Good morning, everyone, and welcome again to the 44th Annual JPMorgan Healthcare Conference. My name is Matt McKeon, 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. With that, I'll hand it over to you guys.
All right. Thank you very much for joining us today. My name's Andrew Toy. Peter is sitting at the desk over there. I'm the CEO of Clover Health. I'd love to take you through where we are, what we think we achieved last year, and where we're going this year. So the usual statements apply here. We're public, of course, like we may make some forward-looking statements. So Clover, we're a Medicare Advantage company. We're a payer. Last year, I stood up here and I said, what are we really focused on doing? So we are focused on the Medicare Advantage market. We had just reached Adjusted EBITDA profitability, and we were saying to ourselves, Okay, the core fundamentals of our model are differentiated. It's a vertical approach, one that not many people are taking, but have huge advantages.
And we think that if we can get to profitability, which we did, the next phase is going to be a return to growth. That's what I talked about last year. We're going to be returning to growth. And so that's what we did, and we were very successful at that. I'll talk about that. We are positioned this year. We are already Adjusted EBITDA profitable, as I said. We are now aiming to deliver GAAP net income profitability this year. So that will be good to deliver profitability on GAAP. And we continue to deliver industry-leading clinical quality. And I'll talk about that as well. So the key thing about what we're doing is that we are going to succeed as a business, as a payer, by doing the right thing in terms of improving the outcomes of our members.
So the right-hand side about improving quality drives our business and drives our profitability and also drives our growth. All of these things are connected, and these are the things that we're aiming to achieve. So in terms of our accomplishments, first of all, we delivered significantly above the market in terms of growth. We delivered 53% year-on-year growth. We had already been delivering 27% growth in the year before, and this year we delivered 53% growth. We had very, very high retention, and we were mainly focused on MA switchers in our core markets, and we had also delivered on that as well. So this is a very high number.
We're proud of it, and it's also growth not just for growth's sake, but it's disciplined growth in our core markets that enables us to feel good because our management capabilities around our technology and around improving clinical outcomes are all available in the markets where we grew. I already talked about the fact that we are going to sustain our Adjusted EBITDA profitability and grow that in order to hit the GAAP profitability line this year. We feel good about that. Also, HEDIS quality, a measure of clinical quality. We are the number one PPO in the country in Medicare Advantage on HEDIS quality. That's for the second year in a row. So we're feeling very good about the fact that while we are improving the business, we are also improving the outcomes and the clinical quality that we deliver to our members.
And then I will also talk about our Counterpart Health business, where we bring our technology platform to other plans, other payers. And I'll talk about that at the end. But together, all of these things are based around the fact that we are, at our heart, oriented around technology, oriented around the assistant called Counterpart Assistant. Clover Assistant is another way we refer to it. And this technology, this AI-driven technology, is at the core of all of these achievements. So what does that technology allow us to do? We aim to empower every physician with technology to identify, manage, and treat chronic diseases earlier. This is fundamentally what makes us different. We've talked about it for years and years. It is our technology vision. It's not technology for technology's sake. It's not AI for AI's sake or data for data's sake.
It is bringing together interoperability, bringing together, adding on AI, adding on capabilities and tools for physicians, all to deliver this outcome: treating chronic diseases earlier, identifying them earlier, which allows us to change the cost curve, which allows us to deliver that nation-leading HEDIS scoring. So when you diagnose something earlier, you manage it earlier, you manage it more cost-effectively, you deliver a better outcome. That earlier dimension does a lot of work. So I think we're one of the only health plans who will say this is the core of our mission. I will also note that technology enables us to say every physician. Others sort of say, well, how do you use technology to identify the good ones and the bad ones and steer to the good ones? That's not what we aim to do.
What we aim to do is actually help physicians improve their own performance, and that's why we add that line, that technology can be an every physician thing and not a select your physicians thing. Those are very different approaches, and health plans often think about selecting physicians versus helping them all improve, and we're about helping them all improve. That's how we deliver all these results, so we have our AI-powered assistant. We have a significant addressable market. That's why we're able to grow so much within Medicare Advantage. We are thinking very strategically about which markets we're going to grow within, and we are also delivering through our own clinical arm care into all settings, every physician in the wide network, and we have added care into the home as well, which is something we deliver through our own employees.
