Clover Health Investments Corp (CLOV) 2025 Q1 法說會逐字稿

Ladies and gentlemen, good afternoon, and welcome to the Clover Health first-quarter 2025 earnings conference call. (Operator Instructions) As a reminder, today's call is being recorded.

女士們，先生們，下午好，歡迎參加 Clover Health 2025 年第一季財報電話會議。（操作員指示）提醒一下，今天的通話正在被錄音。

I would now like to turn the call over to Ryan Schmidt, Investor Relations for Clover Health. Please go ahead.

現在我想將電話轉給 Clover Health 投資者關係部門的 Ryan Schmidt。請繼續。

Good afternoon, everyone. Joining me on our call today to discuss the company's first-quarter 2025 results are Andrew Toy, Clover Health's Chief Executive Officer; and Peter Kuipers, the company's Chief Financial Officer. You can find today's press release and the accompanying supplemental slides as well as the company's most recent investor deck in the Investor Events and Presentations section of our website at investors.cloverhealth.com. This webcast is being recorded, and a replay will be available in the Investor Relations section of the Clover Health website.

大家下午好。今天與我一起參加電話會議討論公司 2025 年第一季業績的有 Clover Health 執行長 Andrew Toy 和公司財務長 Peter Kuipers。您可以在我們網站 investors.cloverhealth.com 的「投資者活動和簡報」版塊找到今天的新聞稿、隨附的補充幻燈片以及公司最新的投資者簡報。本次網路直播已錄製，重播將在 Clover Health 網站的「投資者關係」版塊提供。

I'd also like to caution you that we may make forward-looking statements during today's call that are subject to risks and uncertainties, including expectations about future performance. Factors that may cause actual results to differ materially from expectations are detailed in our SEC filings, including in the Risk Factors section of our most recent annual report on Form 10-K and other SEC filings.

我還想提醒您，我們可能會在今天的電話會議上做出前瞻性陳述，這些陳述受風險和不確定性的影響，包括對未來業績的預期。我們向美國證券交易委員會 (SEC) 提交的文件中詳細說明了可能導致實際結果與預期存在重大差異的因素，包括我們最近的 10-K 表格年度報告和其他美國證券交易委員會 (SEC) 文件中的「風險因素」部分。

Information about non-GAAP financial measures referenced, including a reconciliation of those measures to GAAP measures, can be found in the earnings materials available on our website.

有關所引用的非 GAAP 財務指標的資訊（包括這些指標與 GAAP 指標的對帳）可在我們網站上的收益資料中找到。

With that, I'll now turn the call over to Andrew.

說完這些，我現在將電話轉給安德魯。

All right, everyone. Thanks for joining us today. I'm excited to dive into our first quarter 2025 results. We've been working hard at Clover, and it's really showing in our Medicare Advantage performance and overall business growth. Let's break down what we've accomplished and why it matters.

好的，各位。感謝您今天加入我們。我很高興深入了解我們 2025 年第一季的業績。我們一直在 Clover 努力工作，這在我們的 Medicare Advantage 表現和整體業務成長中得到了充分體現。讓我們來分析一下我們所取得的成就以及它的重要性。

First, let's talk about MA plan growth where we're doing very well. We've seen some significant numbers this quarter. We're looking at a 30% jump in MA membership, 33% growth in our revenue and a whopping 279% increase in adjusted EBITDA year over year. That's not just numbers on a page, that's real momentum. And what's driving this?

首先，讓我們談談我們做得非常好的 MA 計劃成長。本季我們看到了一些重要的數據。我們預計 MA 會員數將增加 30%，營收將增加 33%，調整後 EBITDA 將年增 279%。這不僅僅是紙面上的數字，而是真正的動力。是什麼原因導致這現象的發生？

It's our focus on getting people the right health care right when they need it, earlier, higher quality and critically more affordable. This isn't just about growth for growth's sake. It's about making a real difference in people's lives by lowering barriers in care, whether it be by reducing out-of-pocket costs or delivering care to them right in their homes. We even released a new white paper last week showing how Clover Assistant helps better manage congestive heart failure, leading to better care and fewer hospital visits. That's the impact we are aiming for.

我們的重點是讓人們在需要的時候獲得正確的醫療保健，更早、更高品質、更實惠。這不僅僅是為了成長而成長。它旨在透過降低護理障礙來真正改變人們的生活，無論是透過減少自付費用還是直接在家中提供護理。我們甚至在上週發布了一份新的白皮書，展示了 Clover Assistant 如何幫助更好地管理充血性心臟衰竭，從而提供更好的護理並減少就診次數。這就是我們所追求的效果。

Next up, let's discuss our confidence in the rest of the year. This quarter's performance really reinforces that we're on the right track to hit our full year 2025 goals and improved guidance. We had a strong enrollment season, and those new members are utilizing care at expected levels. That's key. We're planning to keep this momentum going throughout the year.

接下來，我們來討論一下對今年剩餘時間的信心。本季的表現確實證明我們正朝著實現 2025 年全年目標和改進指導的正確方向前進。我們迎來了強勁的入學季，新會員的護理利用率達到了預期水準。這很關鍵。我們計劃全年保持這種勢頭。

But what's most important, it's how we're taking care of these new members. We're using Clover Assistant to power their primary care, making sure they get the best health outcomes and the most efficient care. This isn't just about enrolling more seniors. It's about making sure we look after them in the right way. Now let's talk about how we're managing things behind the scenes.

