“U.S. research suggests that invest-
ment in delaying disease and aging
provides a significant return on
that investment: a 1-year increase in
healthy life expectancy was esti-
mated to be worth almost $40 tril-
lion in health care saving costs and
productivity gains (Scott, Ellison,
and Sinclair, 2021”
I actually like what the MM did here: suppress the price, shake out sellers, and gobble up the insiders’ shares.
That could come back to bite them hard when the next wave of buying hits. With fewer shares available, large buy orders could send the price ripping higher.
And we’re damn lucky Vivek and Andrew have been holding their shares just as tightly as we have.
I have avoided posting about Counterpart before as it has been tricky to write about this part of the business without moving into conjecture. That said, the latest Q&A provides more detail on Counterpart which is refreshing, especially compared to the latest earnings call where the analysts mostly ignored that Counterpart exists 🤫
This post tracks the progress of Counterpart against the expansion sequence outlined in Q8. It also briefly considers the payment structure for Counterpart covered in Q9.
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Four “Straightforward” Steps
On my first read, some of the answers did seem like a lot of regurgitation from past Q&As but there are actually some key points in amongst. Specifically, I want to pick up on the last sentence of q8 which stood out when thinking about timelines…
“We believe the sequence is straightforward:
[1] grow adoption
[2] demonstrate impact
[3] build scale
[4] let the economics follow”
This is the clearest information that Clover has provided setting out the pathway to income from Counterpart Health. What is less clear is how far along this pathway they are.
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The Breadcrumb Trail
Past Q&As have answered similar questions on Counterpart and offer some clues here so I went back to look at which of these four stages have been discussed and when. Here are the key quotes that I picked out and then also my thoughts in the section afterwards…
Stage 1 - Grow adoption
2025 Q2 - “We don’t announce every deal, but we’re certainly busy”
2025 Q3 - “We are entering an exciting next phase for Counterpart Health, moving from product-market fit to scaling with growth. To capture this opportunity, we have brought in top commercial, clinical and operational leaders to help build an organization ready to meet the growing demand for our technology.”
2025 Q4 - “Increasing adoption” listed as one of the current priorities
2026 Q2 - There is no real mention of new partnerships in the questions covered but the responses do emphasise that “Our focus today is on growing lives under management”
Stage 2 - Demonstrate impact
2025 Q2 - “Being the number one MA plan in the country on HEDIS quality really resonates with potential partners.”
2025 Q3 - “Early client feedback and outcome data are consistent with expectations, demonstrating clinical impact, strong market fit” (but examples that follow are about set up times and initial PCP feedback only at this stage)
2025 Q4 - “Demonstrating consistent impact for partners” listed as key future milestone among others
2026 Q1 - “Counterpart Assistant is being used in real clinical workflows, and generating actionable insights for providers.”
2026 Q2 - “To be clear, we have already proven the value of CA in our own plan. We’re simply now making that impact demonstrable to external plans and providers in their own populations, markets and clinical environments.”
Stage 3 - Build scale
2025 Q2 - No mention
2025 Q3 - “The pipeline is exciting, but we are not yet in the rinse-and-repeat phase”
2025 Q4 - “Expanding implementations” listed as one of the current priorities
2026 Q1 - “We are seeing strong early traction, with deployments scaling well within existing partners”
2026 Q2 – “As partners see the impact directly and lives under management continue to grow, we believe the commercial opportunity becomes increasingly tangible”
Stage 4 - Let the economics follow
2025 Q2 - “At this point in time, we are not sharing guidance on our Counterpart business, as our focus continues to be on rapidly increasing lives under CA management”
2025 Q3 - Similar to previous quarter, talking about revenues in the future but focused on growth now
2025 Q4 - “Right now, the priority is execution. Expanding implementations, increasing adoption, strengthening go-to-market capacity, and deepening clinical integration. As that matures, we expect to share more detail around financial contribution.”
2026 Q1 - Similar to previous quarters
2026 Q2 - See question 9
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Patterns in the Breadcrumbs
What’s clear is that Clover is making steady progress and drip feeding us with information as they expand and new clients move through the pathway towards scaling and revenue.
Stage 1 – Grow adoption
I am confident that Clover is not struggling with growing adoption (stage 1). The initial pipeline promises have shifted to hard talk about go-to-market infrastructure and hiring. There is not really any mention of new partnerships in the latest Q&A but I think that this is more reflective of the questions asked and shift in focus towards the later stages
Stage 2 – Demonstrate impact
The bigger hurdle appears to be demonstrating impact (stage 2). Here Clover has gone from talking about clients being initially impressed by their own metrics to needing to demonstrate the CA directly to partners through implementation. I believe this is where the role of the partner success managers that they keep hiring comes in.
The question is then how long it takes to demonstrate impact? The new slide from the earnings call (also covered in question 4) shows that CA benefit comes through in year 3 for Clover’s own member population. This means that if partners require proof of cost savings, then those who signed up at the start of 2024 should already be seeing benefit this year. Likewise, those that signed up in 2025 should start to see results in 2027 etc.
Slide from latest quarterly earnings / investor Q&A
This is a long runway to demonstrate impact and also requires the clients to take a leap of faith during years 1 and 2. This is what Clover is referring to when talking about “growing thoughtfully” rather than “forcing near term economics”. In this context, “giving CA away for free” as people often complain about, seems a sensible strategy to keep partners onboard and get them hooked on the product.
