Upward Health Announces Contract with Clover Health to Serve Patients In Four States Under New Direct Contracting Initiative

PROVIDENCE, R.I.--(BUSINESS WIRE)--Upward Health, a leading in-home medical and behavioral primary care provider, today announced a new Preferred Provider relationship with Clover Health, an innovative technology company improving health outcomes for America’s seniors, to serve patients with complex medical, behavioral, and social challenges through Clover’s in-home primary care program, Clover Home Care. The effort was launched shortly after Clover was identified as a participant in CMS’ new Direct Contracting initiative, which is designed to improve healthcare quality and contain costs for beneficiaries with Original Medicare.

As Clover scales Clover Home Care through Direct Contracting, the company has contracted with Upward Health to provide integrated home-based medical and behavioral care for aligned beneficiaries with complex needs in the States of New York, Pennsylvania, Georgia, and Texas.

“We believe Upward Health delivers a truly holistic, integrated home-based model combining medical, behavioral and social support for high risk beneficiaries,” said Dr. Kumar Dharmarajan, Chief Scientific Officer of Clover. “Clover is focused on reducing costs through improved health outcomes, and scaling home-based care for our most vulnerable beneficiaries through CMS’ Direct Contracting model is a key component of our strategy.”

In addition to in-home services, Upward Health offers Facilitated Virtual Care™ to expedite access for primary physical, behavioral, urgent and specialty care and to maintain the health of complex patients managing multiple chronic conditions. This enables same-day access to providers for patients who have difficulty getting to a provider’s office – or those who cannot wait for the next available appointment. Facilitated Virtual Care is also available for patients suffering from mental illness and substance use disorders who need expedited psychiatric care or therapy. The company also offers extensive support through field-based personnel for patients struggling with social determinants of health such as food, housing, transportation, and social isolation.

“Upward Health is excited to work with Clover Health and its Participant Providers on this important program” said Glen Moller, CEO of Upward Health. “We are particularly looking forward to providing Clover Home Care patients with integrated primary medical and behavioral care, along with necessary support for social challenges that may hinder their abilities to get well or manage chronic conditions. Our use of the Clover Assistant technology will help ensure that we can provide integrated whole person care in close collaboration with the network of providers supporting patients. We think this will result in better care.”

To learn more about the CMS Direct Contracting Initiative, please go to: https://innovation.cms.gov/innovation-models/direct-contracting-model-options

ABOUT UPWARD HEALTH

Upward Health is an in-home multidisciplinary provider that partners with health plans and other risk-bearing entities to address the unique needs of the most high-risk, high-need users of the health care system today. Using a unique, in-home community-based approach to meeting a patient’s needs, Upward Health facilitates and delivers care that improves outcomes and the quality of life for every patient it serves. To learn more, please visit www.upwardhealth.com.

To discuss Upward Health services for your family members or patients, please contact Kim Knighten at [e-mail].

About Clover Health

Clover Health (Nasdaq: CLOV) is a next-generation insurance company dedicated to achieving health equity for all Americans. While our mission is to improve every life, we particularly focus on seniors who have historically lacked access to affordable high quality healthcare.

We aim to provide great care, in a sustainable way, by having a business model built around improving medical outcomes while lowering avoidable costs. We do this while taking a holistic approach to understanding the health needs and social risk factors of those under our care. This strategy is underpinned by the company’s proprietary software platform, the Clover Assistant, which 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.

Making care more accessible is at the heart of our business, and we believe patients should always have the freedom to choose their doctors. To support this belief, we offer two models of care: affordable Medicare Advantage plans with extensive benefits; and care coordination for Original Medicare beneficiaries through Direct Contracting. In both cases, we provide primary care physicians with the Clover Assistant and also make comprehensive home-based care available via the Clover Home Care program.

With corporate headquarters in Nashville, Clover’s workforce is distributed around the U.S. with a team of world-class 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.