但最重要的是我們如何照顧這些新成員。我們正在使用 Clover Assistant 為他們的初級保健提供支持，確保他們獲得最佳的健康結果和最有效的護理。這不僅僅是為了招收更多的老年人。這是為了確保我們以正確的方式照顧他們。現在讓我們來談談我們如何管理幕後事務。

Our Part C and Part D utilization costs are both tracking as expected. We are also navigating the HEC V28 phase-in smoothly with Clover Assistant. Why is this important? Because it shows our technology-first care model is adaptable and can handle changes in the industry. We're not just reacting, we're staying ahead of the curve, making sure our members get better care management.

我們的 C 部分和 D 部分的利用成本均符合預期。我們也利用 Clover Assistant 順利引導 HEC V28 的逐步實施。為什麼這很重要？因為它表明我們的技術優先護理模式具有適應性，可以應對行業變化。我們不只是做出反應，我們還保持領先地位，確保我們的會員得到更好的護理管理。

That's a huge advantage for us. A big part of our confidence comes from our control of our care model, whether in the wide PPO network with PCPs using Clover Assistant or via home care in our Clover Care Services division, care is what we do.

這對我們來說是一個巨大的優勢。我們的信心很大一部分來自於我們對護理模式的控制，無論是在使用 Clover Assistant 的 PCP 的廣泛 PPO 網絡中，還是透過我們 Clover Care Services 部門的家庭護理，護理都是我們所做的事情。

Speaking of Clover Care Services, our mission is simple: to deliver additional support to Clover members when and where they need it. Every Clover member is eligible for a personalized in-home Clover Care visit and coordinated care services tailored to their health journey. We work closely with Clover Assistant using physicians to identify members needing support and deliver that support directly to them.

說到 Clover Care Services，我們的使命很簡單：在 Clover 會員需要的時間和地點為他們提供額外支援。每位 Clover 會員都有資格享受個人化的 Clover Care 上門服務以及根據其健康歷程量身定制的協調護理服務。我們與 Clover Assistant 密切合作，利用醫生來識別需要支援的會員並將支援直​​接提供給他們。

For example, our Welcome Home Clover Care visit helps members transition from hospital inpatient stays. For members with the highest needs, we offer a comprehensive in-home care program focused on palliative and advanced illness support.

例如，我們的「歡迎回家 Clover Care」探訪可以幫助會員從住院過渡到住院。對於需求最高的會員，我們提供以安寧療護和晚期疾病支持為重點的綜合家庭照護計畫。

These services drive strong performance for our health plan and provide tailored personalized care for our Clover members. We're also pleased about the recent CMS final rate notice for 2026. It's a positive for us and will add to our momentum, especially with our 4-star PPO plan coming next year.

這些服務推動了我們的健康計劃的強勁表現，並為我們的 Clover 會員提供量身定制的個人化護理。我們也對最近發布的 CMS 2026 年最終費率通知感到高興。這對我們來說是積極的，並將增強我們的發展勢頭，特別是明年我們的四星級 PPO 計劃即將推出。

But let's be clear, our real strength is in our architecture and in our operations. It's in our innovative care model, our wide networks and the clinical and financial results we get from Clover Assistant. I've spoken about this before, and I want to emphasize that we would feel good no matter what the rate notice was. That's because we're not just relying on favorable rates, we're building a solid foundation for long-term success.

但我們必須清楚，我們真正的優勢在於我們的架構和營運。它體現在我們的創新護理模式、廣泛的網絡以及我們從 Clover Assistant 獲得的臨床和財務結果中。我之前已經談過這個問題，我想強調的是，無論利率通知是什麼，我們都會感覺良好。這是因為我們不僅依賴優惠利率，我們還在為長期成功奠定堅實的基礎。

Looking ahead, we see even more growth and profitability coming in 2026 and beyond. This isn't just wishful thinking. It's based on our strategy of expanding Clover Assistant reach, managing our members with personalized care and the financial boost we'll get from our 4-star rating.

展望未來，我們預計 2026 年及以後將實現更大的成長和獲利。這並非只是一廂情願的想法。它基於我們擴大 Clover Assistant 覆蓋範圍的策略，以個性化服務管理我們的會員，以及我們從四星評級中獲得的財務支援。

It's too early to talk about bid specifics right now, but our intention is to keep building a growth flywheel, and we expect it to start spinning much faster as we go into next year. And for areas where we don't have an MA plan, we're pushing forward with counterpart health. We're seeing a great opportunity here to partner with others and bring Clover Assistant to even more people.

現在談論投標細節還為時過早，但我們的目的是繼續建造增長飛輪，我們預計進入明年它將開始旋轉得更快。對於沒有 MA 計劃的地區，我們正在推進相應的醫療計劃。我們看到了與其他人合作並將 Clover Assistant 帶給更多人的絕佳機會。

We're already working with several partners, and we have more in the pipeline. Organizations are seeing the value of counterpart Assistant in improving care and managing costs, and we believe this is a big area of growth for us.

我們已經與多家合作夥伴展開合作，並且還有更多合作夥伴正在籌備中。組織看到了對應助理在改善護理和管理成本方面的價值，我們相信這是我們的一大成長領域。

To support this growing deal flow, we are actively taking steps to add implementation resources to ensure successful onboarding and integration for our partners. I'm excited about traction in this area, and I think the opportunity to bring CA to many people served by other MA plans is a very real one.

為了支持不斷增長的交易流，我們正在積極採取措施增加實施資源，以確保我們的合作夥伴成功加入和整合。我對這一領域的進展感到很興奮，我認為將 CA 帶給其他 MA 計劃服務的許多人的機會是非常現實的。

Finally, I want to highlight the real-world impact of Clover Assistant. Our research shows that doctors using Clover Assistant diagnose chronic kidney disease and diabetes earlier. And we just released our latest paper on congestive heart failure, showing that Clover Assistant usage is associated with better care, fewer hospitalizations and fewer readmissions related to CHS.