So we feel like we can deliver care into almost every site with almost every clinician, all around the same clinical platform, the assistant. So this is a really important slide. This is what explains how it all ties together. So I'll spend some time on it. My own background, I'm the CEO of Clover Health. I am a computer scientist by training. I'm probably one of a few, maybe I'm the only computer scientist really running a health plan. And so when we think about this, there's a lot of people working on how do we bring AI into health care. But you need to bring it all the way into health care. You need to deliver a real result for a real human being. And so we are absolutely, in my mind, the AI leader in Medicare Advantage.
We are focused on using the data available to us, longitudinal data via claims, interoperability networks that bring data that are getting better and better every month, bringing data into our systems, cleaning that data, analyzing that data, and applying AI to all of that in the cleaning, in the aggregation, in the insight generation. And we train our models to support improved clinical outcomes, that earlier detection I talked about, that earlier management that I talked about. And it's built to be the core of what we do. From the very beginning, it's cloud native, it's ML native. And the nice thing about that technology is that as AI LLM technology improves, which we all know is improving every single day, we can add that to our core platform because it's not that we are building all of those models ourselves. We can use foundational models.
We can add on top of foundational models. We can train our own models. We can do prompting modification because all of this is a rising tide that improves our own platform. So as LLMs have come online in the last couple of years, we have integrated those into our own clinical platform and used them to supplement our own data and our own insights because we already have the engine, and this is just a way to turbocharge that engine. When you have all those capabilities, when you are able to put those already at the fingertips of physicians, which is what we're able to do today, what that means is, and this is what the line on the top says, we can empower any doctor, any clinician on the wide network. So we often talk about the wide network. Why is that important?
Because in our core business, which is the health plan business, what people see is when they go shopping, they don't shop and say, hey, I want an AI-powered health plan. Maybe one day they will, but they don't right now. What they say is, I want doctor choice. I would guess that of the vast majority of people in the U.S. at this conference, all of you, when people pick their health plans, they generally pick the PPO. Or if you pick the HMO, it's because you settle for the HMO. You don't pick the HMO, you settle for the HMO. But people want the PPO. And why is that? Because they want physician choice. They want to know that if there's an expert they want to go to, they can go to the expert. They don't want referrals. They don't want gatekeeping.
They don't want all of these things. What they want is to think and know that they can go to any physician, and so that's what we focus on. 98% of our membership is within a PPO. Why is the PPO? Why doesn't everyone just do the PPO? Well, many people have been going into the PPO for the last few years, and much of the industry retreated from the PPO last year. Why is that? Because it is very difficult to manage care on a wide network. Because instead of it's very easy, well, not very easy, but it's more straightforward to say, let's select those physicians and let's work with those than it is to say, here are all the physicians in an area, how do we improve those physicians, so the PPO is more challenging for cost of care.
It is more challenging for HEDIS and clinical scores. What our technology approach on the left-hand side allows us to do, because we are so focused on that as the core of the business, it enables us to give that technology, and we give it away effectively for free to physicians. When they use it, we see their performance improve, and I'll talk about that more in a second, but if you believe that we can give that technology to anybody and their performance improves, they're detecting those diseases earlier, they're identifying diabetes earlier, what that means is we are able to deliver the cost of care and clinical quality of an HMO within a PPO construct. We have effectively removed the trade-off of the PPO, so we get the benefits that that's what people want as a product.
We get the benefits of the HMO in terms of managing clinical quality and total cost of care. And what that means is, taken together, that we feel very comfortable that we can grow in a market segment that others find challenging, in a market segment that is desired by the consumers, and do that in a very sustainable way, improving our profitability, maintaining our business discipline. So what does that mean on the clinical side? All of these are the greatest hits of aging. As we all get older, we are going to develop one or more of these conditions. That is just a function of being human. It is a function of aging. Diabetes, metabolic syndrome, related. CHF, heart disease. CKD, kidney disease. COPD, lung disease. These aren't the only conditions that people will develop, but these are the major things, the diseases of aging.
