Clover Health CEO Andrew Toy is feeling bullish about his company’s AI positioning.
“We are absolutely, in my mind, the AI leader in Medicare Advantage,” he said Jan. 15 at the J.P. Morgan 2026 Healthcare Conference in San Francisco.
Clover has been aiming for full-year GAAP net income profitability, already achieving 53% MA PPO membership growth, year over year. Mr. Toy said recent achievements are attributable to the company’s technology focus, particularly with Counterpart Assistant.
“This AI-driven technology is at the core of all of these achievements,” Mr. Toy said. “It’s not AI for AI’s sake … it is bringing together interoperability — 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.”
Counterpart Assistant launched a generative AI chat in the fall, imparting insights from over 100 data sources through conversations.
Mr. Toy said his team has been focused on longitudinal data from claims and interoperability networks. Clover’s systems apply AI to cleaning, data aggregation and insight generation. He said models are trained “to support improved clinical outcomes.” Mr. Toy also said Clover builds onto foundational models, versus building entirely new ones, to integrate into its platform.
“As LLMs have come online the last couple of years, we have integrated those into our own clinical platform and use 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,” he said.
