The Future of Insurance Podcast – Andrew Toy

President, Clover Health

Season 2, Episode 23, April 5, 2022

Guest Bio

Andrew Toy is the President at Clover Health (NASDAQ: CLOV), where he is responsible for driving the vision for how technology and analytics can improve the lives of Clover’s members. Andrew joined Clover from Google, where he coordinated enterprise activities for the Android team and ran Machine Learning, Enterprise Search and Analytics for the G-Suite team. Before that, he was the CEO and co-founder of Divide, a company focused on creating a split between work and personal data on mobile devices, which was acquired by Google in 2014. He earned his BS and MS in Computer Science from Stanford.

Highlights from the Show

  • Clover Health is a health insurer focused on Medicare
  • Clover’s mission is to use technology to drive better health outcomes, therefore reducing the total cost of healthcare, allowing more people in more places to be covered
  • The US is fairly unique in that healthcare is almost exclusively provided through an insurance mechanism, meaning there’s a provider, a patient and a payer involved, complicating our ability to get efficiencies as a market
  • The mechanism Clover is using to change outcomes is The Clover Assistant, which ingests different data points from all the various places and ways people get care to provide insights and advice to primary care physicians to help them in providing care to patients
  • Clover does this without limiting patients to only certain providers, and they not only don’t charge providers for access to Clover Assistant, but actually reimburse them at higher rates if they use Clover Assistant
  • Because Clover is focused on helping the overall outcome, it allows them to make longer term decisions on spending on care because they realize, not paying for something today to save money may mean you spend much more tomorrow
    • In P&C, if you don’t have a burglarizing of a home today, that has nothing to do with whether you will or won’t tomorrow, but healthcare is different since not providing care today can mean health is worse (and more costly) tomorrow
  • Why is an insurer best positioned to solve this health issue?
    • Insurers are incented to reduce total healthcare costs, so their incentives are aligned
    • Insurers see all care, regardless of who provides it
    • Insurers have the mechanism to spread health benefits because any savings in one area can be spread to other areas, broadening care
  • For most commercial health insurers, they don’t control members joining or churning since it’s usually driven by people’s employment, so it’s not surprising commercial insurers would be less inclined to build what Clover is building because of their natural tendency away from long-term views

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