We have published a number of papers about, and you can go find them on our website, about how doctors using the assistant, Clover Assistant, are able to identify diseases earlier, manage them earlier, and when they're managed earlier, we deliver better outcomes. When a doctor using Clover Assistant is identifying kidney disease earlier and maintaining more years of healthy kidney function, identifying diabetes earlier, making sure that A1C is regulated earlier. All of these things are things we publish papers on that we see in our data where we compare physicians using our tool to physicians not using our tool, and we're constantly investing and making that better and better and better, so that's not point of time statistics, though the analysis is point of time. These are things that we are investing in every year and have invested in for multiple years.
So all of that is tied to why we feel comfortable that as we return to growth, as we deliver profitability and are now growing significantly, when we grow, we are going to grow in a disciplined way around where we're able to have a lot of physicians using Clover Assistant. And so this year, on the left-hand side, as you can see on this slide, we grew around 53%, growing from about 100,000 members to about 150,000 members, just north of 150,000 members. At the same time, first-year members who are typically the most challenging members, when people first come to you, the first year they're with you is the year that they're going to have the worst total cost of care, the worst clinical outcomes. That's because they're not yet managed by us. When they come to us from another plan, they're not yet fully managed by us.
It takes a little bit of time for us to get them onto our management program. We still anticipate that this year there will be a significant improvement in the contribution profit within that first membership, first-year cohort of membership. So between those two things, because we feel really good about that contribution profit adjustment, that is a major driver on how we intend to deliver net income profitability this year, GAAP profitability this year. So there's a clear line of sight. We want to make sure that all this happens. Obviously, we'll talk about that more as we go through the year. But the key thing is that this is a huge amount of growth for almost any Medicare Advantage plan. The reason we feel good about it is it's in our core markets. We had a lot of retention.
We feel good about the Contribution Profit of first-year members, so all of these dimensions on this slide are the things that are affecting this, how we feel, the tailwinds that we feel we see in the industry. First of all, we are going to have a four-star payment year, the first four-star payment year that we have in 2026. I think that's obviously very important. Second of all, there was a significant CMS rate notice affecting the benchmark and an increase in the Part D direct subsidy for payment year 2026. That's obviously a tailwind. In the growth season, we had very, very high retention, and our returning cohorts are the main drivers of our profitability and Contribution Profit. That high retention, the best retention, I think, amongst the best retention we've ever had, significant tailwind.
We increased Clover Assistant coverage last year in our core markets, and we feel good about that and also, of course, we are still not fully at scale. We are still not fully mature, so I think that there's a lot of room for us to improve SG&A efficiency just as a company and when you add in AI-driven efficiencies, I think even more opportunity, so you should see us constantly working on SG&A efficiency through the next few years, so as we look at this, and I mentioned the cohorts just now, I think the major thing I would want people to take away is that new members are contribution profit negative. I want to get that to break even, but let's call them negative right now. They were significantly negative last year. They're going to be less negative this year. That feels good.
We're going to be focused on improving the Contribution Profit, meaning reducing the loss of those new members. That's not unique to Clover. That's just the industry that you get pressure from those first-year members. I think that we are going to have market leading, and I want us to have market leading Contribution Profit loss on those new members. I want to get that to break even, actually, but we're still losing a bit. And I think that will be market leading. And I think our returning cohorts, I would consider to already be really, really strong. So those are the core of our profit-generating engines, core of how we maintain Adjusted EBITDA and net income profitability is the fact that the returning cohorts improve generally year on year. And if you look on the right-hand side, that is largely driven by Clover Assistant.
If you look at these vintages of Clover Assistant joiners, Clover Assistant managed members get more and more profitable year on year, and the reason they're getting more profitable is if you think about that early diagnosis and you think about the area under the curve, if you diagnose something earlier, it might even cost you a little bit more money because they're now taking a medication they weren't taking before, or they're now having a few more doctor visits that they weren't having before. You have to invest in that earlier. If you find something earlier, you're going to start managing it.