最後，我想強調一下 Clover Assistant 的實際影響。我們的研究表明，使用 Clover Assistant 的醫生可以更早診斷出慢性腎臟病和糖尿病。我們剛剛發布了關於充血性心臟衰竭的最新論文，表明使用 Clover Assistant 可以獲得更好的護理、減少住院次數以及減少與充血性心臟衰竭 (CHS) 相關的再入院次數。

Heart failure is a huge issue, and we're making a real difference. We're giving our doctors the tools they need to provide better care, and it's showing in the results. So to sum it up, we've had a fantastic start to 2025.

心臟衰竭是一個嚴重的問題，我們正在做出真正的改變。我們正在為醫生提供他們提供更好護理所需的工具，而這已在結果中得到體現。總而言之，我們在 2025 年有一個美好的開始。

Our approach powered by Clover Assistant and our home care program is driving strong growth in membership, revenue and adjusted EBITDA. We're confident in our 2025 goals and excited about our future.

我們採用 Clover Assistant 和家庭護理計劃的方法正在推動會員人數、收入和調整後 EBITDA 的強勁增長。我們對 2025 年的目標充滿信心，並對我們的未來感到興奮。

Now I'll hand it over to Peter for the financial update.

現在我將把財務更新交給彼得。

Thank you, Andrew. First, let's start with the results, and then I will cover the drivers in more detail. I'm very pleased with our strong first quarter performance, where we have delivered a combination of 30% membership growth and 33% total revenue growth while growing adjusted EBITDA by 279% and adjusted net income by 322% year over year. We are executing very well against our strategy. Let's now move into the drivers.

謝謝你，安德魯。首先，讓我們從結果開始，然後我將更詳細地介紹驅動因素。我對我們第一季的強勁表現感到非常滿意，我們的會員數量增長了 30%，總收入增長了 33%，調整後的 EBITDA 同比增長了 279%，調整後的淨收入同比增長了 322%。我們的策略執行得非常好。現在讓我們進入驅動程式。

Starting with membership and revenue. Insurance revenue grew by 34% year over year to $457 million, driven by 30% Medicare Advantage membership growth from strong AEP and OEP enrollment seasons. Member retention was also strong during both the AEP and OEP season.

從會員和收入開始。保險收入年增 34% 至 4.57 億美元，這得益於 AEP 和 OEP 註冊季節強勁增長導致醫療保險優勢計劃 (Medicare Advantage) 會員人數增長 30%。在 AEP 和 OEP 賽季期間，會員保留率也很高。

Our first quarter results give us conviction in our new member cohort management strategy. Similar to AEP, the majority of our OEP growth occurred in our core New Jersey markets where we have a strong Clover Assistant network presence.

我們第一季的業績讓我們對新會員群管理策略充滿信心。與 AEP 類似，我們的 OEP 成長大部分發生在核心新澤西市場，我們在該市場擁有強大的 Clover Assistant 網路影響力。

During the quarter, new members were effectively onboarded and our results demonstrate strong management of both our new member and profitable returning member cohorts with performance in line with expectations. This is reflective of our pricing discipline, geographic growth strategy and our efforts to proactively engage with new members via Clover Assistant powered primary care.

在本季度，新會員得到了有效的加入，我們的業績表明，我們對新會員和盈利回歸會員群進行了強有力的管理，業績符合預期。這反映了我們的定價原則、地理成長策略以及我們透過 Clover Assistant 支持的初級保健主動吸引新會員的努力。

Given our experience over the last number of years, we have strong conviction that the unit economics for our new member cohort will improve as we've seen on average a more than a 700 basis point improvement in loss ratios between year one and year two cohorts and an approximate 1,500 basis point improvement between year 1 and year three cohort members.

根據我們過去幾年的經驗，我們堅信新成員群體的單位經濟效益將會提高，因為我們平均看到第一年​​和第二年成員之間的損失率改善了 700 個基點以上，第一年和第三年成員之間的損失率改善了約 1,500 個基點。

This demonstrates the effectiveness of our model over the long term by providing earlier and better care management at a lower total cost of care. Overall, we are confident that our medical costs are in line with expectations.

這證明了我們的模型長期的有效性，即以較低的總護理成本提供更早、更好的護理管理。整體而言，我們有信心我們的醫療成本符合預期。

We experienced elevated inpatient utilization in January from an uptick in lower intensity care related to a later cold and flu season. However, trends quickly normalized starting in February and continued through March.

由於感冒和流感季節後期導致護理強度降低，1 月住院病人利用率上升。然而，從二月開始趨勢迅速恢復正常並持續到三月。

Operationally, we continuously perform checks into our data and metrics via prior authorizations, weekly claims and real-time Clover Assistant insights from provider interactions to identify patterns in our utilization. Focusing next on SG&A. I'm pleased with the operating leverage that we are demonstrating.

在營運方面，我們透過事先授權、每週索賠和來自提供者互動的即時 Clover Assistant 洞察不斷檢查我們的數據和指標，以確定我們的利用模式。接下來關注銷售、一般及行政費用 (SG&A)。我對我們所展現的經營槓桿感到滿意。

This quarter, adjusted SG&A as a percentage of total revenue decreased to 18% of revenue, representing an improvement or decrease of 360 basis points year over year while absorbing the increased growth and variable costs associated with higher membership and our continued strategic quality investments into our business.

