Spiras Health Secures Five Year Value-Based Contract with Clover Health Direct Contracting Entity

NASHVILLE, Tenn. – Spiras Health today announced a five-year agreement with Clover Health, an innovative technology company improving health outcomes for America’s seniors, to provide complex care management services to Medicare members in Kansas and New Jersey. The value-based contract will provide Spiras Health’s personalized, multi-modal approach to some of Clover’s most vulnerable patients.

As Clover scales Clover Home Care, its in-home primary care program for medically complex and homebound members, through the U.S. Centers for Medicare and Medicaid Services’ (CMS) new Direct Contracting model, Spiras Health will support the growing number of Clover-aligned beneficiaries with complex chronic conditions. Its model includes home-based services, virtual care, and remote patient monitoring — all at no cost to patients. A dedicated clinical team will provide eligible individuals with in-home, virtual, and telephonic visits to promote treatment compliance, identify social determinants that may impact health, and support the patients’ physicians and care teams.

“Spiras Health and Clover Health share a commitment to addressing the needs of patients with complex chronic conditions with a unique and specialized home-based approach focused on improving the patient’s health and quality of life while reducing costs,” said Scott A. Bowers, CEO of Spiras Health. “We are excited to work with Clover Health’s technology platform and provider network to bring a value-based approach to their most vulnerable patients right in their own homes.”

Within the new Direct Contracting program from CMS, Clover will use its proprietary platform, the Clover Assistant, to proactively identify fee-for-service Medicare patients with complex chronic conditions who are eligible for Clover Home Care and may benefit from Spiras Health’s high-touch, individualized delivery model. Spiras’ Clinical Care Teams — led by an Advanced Care Nurse Practitioner and including state-licensed nurses, respiratory therapists, and other allied health professionals — work with each patient’s physician to diagnose, treat, educate, and engage the patient in self-care.

“As Clover scales Clover Home Care, we’ll be searching for like-minded partners. We believe Spiras Health has the right combination of home-based and virtual support to help address multiple issues that contribute to poor health outcomes and high utilization of care for patients with complex chronic conditions,” said Kumar Dharmarajan, Chief Scientific Officer of Clover. “Many of these patients are frequently hospitalized or in the ER with exacerbations that could be prevented. With the help of Spiras Health, we look forward to scaling our in-home primary care program to bring a high level of complex care management to the fee-for-service Medicare population.”

About Spiras Health
Spiras Health is a clinical provider of care management and other health-related services to individuals with complex and chronic needs. Its approach to care delivery includes a combination of home-based services, telehealth, two-way digital communications, and remote patient monitoring, with a focus on reducing costs associated with avoidable hospital utilization. By identifying and assessing members with an elevated probability of avoidable costs, Spiras develops actionable plans of care and addresses barriers including social determinants of health. The company optimizes engagement and activation by building trusting relationships through a multi-modal care approach that delivers improved satisfaction, clinical metrics, and financial savings. Savings are achieved through substantial and sustained reductions in hospital and emergency department utilization via a geographically and economically scalable delivery model.

About Clover Health
Clover Health (Nasdaq: CLOV) is a next-generation insurance company dedicated to achieving health equity for all Americans, with a focus on seniors who have historically lacked access to affordable, high-quality healthcare. Clover aims to provide great care sustainably through a business model centered on improving medical outcomes while lowering avoidable costs. Its proprietary software platform, the Clover Assistant, aggregates patient data from across the health ecosystem to support clinical decision-making by providing physicians with real-time, personalized recommendations at the point of care.

Clover offers two models of care: affordable Medicare Advantage plans with extensive benefits, and care coordination for Original Medicare beneficiaries through Direct Contracting. In both models, primary care physicians are supported by the Clover Assistant and comprehensive home-based care via the Clover Home Care program.

Headquartered in Nashville, Clover’s workforce is distributed across the U.S., with a team of technologists based in Hong Kong. The company manages care for Medicare beneficiaries in eleven states, including Arizona, Georgia, Kansas, Mississippi, New Jersey, New York, Pennsylvania, South Carolina, Tennessee, Texas, and Vermont.