But if you think about the payoff, because you started managing it earlier, compared to the counterfactual, compared to someone who wasn't managed earlier, that year two, three, four, and five, that's where you're going to start to see the huge benefits of managing that earlier because you flattened the curve earlier. You reduced the progression of that disease earlier. So compared to another plan who's not doing that, you're going to see significant improvements in the total cost of care in their clinical outcomes. So I think that's why you're seeing that our core philosophy driven by technology, the earlier diagnosis, earlier management, has that multi-year payoff, has that compounding effect.
And the nice thing that we're also seeing is that as we now have more and more of these cohorts coming in, being less profitable in the beginning and then improving over time, those are now layering the way you would expect them to layer. So you have people from several years ago driving a very mature vintage, a slightly less mature vintage, a slightly mature vintage, but all of them are improving year on year. And then as we add new members into the beginning of that stack, we mature those vintages, and all of those can be improved by investments in our technology. To be very clear, I think that I want to say that we have multiple cohorts. I'm proud that those cohorts stack up.
And I'm also proud that because our approach is based upon technology, that we will be able to improve each of those cohorts, even the older vintages, through developing features and releasing them within Clover Assistant. I think that's something that's really, really interesting that others do not have access to. Because if you think about it from a network contracting standpoint, if you contract with a certain physician group, then your speed of improvement is constrained to how fast that physician group can improve. And so you're like, what are they doing? What are they trying to do? They can think about it that way. That's not bad, but you're constrained to that. If you roll out a new program, you're constrained to how fast that vendor you're using for that care management program can improve.
Because we are built on technology and the progress of each of these cohorts is driven by our own technology, we built it. As things like AI get better and better, we can integrate that very quickly into our core technology stack. We're doing that every sprint, every month, and we can see improvements within each of those cohorts simply by pushing out new models and pushing out new features into our Clover Assistant network. That is a very, very different way of thinking about clinical management within a payer construct, so which brings us to Counterpart Health. Counterpart is a fully owned subsidiary. It's one of our divisions, and Counterpart is where we bring our own technology into plans that are not our own plan. I have a Clover MA plan. That's the one I talked about just now that grew from 100,000 lives- 150,000 lives.
Counterpart is where we make our technology, all the technology I just talked about, available to other health plans. Our vision here is that Counterpart Health brings Clover's AI technology, the Assistant, to every Medicare-eligible life. And there are a couple of ways we can do this. But the way I think about this is that we already have the number one PPO in the country. I already talked about that. We're very proud about that in clinical outcomes. There are many other plans who would love to improve the outcomes, the HEDIS scores within their population. We have that really interesting compounding cohort dynamic because of the earlier diagnosis of disease within our patient cohorts. That's all driven by our technology. We can bring that to others. Remember, we built this from the very beginning. My background as a software engineer is in B2B software.
We were cloud-native from the very beginning. We built it to be multi-tenant. And all the ML engines and the data engines are built in a perfectly modern way from the very beginning, even for our own plan. So we are in a great place where, from a technology stack perspective, we could bring it to others. You might ask, Andrew, why would you bring it to others? Wouldn't you use this for a competitive advantage for your own plan? It is a competitive advantage for our own plan. Don't get me wrong. But remember, I said that we were very disciplined about where we grew. I think that's a really important dynamic. We want to be focused on our core markets where we have a tremendous total addressable market. We have plenty of room to grow, plenty of room to grow in our core markets.
I do not feel constrained on that at all. And that will be our main profitability engine. So that's probably going to be us in, call it, three to five states is where we'll have our own plan. Counterpart, we will have in all the other locations. We're not going to grow our own plan to every single other state in the country. There's just physics of Medicare Advantage where that's just challenging and not necessarily the best use of capital. We can invest the capital to drive our business engine and our market share in our core markets. And Counterpart can bring our technology to plans in every other market in the U.S. by partnering with local plans and helping them see the same improvement in their clinical quality scores, see the same improvement in earlier diagnosis, and see the same improvement in total cost of care.
So our software is ready. This is already running in multiple places. We announced this, I would say, maybe coming up on two years, 18 months ago. And we have done a number of pilots, a number of deployments. It's being used already in markets outside of our own plan. This is not a future-looking vision. This is already happening. I expect this to continue to have momentum, continue to accelerate. We're deploying more and more users every day. We are rolling out to more and more physicians every day in markets where we never would have had that because we don't have a plan. We are partnering with other plans to do this. So I think there's an extensive opportunity in this particular area. What customers are we targeting? This has moved around a little bit.