本季度，調整後的銷售、一般及行政費用佔總收入的百分比下降至 18%，同比提高或減少 360 個基點，同時吸收了會員人數增加和我們對業務持續的戰略質量投資相關的增長和變動成本。

Our profitability metrics are strong. GAAP net loss during the first quarter of 2025 improved by $18 million year over year to a loss of $1 million. First quarter 2025 adjusted EBITDA improved by 279% to a profit of $26 million. Similarly, adjusted net income grew by 322% year over year to a profit of $25 million.

我們的獲利指標強勁。2025 年第一季 GAAP 淨虧損年增 1,800 萬美元，至虧損 100 萬美元。2025 年第一季調整後 EBITDA 成長 279%，利潤達 2,600 萬美元。同樣，調整後的淨收入年增 322%，達到 2,500 萬美元的利潤。

Lastly, insurance BER for the first quarter 2025 was 86.1%, which represents a modest increase year over year, but importantly, is in line with our expectations and consistent with our full year 2025 guidance given seasonality.

最後，2025 年第一季的保險 BER 為 86.1%，同比略有增長，但重要的是，這符合我們的預期，考慮到季節性，與我們對 2025 年全年的指導一致。

We also note that one driver of the year-over-year increase in insurance BER was the implementation of our CA-enabled affiliate entity within our operating structure, which the plan now employs to engage providers directly and better service our health plan and membership in New Jersey.

我們還注意到，保險 BER 年成長的一個驅動因素是我們在營運結構中實施了 CA 支援的附屬實體，該計劃現在採用該實體直接與提供者合作，為我們的健康計劃和新澤西州的會員提供更好的服務。

The goal of this entity is to drive higher quality and better health outcomes for our members via better care coordination services, unified care management and a deeper focus on our partnerships with local physicians.

該實體的目標是透過更好的護理協調服務、統一的護理管理以及更加重視與當地醫生的合作，為我們的會員提供更高品質、更好的健康結果。

Overall, we're proud of our strong results this quarter. As we look ahead to the rest of the year, please note that we expect typical Medicare Advantage seasonality trends in the form of higher utilization levels in the back half of the year with more of an impact in the fourth quarter of the year as is typical.

總體而言，我們對本季的強勁業績感到自豪。展望今年剩餘時間，請注意，我們預計典型的醫療保險優勢季節性趨勢將以下半年利用率更高的形式出現，而第四季度的影響將更大，這是很常見的。

That said, this is simply seasonality. Our first quarter performance reinforces our conviction in our improved 2025 guidance, which I will cover later in this call. Turning next to the balance sheet. We are pleased to announce that during the first quarter, we have successfully repurchased 5 million shares of common stock, making up the remaining $80 million authorized under our buyback program announced in May of last year. This strategic decision reflects our confidence in the company's long-term value and the strength of our balance sheet.

話雖如此，這只是季節性現象。我們第一季的業績增強了我們對改進的 2025 年指引的信心，我將在本次電話會議的稍後部分討論這一點。接下來看資產負債表。我們很高興地宣布，在第一季度，我們成功回購了 500 萬股普通股，完成了去年 5 月宣布的回購計畫授權的剩餘 8,000 萬美元。這項策略決策反映了我們對公司長期價值和資產負債表實力的信心。

We ended the first quarter of 2025 with cash, cash equivalents and investments totaling $391 million on a consolidated basis with $126 million at the parent entity and unregulated subsidiary level. Our unregulated cash was impacted by various working capital and timing dynamics as well as the stock buyback program. We're confident that this balance will increase throughout the year, allowing us to operate from a position of strength as we invest in our growth model.

截至 2025 年第一季度，我們的現金、現金等價物和投資總額（合併基礎）為 3.91 億美元，其中母公司和非監管子公司的現金、現金等價物和投資總額為 1.26 億美元。我們的不受管制的現金受到各種營運資金和時間動態以及股票回購計畫的影響。我們相信，這一餘額將在全年不斷增加，這將使我們能夠在投資成長模式的同時保持優勢。

During the first quarter of 2025, cash flow used in operating activities was $16 million and was similarly impacted by working capital and timing-related dynamics. That said, given our business momentum, we continue to expect to be on pace to generate strong cash flow from operating activities for the full year.

2025 年第一季度，經營活動所用現金流為 1,600 萬美元，同樣受到營運資金和時間相關動態的影響。儘管如此，鑑於我們的業務發展勢頭，我們預計全年仍將保持強勁的經營活動現金流。

Days in claims payable was 37 days as of March 31, 2025, representing a decrease of 22 days sequentially. This reflects the normalization of our claims inventory and timeliness of claims payments to historical levels. If you recall, at this time last year, we were simultaneously navigating the industry-wide Change Healthcare incident as well as the transition to our back-office BPaaS Medicare Advantage ecosystem.

截至 2025 年 3 月 31 日，賠付天數為 37 天，比上一季減少 22 天。這反映了我們的索賠庫存和索賠支付及時性的正常化，達到了歷史水準。如果你還記得的話，去年這個時候，我們正在同時應對全行業的變革醫療保健事件以及向後台 BPaaS 醫療保險優勢生態系統的過渡。

We are pleased to report the successful conclusion of this and expect our claims payment patterns to now be at typical go-forward ranges. For our full year 2025 guidance, we believe that we are well positioned to accomplish our goals this year and are providing the following guidance update.

我們很高興地報告此事成功結束，並預計我們的索賠支付模式現在將處於典型的未來範圍。對於我們 2025 年全年指導，我們相信我們已做好準備實現今年的目標，並提供以下指導更新。

We are reconfirming our Medicare Advantage membership to average between 103,000 and 107,000 members, reflecting 30% growth year over year at the midpoint and continued intra-year growth through the SEP period in 2025, all driven by a robust plan benefits, competitive positioning, and our 4-star rating. We are also reconfirming our insurance revenue of between $1.80 billion and $1.875 billion reflecting year-over-year growth of 37% at the midpoint of the range.

