately **100,000 to 150,000 members** [4][18] - The previous year’s growth was **27%**, indicating a significant acceleration in growth [4] - Clover Health is focused on **disciplined growth** in core markets, emphasizing high retention rates among members [5][20] Clinical Quality and Technology - Clover Health is recognized as the **number one PPO in the country** for Medicare Advantage based on **HEDIS quality** metrics for two consecutive years [5][39] - The company utilizes an **AI-driven technology platform** called Clover Assistant, which empowers physicians to identify and manage chronic diseases earlier, leading to improved clinical outcomes [6][11] - The technology is designed to be accessible to all physicians, not just a select few, which differentiates Clover from other health plans [8][9] Market Strategy - Clover Health is strategically focused on **growing within core markets** where it has established management capabilities and technology [5][18] - The company plans to expand its **Counterpart Health** division, which offers its technology to other health plans, thereby increasing its market reach [28][30] - Clover Health aims to maintain a **four-star payment year** in 2026, benefiting from a favorable **CMS rate notice** and increased **Part D direct subsidy** [20][41] Member Economics - The company acknowledges that **first-year members** typically have negative contribution profits but anticipates improvements in this cohort's profitability over time [21][22] - Returning cohorts are expected to drive profitability, with a focus on improving contribution profit from new members [22][39] AI and Healthcare - Clover Health emphasizes the importance of **AI in improving clinical outcomes** rather than merely focusing on AI as a product [45][48] - The company believes that advancements in foundational AI models will benefit its operations, as it integrates these improvements into its existing technology [45][46] Competitive Landscape - Clover Health differentiates itself by focusing on **physician choice** and avoiding the limitations of HMO plans, which often restrict access to specialists [13][15] - The company aims to provide a **PPO model** that combines the clinical quality management of an HMO with the flexibility of a PPO [15][16] Additional Important Insights - Clover Health is committed to **investing in technology** to enhance its service offerings and improve clinical management [27][37] - The company is focused on **SG&A efficiency** improvements, leveraging AI-driven efficiencies to enhance operational performance [21][20] - Clover Health's approach to member acquisition emphasizes **affordability and access**, with a focus on keeping costs manageable for members [53][54] This summary encapsulates the key points discussed during the Clover Health Investments FY Conference, highlighting the company's financial performance, clinical quality, technology strategy, market approach, and competitive positioning within the Medicare Advantage industry.

Financial Performance and Growth - Clover Health is positioned for 2026 GAAP Net Income profitability [9] - The company anticipates a greater than $70 Per Member Per Month (PMPM) revenue tailwind from a 4-Star rating and favorable rate update [26] - Clover Health experienced a +53% year-over-year (YoY) growth in Medicare Advantage membership, up from +27% in 2025 [11] - Clover Health expects to deliver FY26 GAAP Net Income Profitability, benefiting from 4 Stars, strong retention, stable benefits, and industry pullback [47] Clinical Model and Technology - Clover Assistant (CA) is a key component, with models trained to support improved clinical outcomes [20] - Counterpart Health (CPH) is rapidly expanding with +450% YoY customer users, scaling alongside the growing MA profit engine [37] - Clover Health's Medicare Advantage PPO plans received a score of 4.72 out of 5 Stars on HEDIS for the Plan Year 2026 [38] - Clover Assistant use is correlated with improved medication adherence, with medication fills increased by ~5% on the day of the Clover Assistant visit [118] Market and Strategy - Clover Health is focused on strategic market-leading growth [18] - The company is targeting sustained Adjusted EBITDA profitability [11] - Approximately 97% of members are in current 4 Star payment year PPO [11]

Core Insights - The S&P 500 is experiencing unprecedented concentration, with the 10 largest companies accounting for about 40% of the index's weight, significantly above the long-term average of approximately 20% [1][2] Group 1: Market Concentration - Analysts express concern that high concentration may lead to lower S&P 500 returns over the next decade compared to a less concentrated market [2] - The top 10 stocks in the S&P 500 account for 35% of the index's earnings, making the current weight of 40% reasonable [6] Group 2: Investment Alternatives - The Invesco S&P 500 Revenue ETF tracks the S&P 500 but weights stocks based on trailing-12-month revenue, imposing a 5% weight cap on individual stocks [3][5] - The Invesco S&P 500 Equal Weight ETF measures performance by giving equal weight to all constituents, eliminating concentration risk entirely [8][9] Group 3: Performance and Fees - The Invesco S&P 500 Revenue ETF has returned 545% since its inception in 2008, while the S&P 500 has returned 630%, indicating potential for continued underperformance due to concentration risk [6][10] - The Invesco S&P 500 Revenue ETF has a relatively high expense ratio of 0.39%, while the Invesco S&P 500 Equal Weight ETF has a lower expense ratio of 0.2%, making it a more cost-effective option for investors seeking exposure without concentration risk [7][11]

Membership and Growth - Total membership reached 275,300 as of January 1, 2026, reflecting a 30% Compound Annual Growth Rate (CAGR) since inception[16] - The company projects year-end 2026 membership to be in the range of 290,000 to 296,000[16,46] - From 2024 to Q3 2025, peers averaged 1% annual membership growth[36] - As of January 1, 2026, 80% of new members are new to MA, and 20% are MA plan switchers[47] - January 1 net Medicare Advantage enrollment growth in California was +23,800 (+84% YoY)[47] - January 1 net Medicare Advantage enrollment growth Ex-California was +41,500 (+23% YoY)[47] Financial Performance - The company's total revenue has grown from $127 million in 2014 to $3939 million in 2024[16] - The company raised YE adjusted EBITDA guidance from $48M to $94M at the midpoint from initial guidance to current guidance[52] - The company expects consensus adjusted EBITDA of $145M to be within FY 2026 guidance range[52] Quality and Cost Management - 100% of Alignment's members are in plans rated 4 stars or above, compared to 65% for the industry[40] - The company invests ~4% of medical expenses for at-risk members in employed clinical model[21] - The company has achieved superior growth while managing medical costs effectively, differentiating itself from peers who averaged a 1% annual membership growth and an annual increase in MBR of 160bps[36] Market Position - The company has less than 1% national market share and approximately 6% share in existing markets[53] - The MA market is projected to grow further over the next decade, with MA penetration reaching 58% in 2034[54]

Key Takeaways HUM offered Atlas Oncology's care model to MA members in TN and MS from the beginning of 2026.The model provides holistic cancer support with clinical care, counseling, and care coordination services.Integrated tools and real-time support aim to reduce ER visits and align care with patient goals.Humana Inc. (HUM) recently unveiled a tie-up with Atlas Oncology Partners in a bid to provide enhanced cancer care, particularly for Medicare beneficiaries. Starting Jan. 1, 2026, eligible Humana Medic ...

Clover delivers market-leading Medicare Advantage growth, establishing a strong path to achieve its first-ever full year GAAP Net Income profitability in 2026.Disciplined, core-market growth, strong returning member retention, and improving cohort economics position Clover for compounding earnings and margin expansion.Powered by AI, Clover continues to bring industry-leading clinical quality to members, with ~97% of Clover’s January 1, 2026 membership in flagship PPO plan that is ranked #1 nationally on cor ...

Clover delivers market-leading Medicare Advantage growth, establishing a strong path to achieve its first-ever full year GAAP Net Income profitability in 2026.Disciplined, core-market growth, strong returning member retention, and improving cohort economics position Clover for compounding earnings and margin expansion.Powered by AI, Clover continues to bring industry-leading clinical quality to members, with ~97% of Clover’s January 1, 2026 membership in flagship PPO plan that is ranked #1 nationally on cor ...