So when you bring a new capability to market, you might have confidence, but you want to know where your product-market fit is. I think we are seeing now. We know where the resonance is. It's whoever is top of premium, and I mean that very specifically. Top of premium means you carry the risk. At risk, top of premium for Medicare Advantage. We're staying within Medicare Advantage. We're not bringing this to other things like Medicaid or ACA or Commercial, maybe in the future, but not yet. We have been asked to do that, but we're not going to do that yet. We're staying within MA, and MA payers or risk-bearing providers and aggregators who are taking on MA risk, those are very similar-looking but different kinds of entities. Those are the two places we're seeing a lot of resonance for Counterpart.
And so when we bring them Counterpart Assistant, we show them what it drives within our own plan, the kinds of results that we can deliver. And we have a lot of that data and longitudinal data. We feel very good that there's a tremendous amount of interest. Then people ask us, well, can you deploy this to another entity? We can show them that, yes, we have. Multiple times, we deployed it to the other entity. What kind of data do you need from us as the customer? We can list what kind of data we need, and we can bring a large amount of the infrastructure needed to process that data. They just need to sort of give us certain feeds.
Then we are able to say, and I think we feel confident that if we deploy this into your region, you will see the same improvement. Often, we then start with a pilot, and then we move into production. What kind of challenges are they asking us to solve? MCR pressure, MLR, same kind of thing, like loss ratio pressure, Stars performance because they want much, much better HEDIS performance. They want us to help them utilize the data they have available because they don't think they're using it appropriately. The other thing that I will mention, coming back to that concept of the wide network, is sometimes what they're saying is, what it is, Andrew, we just don't know how to manage all the doctors. If we don't do something, we're going to have to just focus on our HMO doctors.
But we want to work with all the doctors in our region, and we have no way of doing that. Remember, I said that we want to be able to bring technology that works with any physician. That actually resonates with a lot of plans because they feel forced back to the HMO. They want to be on the PPO. And we're like, we can let you stay on the PPO. We can let you work with these same doctors. We can let you keep them in your network, and you don't have to give up on Loss Ratio and Stars in order to do that. So we really do think this is a very special offering. It is something that's developed within an MA plan. And so we can point to the results within our own MA plan.
We can say that we are MA specialists, and we know just as much about the Medicare Advantage, as much about the Medicare Advantage program, sometimes more than the people that we're working with. And that's something that's very differentiated, unique in our offering. We can talk in great detail about how they deploy it into their network because we have all of that experience from our own MA plan. And so when we show them the results, we have a lot of credibility, a lot of credibility that we can help them as well. It sounds a little bit magical because it's all based on technology, but that's the part that we feel really good that we can deliver on. So lots of momentum here. We're continuing to invest. The nice thing is this is really investing in a go-to-market team for Counterpart.
The core technology is fundamentally the same as what we develop for our own health plan. So as we develop more and more features for our own health plan, the first piece of ROI is already positive because we get that from Clover's MA plans. And then all of our Counterpart customers get the benefit of that as well. That's a very interesting proposition because it means that there's not a lot of trade-offs that we have to make. We already know we're going to be able to invest in our technology. We know we can unlock headcount and develop more and more features. We know we can build more and more models so that it works for us. It's going to work for others. And then we can then just expand the TAM of our technology by bringing it to others via Counterpart.
So the beating heart of our plan gives us a huge advantage in terms of developing this software, investing in this software, and rolling it out, that I think is not replicable if the software department was just on a standalone. So looking ahead, just repeating again what we talked about today. We want to maintain our market-leading self-funded growth. So growing vastly above market on a percentage basis, we feel good about that in our core markets. Self-funded means that we feel good that those layering cohorts will be self-funding, meaning the returning cohorts will fund the addition of new cohorts. And that feels good because that's the engine you want for growth. We are looking to deliver for the first time this year within fiscal year 2026, GAAP net income profitability. And that's a big deal. The last milestone was adjusted EBITDA profitability.