我們再次確認，我們的醫療保險優勢計劃 (Medicare Advantage) 會員人數平均在 103,000 至 107,000 名之間，反映出中期同比增長 30%，並且在 2025 年 SEP 期間繼續保持年內增長，所有這些都得益於強大的計劃福利、競爭定位和我們的四星評級。我們也再次確認我們的保險收入在 18 億美元至 18.75 億美元之間，中間值年增 37%。

In tandem with our membership growth expectations, we anticipate more revenue in the second half of the year as compared to the first half, unlike historical patterns. We are reconfirming our adjusted SG&A guidance to be between $355 million and $365 million. This represents adjusted SG&A as a percentage of total revenue of 19% to 20% and is an approximate 200 basis point decrease or improvement year over year at the midpoint of the range.

與我們的會員成長預期一致，與歷史模式不同，我們預計下半年的營收將比上半年更多。我們再次確認調整後的銷售、一般及行政費用指引在 3.55 億至 3.65 億美元之間。這表示調整後的銷售、一般及行政費用佔總收入的百分比為 19% 至 20%，與去年同期相比，該範圍的中點下降或改善了約 200 個基點。

We are increasing our 2025 adjusted EBITDA guidance to now be between $50 million and $70 million. Similarly, we are also increasing our 2025 adjusted net income guide to now be between $50 million and $70 million.

我們將 2025 年調整後 EBITDA 預期上調至 5,000 萬美元至 7,000 萬美元之間。同樣，我們也將 2025 年調整後淨收入預期提高至 5,000 萬美元至 7,000 萬美元之間。

Lastly, we continue to expect insurance BER to be within a range of 87% to 88%. In totality, as Andrew mentioned, we delivered strong results and a very strong start to the year. Throughout the remainder of 2025, we look forward to continuing to balance our strong profitability profile via exceptional cohort management, together with our strategic investments in new membership growth, Clover Assistant technology and expanding both our Clover Home Care Services and counterpart Health go-to-market strategy.

最後，我們繼續預期保險 BER 將在 87% 至 88% 的範圍內。總體而言，正如安德魯所提到的，我們取得了強勁的業績，為今年開了個好頭。在 2025 年剩餘的時間裡，我們期待透過卓越的群組管理、對新會員成長和 Clover Assistant 技術的策略性投資以及擴大我們的 Clover 家庭護理服務和對應健康市場進入策略來繼續平衡我們強勁的盈利狀況。

As such, we have increased conviction in our improved full year 2025 guidance, and we believe that we are very well positioned for accelerated growth and profitability in the future.

因此，我們對改進的 2025 年全年指引更加有信心，我們相信我們已為未來加速成長和獲利做好了充分準備。

Looking forward, first, we will continue to invest in growth and expanding Clover Assistant technology and reach to better manage our new and returning member cohorts.

展望未來，首先，我們將繼續投資於成長和擴展 Clover Assistant 技術，以更好地管理我們的新會員和回歸會員群體。

Second, we believe that we are very well positioned with tailwinds going into 2026 due to an increase to a 4-star payment year in 2026.

其次，我們相信，由於 2026 年支付年度將增加到 4 顆星，因此我們在 2026 年將處於非常有利的地位。

Third, we expect a compounding favorable impact from the recent CMS final rate notice, which is additive to the impact of the improved 4-star rating.

第三，我們預計最近的 CMS 最終費率通知將產生複合有利影響，這將增強 4 星評級提升的影響。

Fourth, we expect the unit economics of our large new cohort of membership added in 2025 to significantly improve in 2026 and beyond as well as continued maturation of our broader returning member cohorts.

第四，我們預計，2025 年新增的大量會員的單位經濟效益將在 2026 年及以後顯著改善，同時，我們更廣泛的回歸會員群體也將繼續成熟。

Lastly, we believe that there will be a continued impact from our efforts to gain operating leverage.

最後，我們相信，我們努力獲得經營槓桿將會產生持續的影響。

With that, let me now turn the call back to Andrew for closing comments.

現在，請允許我把電話轉回給安德魯，請他發表最後評論。

Thanks, Peter. In conclusion, we are incredibly proud of our strong start to 2025. These first quarter results clearly demonstrate our ability to meaningfully grow membership, expand profitability and execute our strategic plan effectively.

謝謝，彼得。總而言之，我們為 2025 年的強勁開局感到無比自豪。第一季的業績清楚地表明了我們有能力大幅增加會員數量、擴大盈利能力並有效執行我們的策略計劃。

Our differentiated model powered by Clover Assistant and our clinically focused home care platform is delivering tangible value and better clinical outcomes, driving our strong Medicare Advantage performance. We are confident in our improved full year 2025 guidance and are strategically investing in our growth model, managing our new and returning member cohorts and expanding Clover Assistant's reach.

我們由 Clover Assistant 提供支援的差異化模式和以臨床為中心的家庭護理平台正在提供切實的價值和更好的臨床結果，推動我們強勁的醫療保險優勢表現。我們對 2025 年全年改進的指導充滿信心，並正在策略性地投資於我們的成長模式，管理我們的新會員和回歸會員群體，並擴大 Clover Assistant 的覆蓋範圍。

These efforts are not only enhancing our current position, but also positioning us for accelerated growth and profitability in the future. We remain excited about Clover's trajectory and are committed to driving long-term value for our members and shareholders alike.