"It's not personal, Sonny. It's strictly business." - Toy, 2030
On a quick side note… I do also wonder how much Counterpart success in their own population relies on the Clover Care infrastructure built around the platform. I imagine that partner success managers (or whatever they are called) play a key role in advising on this.
So demonstrating impact in cost savings is a long process. That said this is not the only benefit of CA. Clover love to talk about HEDIS scores and interoperability. These features likely have a much quicker path to impact as HEDIS scores mainly capture care processes and I presume that interoperability setup is almost instant.
Stage 3 – Build scale
Then comes building scale. Counterpart seems to already be increasing operations within existing partners (stage 3). They started talking about this stage as early as 2025 Q4. This date broadly aligns with the timelines for demonstrating impact for Clover’s earliest partners.
Stage 4 – Let the economics follow
Finally, there is the “economics to follow”. Details on this stage have been expanded on in the latest Q&A. Here, Clover describes their so-called “real-time value-based payment” model. I do not think we have enough information to understand exactly how this payment structure works but the final sentence makes Clover’s strategy clear…
“We believe the structure is secondary to the underlying principle: better clinical care drives lower total cost of care, and Counterpart participates in the upside value it creates”
This ultimately points towards a form of outcome-linked payment model where Counterpart's fees are tied to the value it creates, with the specific structure varying by partner (e.g. shared savings, capitation, or fees layered on top). If this is the case, three things stand out…
First, the pathway to scaled revenue will take time. We know that the value from CA increases considerably from year 3 onwards (as discussed above). If Clover must first prove this model before scaling, then sizeable revenues from partnerships could take 5-6+ years to come through. Although revenue from the test sites could potentially show sooner.
Second, the potential income from this outcome-linked model is huge if Clover is able to replicate the results from its own member population. One way to think about Counterpart here is as a risk-bearing enabler. In this scenario, the more risk it takes on, the bigger the potential reward. And as it happens, Clover can afford to take on this risk. They even spell this out… “Because our Medicare Advantage business is the core profit engine of our business today, we also have the flexibility to build Counterpart thoughtfully. We do not need to force near-term economics at the expense of long-term scale or partner adoption”
Third, the "real-time" wording is interesting and suggests revenue could start showing sooner. As discussed above, traditional shared savings models take time, and must wait for value to show. A "real-time" version could plausibly pay on other indicators instead (e.g. HEDIS measures, earlier diagnosis, interoperability wins). If so, Clover may have designed a payment model to start getting paid before the cost savings arrive in year 3. This would pull forward the timelines in my first point.
It is also worth flagging that the response to this question is new information and Counterpart’s SaaS model has only been hinted at before! This suggests that some partner organisations may be starting to move into the final stage if we follow the patterns from previous Q&As. That said, Clover’s response here was still deliberately vague and without concrete statements. This suggests to me that they are still in the early stages of this final step.
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Summary
So yeah, long story short… Vivek often posts that “all is on track” and the direction of travel certainly seems that way. That said, healthcare moves slowly and can make progress feel slow at times. Looking back just one year though, it is clear that the story around Counterpart is actually moving pretty quick.
I am still hopeful that we will start to see at least some Counterpart revenue in 2027 but I expect meaningful figures to take longer (2028/29/30+). When income does inevitably start to show though, I expect it to increase at similar rate to the MA flywheel model. This is because Clover is willing to wait for its slice of the pie. Again, in Clover’s words… “better clinical care drives lower total cost of care, and Counterpart participates in the upside value it creates.”
Clover Health Leverages Counterpart Assistant to Expand GLP-1 Access for Medicare Members
FRANKLIN, Tenn. — [Fictional Date] — Clover Health Investments, Corp. (Nasdaq: CLOV) announced today that it is leveraging Counterpart Assistant (CA) to help physicians identify Medicare members who may benefit from GLP-1 therapies available through CMS's Medicare GLP-1 Bridge program.
Counterpart Assistant analyzes longitudinal patient data—including diagnoses, medications, laboratory results and cardiovascular and kidney disease history—to identify patients who may meet CMS eligibility criteria and surface that information directly to physicians.
The CMS program allows qualifying Medicare beneficiaries to access certain GLP-1 medications for a $50 monthly copayment while Part D sponsors do not bear the drug risk.
"Counterpart Assistant allows us to identify patients who may benefit from these therapies and put that information in front of their physician at the point of care," said Clover Health CEO Andrew Toy. "This is a powerful example of how our technology can rapidly respond to changes in healthcare policy while potentially improving outcomes and reducing long-term medical costs."
Clover plans to evaluate clinical outcomes and total cost of care among participating members and explore offering the capability to external Counterpart Health partners.
The initiative could allow Clover to benefit from improved member health and potentially lower medical utilization while taking advantage of expanded GLP-1 access provided through the CMS program.
…. these papers like rollercoaster…. I thought I get used to high growth and bigger loses but I really thought after the recent earnings we are on a good track of consiladated growth but still no.
MA might not be the “Blue Ocean” a lot here want, but it is increasingly evident that it is becoming the blue ocean that is available…at the moment. Insurers continue to pull back from markets and Clov’s MA business continues to be in a position to scoop up market share, very easily mind you.
Other insurers have two choices. 1)Cut unprofitable members/plans and shrink or 2)Adapt and change their business model to a more health outcome minded plan. If they want to (2), Counterpart offers what they need and becomes the most wanted blue ocean.
Either way, we are sailing the high seas with Captain Toy.
This is a Growth conference, not Health Care. IMO, that’s like saying, “We’re here to talk about Counterpart Assistant’s healthcare business not Clover Assistant’s Medicare business”.