CMS Upgrades Both PPO and HMO Medicare Advantage Contracts to 4.5 Stars for 2027 Payments
CLOV has more than doubled off its 52-week low of $1.58.
Summary
Clover Health announced that both its PPO and HMO Medicare Advantage contracts have been upgraded to 4.5-star ratings by CMS, which will lead to increased Quality Bonus Payments in 2027.
Key Events · Product Development and Regulatory · CLOV
-
PPO Contract Confirmed at 4.5 Stars
The PPO Medicare Advantage contract (H5141) has been confirmed at a 4.5-star rating for payment year 2027, consistent with a prior court judgment and CMS recalculation.
-
HMO Contract Upgraded to 4.5 Stars
The HMO Medicare Advantage contract (H8010) has also been upgraded from 4.0 stars to 4.5 stars, impacting payment year 2027.
-
Increased Quality Bonus Payments
Both 4.5-star ratings will result in higher Quality Bonus Payments from CMS, significantly enhancing the company's revenue and profitability for 2027.
-
Reinforces Positive Financial Trend
This regulatory success builds on the company's recent achievement of its first-ever positive GAAP Net Income in Q1 2026, strengthening its financial trajectory.
Analysis · CLOV · Finance
This filing confirms the previously announced 4.5-star rating for the PPO Medicare Advantage contract (H5141) and, more importantly, discloses a new upgrade for the HMO Medicare Advantage contract (H8010) from 4.0 to 4.5 stars. Both upgrades are critical as they directly impact Quality Bonus Payments (QBP) for payment year 2027, significantly boosting future revenue and profitability. This positive regulatory development strengthens the company's financial outlook, especially following its recent achievement of positive GAAP Net Income in Q1 2026.
At the time of this filing, CLOV was trading at $4.93 on NASDAQ in the Finance sector, with a market capitalization of approximately $2.6B. The 52-week trading range was $1.58 to $5.18. This filing was assessed with positive market sentiment and an importance score of 9 out of 10.