這些努力不僅增強了我們目前的地位，也為我們未來的加速成長和獲利奠定了基礎。我們對 Clover 的發展軌跡感到興奮，並致力於為我們的會員和股東創造長期價值。

With that, let's open it up for questions.

好了，讓我們開始提問吧。

(Operator Instructions) Jonathan Young, UBS.

（操作員指示）瑞銀 (UBS) 喬納森楊 (Jonathan Young)。

Hey. Thanks for taking the question here. Just starting with the insurance business first. Can you provide any color on how core medical trends are progressing there between new versus the existing cohort? And how are members hitting the out-of-pocket drug max? Is it trending in line with your expectations? And has there been any change in behavior there?

嘿。感謝您在這裡提出這個問題。首先從保險業務開始。您能否提供一些關於新群體與現有群體之間核心醫療趨勢如何發展的資訊？那麼會員如何達到自付藥物費用的最高限額呢？它的趨勢是否符合您的期望？那裡的行為有什麼改變嗎？

Yeah. Thank you, Jonathan. It's Peter. So overall, cost trends are as expected. We also say that the -- both the new members cohort and the returning members cohorts are also from an MCR and BDR perspective, trending in the way both in actuals and what we see in the coming quarters as expected as well.

是的。謝謝你，喬納森。我是彼得。因此整體而言，成本趨勢符合預期。我們還說，從 MCR 和 BDR 的角度來看，新成員群體和回歸成員群體的趨勢都與實際情況和我們在未來幾季看到的趨勢一致。

Okay. And then we didn't hear much on counterpart health here. Just any color on how that go-to-market strategy is progressing, if there's been any more bigger wins and as we look ahead, when can we start seeing contribution?

好的。然後我們在這裡沒有聽到太多關於對方健康的資訊。關於市場進入策略的進展情況，是否有更大的勝利，展望未來，我們何時才能開始看到貢獻？

Jonathan, it's Andrew. Yes, definitely remain excited about the counterpart business, and we are looking to provide more updates on that as we go out throughout the year. We remind everybody that we are not necessarily intending to make announcements around every single deal that we make around there. However, we remain excited about it. All contributions, revenue, et cetera, will, of course, be in the consolidated financials as well.

喬納森，我是安德魯。是的，我們絕對對對應業務保持興奮，並且我們希望在全年提供更多有關該業務的更新。我們提醒大家，我們不一定打算宣布我們在那裡達成的每一筆交易。然而，我們對此仍然感到興奮。當然，所有捐款、收入等也將計入合併財務報表。

And we're going to be talking more about that as we proceed in the quarter. But right now, we're very focused on making sure that we improve profitability in the insurance segment.

隨著本季度的進展，我們將更多地討論這個問題。但目前，我們非常注重確保提高保險領域的獲利能力。

(Operator Instructions) Matt Hewitt, Craig-Hallum Capital.

（操作員指示）Craig-Hallum Capital 的 Matt Hewitt。

Good afternoon. Thanks for taking the questions. Maybe first up and sticking with the counterpart theme. Have you had some, I guess, feedback or how have the initial implementations gone? And what are you hearing from those partners regarding the key metrics that you would be looking for once those -- once the platform is implemented and they've had a chance to use it for a little bit?

午安.感謝您回答這些問題。也許首先要堅持對應主題。我想，您是否收到一些回饋，或初步實施進度如何？您從這些合作夥伴那裡聽說了什麼關於平台實施後您會尋找的關鍵指標——一旦他們有機會使用它一段時間？

Yeah. Thanks. So definitely, what we're looking for and what we're aiming to do is to make sure that we deliver the amount of value within our counterpart customer base as similar to what we see within our own MA plan and within the providers that use the assistant within our own network.

是的。謝謝。因此，毫無疑問，我們正在尋找的和我們的目標是確保我們在對應客戶群中提供的價值與我們在自己的 MA 計劃中以及在我們自己的網絡中使用助手的提供者中看到的價值相似。

So that's what our aim is. That's the power of the software approach is that we can develop the product, we can then use it to help manage care to identify diseases earlier within almost any part of the Medicare population, whether it be under our own plan or whether it be with other people's plans, third-party plans.

這就是我們的目標。軟體方法的強大之處在於，我們可以開發產品，然後使用它來幫助管理護理，以便更早地發現幾乎任何一部分醫療保險人群的疾病，無論是在我們自己的計劃下，還是在其他人的計劃或第三方計劃下。

So the key KPIs that we're looking for there are do we still see the engagement with the physicians? Do we still see the earlier diagnosis and management of diseases. Do we still see improvement on the HEDIS side of things?

那麼，我們正在尋找的關鍵 KPI 是我們是否仍然看到與醫生的互動？我們是否仍然能夠看到疾病的早期診斷和管理。我們是否也看到 HEDIS 方面的情況有所改善？

As we said, we're very proud of our performance there. It's all the same metrics that we use within our own plan, but translated into third-party counterpart usage. And our initial data, we feel optimistic on that, and our goal was that those would be effectively equivalent.

正如我們所說，我們對自己在那裡的表現感到非常自豪。這些指標與我們在自己的計劃中使用的指標相同，但可以轉化為第三方對應的使用方式。我們對我們的初始數據感到樂觀，我們的目標是它們能夠有效地等效。

That's great. And then maybe shifting gears a little bit. Given some of your success over the past, call it, couple of years, has there been any changes in the competitive landscape? Are you seeing some of your peers adapting or shifting to your model a little bit more? Are you seeing any new competitive entrants?

那太棒了。然後可能稍微改變一下方向。鑑於你們過去幾年取得的一些成功，競爭格局是否發生了變化？您是否看到一些同行正在逐漸適應或轉向您的模式？您是否看到任何新的競爭者？

And how does that change your game plan, if at all? Thank you.

