Clover Health, an insurance startup trying to use data to keep customers healthy
<i>Uncle Sam pays Clover a monthly fee for each Medicare Advantage customer the startup enrolls. The amount varies depending on where the person lives, but it averages $850 before adjusting for chronic conditions or healthy habits, the Medicare Rights Center says. Clover uses the money to pay members’ bills and generates almost all its revenue from whatever is left over after reimbursing doctors, hospitals, labs, pharmacies and other points of care. The company offers plans with no monthly premiums or ones that go as high as $225. Clover says the amount it gets from those payments and copays isn’t significant.</i><p>So it sounds like the company&#x27;s biz model is to send nurses out in the field to get senior citizens to enroll in Medicare, check up on them and collect data, and sell them healthy lifestyle products (gym memberships, cooking classes, etc.). As a 23 year old I&#x27;m not sure if this is any different than what big insurance co&#x27;s do for their Medicare enrollees.<p>The actual tech part seems to be the web portal&#x2F;CMS (Django) and the storage and management of this tangential customer data that is generated with each visit:<p><i>Clover uses Python for all of our backend coding so using a pipeline orchestration tool that is itself written in Python is valuable for us. Airflow meets that requirement and it’s the tool we’ve chosen to manage all of our pipelines.</i><p>Here&#x27;s the actual coverage sheet if you want to compare with your&#x2F;your parent&#x27;s plans: <a href="https:&#x2F;&#x2F;cdn.cloverhealth.com&#x2F;filer_public&#x2F;c4&#x2F;a8&#x2F;c4a894d0-000e-47b8-873e-92bd323db9bb&#x2F;benefitssummary_carepointplan_2017.pdf" rel="nofollow">https:&#x2F;&#x2F;cdn.cloverhealth.com&#x2F;filer_public&#x2F;c4&#x2F;a8&#x2F;c4a894d0-000...</a><p>Deductibles (excluding prescription drugs) are $6,700 annually. Someone maxing out prescription charges would spend an additional $5,000 per year. I&#x27;m not sure how that compares to a traditional provider.<p>Tangentially: I think we&#x27;ve almost stretched the definition of the word &quot;startup&quot; into oblivion at this point. It doesn&#x27;t mean anything to me anymore.