We have been profitable there for a while and cash profitable. We are now going to be GAAP profitable. I'm very proud of that. We are going to maintain our industry-leading clinical performance. Again, number one in the country on the PPO, I think, is a massive accomplishment, big accomplishment for our health plan, big selling driver for Counterpart. We are going to keep expanding and investing in there as well. We'll be looking to announce more around what we're doing there, etc., throughout the year. Counterpart's on a different cadence in our MA plan, but we're very excited about what we see. We found our product-market fit. It's about driving forward and making sure that those pilots keep expanding, keep expanding, and then deploy more and more throughout the entire country. You should hear more about Counterpart nationwide presence as we go through the year.
And those will benefit from all the features that we release within the Assistant this year and next as well. So that's our goal. It's about execution within the core plan. It's about maintaining discipline, profitable growth within our plan, investing deeply within our technology because the AI era allows us to be a huge rising tide that drives the performance of our own technology and then bringing it to others through our third-party sales. Brought all together, I think this is a fairly unique proposition that only Clover can offer. So I'm going to stop there and jump over to questions.
Great. So we have a few questions in the queue from the telecast. So we'll start there. So you just walked us through strong AEP results with 53% membership year-over-year growth in Clover's path to its first full year of GAAP net income profitability this year.
As you look at the much larger new member cohort entering into 2026, what gives you confidence that underlying cohort economics improve year-over-year and that this growth is sustainable?
Yeah, thanks, so I think there's one thing here where a lot of growth can be scary within the Medicare Advantage industry, and so a lot of people are asking this question right now, which is, but you feel good about the growth, right, and the answer is, yes, I do feel good about the growth, and I think that coming back here, this is a simple way to look at that particular answer to that question is there's a number of different factors, not just one single factor that controls for that, but this has a lot of them on there. We have a four-star payment year this year. We have the CMS rate update, which was different, which is higher than last year. The Part D direct subsidy, which is higher than last year, which was like revenue. We have really strong retention.
Retention within core markets should be emphasized on this slide as well, which I think is fantastic, and growth within core markets. CA performs better and better and better. And we are improving SG&A year on year. So while we have a lot of growth, a lot of things are fundamentally different this year than last year as well. So I think that we are investing in growth. Don't get me wrong. We're investing in that first-year cohort. We want that cohort compounding that I talked about just now. But we also have a significant number of tailwinds that are affecting this year that makes us feel very confident. And of course, we always look year on year to see how much we want to grow and how much we want to price, how we want to price our product during the bid.
This year, we wanted to grow, and I think we delivered on that.
Great, and then there's obviously a lot of attention recently on AI across healthcare, including both consumer-facing and oriented tools focused on engagement and info access from your perspective. How do you think about the role of those tools relative to clinician-facing platform like Clover Assistant?
Yeah, that's an interesting one. So ChatGPT Health was announced just before this conference. Claude, Anthropic's offerings were being offered. The way I think about that is two different dimensions. Number one, all improvements to the core models, the foundational models, accrue to benefit to us. We can just use those foundational models. We're almost customers, the target customers of those foundational models. So you should expect as those foundational models improve, that is a natural rising tide to what we provide. We do not compete with those models. If I was a startup, I might think of something that's slightly differently because I have to say, like, well, how does what I offer differentiate it to what the foundational models can offer, right? That might be how I think about it if I was a startup. I don't think about that at Clover because we have our own plan.
And what that means is any advancement in the technology can be deployed for the benefit of our members and the benefit of our business. And I think that's a very nice place to be sitting right now. So fundamental models, all for progress, that makes a lot of sense. The second dimension is that any patient-facing model, any direct-to-consumer model, which tends to be where the foundational models aim, is highly complementary to what we do. Remember, what we do is we use AI and data to make physicians better. We are a clinician-facing product, and we absolutely are able to do that because we sit so deeply within the care stack as a payer. So that's where we want to sit. Don't get me wrong. There's great things you can do with direct-to-patient, and we think about those things all the time. But is our core DNA direct-to-consumer?