如果有的話，這會如何改變你的比賽計畫？謝謝。

Yeah. I think that what we see here is that we have been focused on the PPO and the wide network and managing care within that wide network for quite some time. And others have been focused, and it's perfectly legitimate as a model to value-based programs within their network, deploying those out, but rarely with a software backing, right?

是的。我認為我們在這裡看到的是，我們已經專注於 PPO 和廣泛的網絡，並在廣泛的網絡內管理護理很長一段時間了。其他人也一直關注這一點，並且它作為其網絡內基於價值的程序的模型是完全合法的，可以部署這些程序，但很少有軟體支持，對嗎？

Like most people's development of software has been for employed physicians, it's been for insurance operations. And while those are both good things, the assistant kinderpart Clover Assistant is usable by the broader wider network, and that is a distinct moat and advantage that we have.

就像大多數人開發的軟體都是為了受僱的醫生一樣，它也是為了保險業務。雖然這些都是好事，但助手 kinderpart Clover Assistant 可以被更廣泛的網路使用，這是我們獨特的護城河和優勢。

So that's something we're excited to bring as a model to drive clinical value to lots of different markets, lots of different places, we think we can look after a large percentage of the total Medicare population in the US.

因此，我們很高興能夠將此作為一種模式，將臨床價值推向許多不同的市場、許多不同的地方，我們認為我們可以照顧到美國很大一部分醫療保險人口。

And I think that what we're seeing is that others have struggled a bit on the PPO and are pulling back on benefits are perhaps not really investing as much as they used to, cutting back on marketing, cutting back on commissions.

我認為，我們看到的是，其他公司在 PPO 方面遇到了一些困難，正在減少福利，可能沒有像以前那樣進行大量投資，削減行銷，削減佣金。

And that is just a natural cycle of the market. We are staying the course. We feel good about where we are. We feel that our model is working. We feel that it is highly differentiated.

這只是市場的自然循環。我們會堅持到底。我們對目前的狀況感到滿意。我們覺得我們的模型正在發揮作用。我們覺得它有高度的差異化。

Got it. All right. Thank you.

知道了。好的。謝謝。

(Operator Instructions) Richard Close, Canaccord Genuity.

（操作員指示）Richard Close，Canaccord Genuity。

Yes. Congratulations on a great start to the year, first of all. Andrew and Peter, you guys mentioned accelerated growth in the years to come. You talked about the growth flywheel and expect faster growth next year. So maybe can you break that down a little bit? Obviously, your positive rate adjustment for next year and then the 4 stars.

是的。首先，恭喜您今年有一個好的開始。安德魯和彼得，你們提到了未來幾年的加速成長。您談到了成長飛輪，並預計明年的成長速度會更快。那你能稍微解釋一下嗎？顯然，您明年的利率將進行積極的調整，然後是 4 顆星。

But how are you thinking about the building blocks to growth? And where does the acceleration come from beyond, I guess, the positive on rate and star?

但是您如何看待成長的基礎？那麼，我猜，除了速率和星級的正值之外，加速度又是從何而來？

Yeah. Thank you, Richard. This is Peter. So what we see, of course, now also now that we have experience with a large cohort joining the plan this year, that's a reconfirmation for us to really see the cohort economics for both new members and then also the returning members. So that is a large factor as we look at unit economics and profitability going into next year.

是的。謝謝你，理查。這是彼得。因此，我們現在看到的是，今年我們有了大批成員加入該計劃的經驗，這再次證實了我們能夠真正看到新成員和回歸成員的群體經濟狀況。因此，當我們考慮明年的單位經濟效益和獲利能力時，這是一個重要因素。

Yes, absolutely, the rate notice will be a tailwind. But with our model, we don't necessarily need that, if you will. We are, of course, now looking at bids, some more news to come there. So likely there will be some adjustments there from a benefit perspective. And then, of course, we also have, of course, the cost actions we've taken as well.

是的，絕對如此，利率通知將起到推動作用。但在我們的模型中，如果你願意的話，我們不一定需要這樣做。當然，我們現在正在關注投標，將會有更多新聞。因此從利益角度來看可能會有一些調整。當然，我們也採取了成本措施。

We'll have more leverage from an SG&A perspective also. And then lastly, we believe that from our product road map from a Clover Assistant technology perspective, we'll have additional impact as well, starting with the clinical side and then, of course, the results flowing through to the financials as well over time.

從銷售、一般及行政費用 (SG&A) 角度來看，我們也將擁有更大的槓桿作用。最後，我們相信，從 Clover Assistant 技術角度來看，我們的產品路線圖也將產生額外的影響，首先是臨床方面，然後當然，隨著時間的推移，結果也會影響到財務方面。

Yeah. And then just jumping in here. Obviously, we are -- as a reminder to all, is that we're going from a payment year. We're being paid on 3.5 stars this year, and we'll be going to paid on 4 stars next year, which affects the benchmark. And so we're looking at what we do.

是的。然後就跳到這裡。顯然，我們——提醒大家，我們將從付款年開始。我們今年的薪酬是以 3.5 顆星計算的，明年我們將以 4 顆星計算，這會影響基準。因此我們正在審視我們所做的事情。

As Peter said, we're still early on, and we're not talking about bid just yet. But obviously, we're factoring that into our bid discussions. Others might be moving downwards in our markets on the star rating. And so that will put some pressure on their benefits, whereas we can -- we think we have room as we are moving upwards. Another dimension on that, as Peter said, was a lot of that's being driven by CA.