No. Our core DNA is direct-to-clinician, and that is the main thing we think about our tool. So a lot of these offerings actually are things we could roll out that supplement the Assistant platform. It is not something that we necessarily are overlapping with our investments.
Great. Are there any questions from the audience before we keep pushing on the telecast? Great. So on the AI topic, many healthcare AI tools are still in pilot phases or limited deployment. You've shown Clover Assistant operating at scale across a wide network of PPOs. What have you learned from deploying AI in real clinical environments that others may be underestimating or misunderstanding?
Yeah. So we talk about AI a lot. I was at Google before this, and I was in the cloud team. We talked about AI, talked about ML, all those kinds of things. The key thing that I think is really interesting that I love about being at Clover, about how we approach this at Clover, is that we are focused on the results of AI. Others talk a lot about AI. And don't get me wrong. I think they're very focused on delivering stuff. There's great stuff that's happening. But we are focused on making people's lives better. We are focused on that earlier diagnosis. Our papers are about, was there an earlier diagnosis? Did something happen? It's not academic. Did something literally happen? Our data is not based on model results or predictions or sandbox results.
They're based upon when an actual doctor, not employed by us in the wide network, used our tools, our software, our capabilities. Did someone's life get better? And I think the answer is yes. That is what's happening. That's very exciting. And that drives the business on total cost of care. That drives clinical outcomes. And so when we go out and we talk to members, remember I said earlier, we don't say, hey, don't you want AI? Very few people say, I want AI. Seniors are saying, I want to feel better in my health. I want to live longer. I want to be able to do more things. I want affordable healthcare, right? I want more access to healthcare. All of our AI capabilities drive our ability to offer them what they want: affordability, access, better outcomes.
When we talk to physicians, they don't say, "I wish I had more AI." Some of them do, but the majority do not. What they say is, "I wish I could just have more information about my patient more quickly." We can give them that. "I wish there was a simple way for me to know what I need to look at before I treat this particular patient in this encounter." We can give them that. "I wish there was a more clinical approach to sort of engaging with the care plan and thinking about how this person is being managed." We can give them that, right? And so what's interesting about what I think we've learned is that AI is critical as something that can be delivered, can be used to deliver things that clinicians want and what patients want.
But rarely is AI what they are asking for in and of itself. That tends to be like a VC thing or a PE. We think about it here at conferences like this. But we are using AI every day. We are using the data every day to drive performance in ways that doctors care about, in ways that patients care about.
And then it seems like we have a question in the audience, so I think this will be the last one.
Yes.
Yeah, great presentation. I'm wondering, all the great things you're talking about, how are people learning about this at the point when they're purchasing, deciding which plan to enroll in, in AEP, especially how you differentiate? If you have $0 premiums, so many MA plans have $0 premiums. How are they choosing Clover?
Yes, great question. So at that point, $0 premiums, I think, is a little bit table stakes right now. So thank you for framing it that way, table stakes. Next, I think people do look at not just they're sophisticated enough, they're sophisticated buyers to look at copays and coinsurance. So what they'll look at, number one, is premium, right? Then they'll look at PPO vs HMO. And I think a lot of them know because their doctors kind of tell them. They're like, hey, be careful of those HMOs. You might not be able to see me anymore and stuff. So then they look to try and get a PPO. So then the next behind that, and a lot of people pull back from PPO. Don't get me wrong this year.
Then they will look at the actual copay and coinsurance because a lot of PPOs. They might be a PPO. You might be able to see the doctor, but it might be like a $10 copay in-network and like a 30% coinsurance out-of-network. And so they'll look at that and estimate how much it actually costs. And so what I think you'll see in our plans, because I talked about accessibility, it's so important, is that we try and keep those costs very, very manageable for people. We're not trying to sort of smuggle them into the in-network. We're trying to actually improve the whole network, if that makes sense. And so I think that's what they're shopping on. We tend to talk a lot about supplemental benefits. I think that is important to people.
But that's also moving into a little bit of table stakes these days in our markets anyway, right? They're just looking for the usual, the gym memberships, like an OTC card. Those are, again, in the table stakes range. I think we're out of time. So I appreciate it. Thank you for the question. Thank you for that. And thank you to everyone for your interest in Clover.
Thanks, Toy.