正如彼得所說，我們還處於早期階段，目前還沒有談論競標。但顯然，我們在競標討論中已經考慮到了這一點。在我們的市場上，其他公司的星級評分可能會下降。因此，這將對他們的福祉造成一些壓力，而我們可以——我們認為我們在向上發展的過程中還有空間。正如彼得所說，另一方面，這在很大程度上是由 CA 推動的。

CA helps our star ratings. We are very proud. We're the number one plan of over 2,000 lives on HEDIS under the Star ratings. That's driven by our technology platform. We look to maintain that advantage going forward, which will help us with Stars, which will help us with benefits, too.

CA 幫助我們評定星級。我們感到非常自豪。我們是 HEDIS 星級評定中超過 2,000 個生命計畫中排名第一的計畫。這是由我們的技術平台所推動的。我們希望在未來保持這一優勢，這將有助於我們獲得明星，也將幫助我們獲得利益。

Okay. And I guess I have -- or my follow-up is somewhat centered on New Jersey. First, in terms of New Jersey, obviously, you have great penetration there. And I'm curious with respect to this accelerating growth, how you think about like are you bumping up on where you can go in New Jersey? And then do you have to go to new markets? So that's one question.

好的。我想我已經——或者我的後續行動在某種程度上集中在新澤西州。首先，就新澤西州而言，顯然你們在那裡的滲透率很高。我很好奇，對於這種加速成長，您認為在新澤西州可以去的地方會有什麼變化嗎？那麼你必須進入新的市場嗎？這是一個問題。

And then the second part of the question is you mentioned this affiliated entity related to BER. If you can go into that a little bit more for us as well.

然後問題的第二部分是您提到了與 BER 相關的這個附屬實體。如果您能為我們進一步詳細說明一下這一點的話。

Yeah. I'll jump in on the first part, Richard. I'll let Peter take the second part. Regarding New Jersey, I think we have plenty of room to run. We have plenty of room within that market. We have our full platform deployed there.

是的。我將開始第一部分，理查德。我會讓彼得負責第二部分。關於新澤西州，我認為我們還有足夠的發展空間。我們在該市場擁有充足的空間。我們的完整平台已部署在那裡。

It's our home state, like we feel a lot of affection for New Jersey. We have plenty of market share. While we're proud of the market share position we have, we have -- we also have room to take on more market share there. So we feel really good about where we are there. That doesn't mean that we are not going to look at other geos.

這是我們的家鄉，我們對新澤西懷有深厚的感情。我們擁有足夠的市場佔有率。雖然我們為我們所擁有的市場份額感到自豪，但我們還有空間去佔據更多的市場份額。因此，我們對目前的情況感到非常滿意。這並不意味著我們不會考慮其他地理位置。

That's not what I'm saying. I think we certainly will look at other geos. But because we are just right around north of 20% market share on non SNP in New Jersey, we have plenty of room to go before we become saturated. And I'll let Peter take the second part.

我不是這個意思。我認為我們肯定會考慮其他地理位置。但由於我們在新澤西州非 SNP 市場的份額剛好超過 20%，因此在達到飽和之前我們還有很大的發展空間。我會讓彼得負責第二部分。

Yesah So when comparing BER year over year or sequentially quarter over quarter, a couple of things to keep in mind as far as drivers, right? So first of all, new members from a BER perspective are a headwind. That is then offset by returning members as well. Of course, we do have a somewhat elevated medics trend as well, but it appears that, that is much lower than competitors that do not have a clinically technology-focused approach.

是的，那麼，當比較逐年或逐季度的 BER 時，就驅動因素而言，需要記住幾件事，對嗎？首先，從 BER 的角度來看，新成員是一種阻力。這部分損失也會被回歸的成員所抵銷。當然，我們的醫療趨勢也確實有所上升，但看起來，這比沒有採用臨床技術重點方法的競爭對手要低得多。

There's a little bit of timing as well as far as PPD. And then lastly, going back to the CA-enabled affiliate entity that we signaled, I think, last year that we were setting up is really meant to drive higher quality and better care for members.

就 PPD 而言，也存在一些時間問題。最後，回到我們去年發出的信號，我們建立的支持 CA 的附屬實體，實際上是為了提高品質並為會員提供更好的服務。

So activities that, that entity is deploying include, for example, care coordination, care management and also partnerships with local physicians. So that is a fourth factor if you look at both quarter-over-quarter and year-over-year BER.

因此，該實體正在部署的活動包括護理協調、護理管理以及與當地醫生的合作。因此，如果您同時查看季度環比和年度環比 BER，這就是第四個因素。

Okay. Thank you.

好的。謝謝。

(Operator Instructions) With no other questions, this will conclude the Q&A portion of today's conference. I would now like to turn the call back over to Andrew Toy for any additional or closing remarks.

（操作員指示）如果沒有其他問題，今天會議的問答部分將結束。現在我想將電話轉回給安德魯·托伊 (Andrew Toy)，請他發表任何補充或結束語。

All right. Thank you all again for joining us today and for the thoughtful questions. We appreciate your interest in Clover and look forward to updating you more in our next call. So have a great evening, everyone.

好的。再次感謝大家今天的參與和提出深思熟慮的問題。感謝您對 Clover 的關注，我們期待在下次通話中向您提供更多資訊。祝大家有個愉快的夜晚。

Thank you.

謝謝。

Thank you. This concludes today's Clover Health first-quarter 2025 earnings call and webcast. You may disconnect your line at this time, and have a wonderful day.

謝謝。今天的 Clover Health 2025 年第一季財報電話會議和網路廣播到此結束。此時您可以斷開線路，祝您有美好的一天。