Medicare new unicorn Clover Health model or subvert the traditional medical insurance industry
Big data, artificial intelligence, mobile Internet, and cloud computing, known as “Great Wisdom Moving Cloudsâ€, are important technical carriers and driving forces for the industrial Internet. They are subverting the business model of the traditional industry and even the entire value chain. The new unicorn should be shipped. Health, Clover Health is a new unicorn in the field of medical insurance. Clover Health recently received a $160 million Series C round of financing from Apple's investment firm, Greenoaks Capital, with a post-mortem valuation of $1.2 billion.
The US healthcare sector accounts for nearly one-fifth of GDP, a multi-trillion dollar market with huge innovation and profit margins. According to a CB Insights survey, in 2015, medical insurance and insurance technology startups have raised $1.2 billion, more than doubled from $570 million in 2014, compared to $123 million in 2013. Times. It's no wonder that Clover Health's philosophy and operation, which improves efficiency and reduces costs, is highly appreciated by investors.
Traditional medical insurance mode will be too angry
The San Francisco-based company is committed to more integrated, personalized and intrusive services for healthcare through software technology and data integration, which not only improves health care outcomes, but also protects both insured and insurance companies. Cutting costs. "Fundamentally, we use data and software to create a database of users' clinical data to identify gaps in the treatment process and then make up for these gaps," said Kris Gale, CTO of Clover Health. "We have a small team that specializes in targeted interventions to improve medical outcomes." That is to say, data technology is infiltrated into health care. But Clover Health is still at a loss, with a net loss of $346 million in 2016. Its revenue source is more than 20,000 medicare advantage users (three times the number of 7,200 in 2015), the government pays about $850 per month for each Clover user, and this year's $200 million is Clover's main revenue. . It claims to be focusing on market development and expanding its operations rather than on profitability.
There are still many home insurance companies like Clover Health, and large ones are Oscar Health, Flatiron Health, iCarbonX, etc., and new types are still being produced. Past experience has shown that launching a new medical plan is very difficult. Of the 23 companies, 12 have already failed, and many others have fallen into financial difficulties and are struggling. Those traditional health care companies, such as United Healthcare, Aetna, etc., occupy most of the market. They may also catch up, integrate data, or buy new technology, and become a big data high-tech company, becoming a strong competitor of Clover.
Clover Health is the practical application of technology such as “Dazhi Yunyun†in medical insurance, making medical care more automated (electronic data is easy to integrate, transfer, compare, etc.), personalization (for personal intervention and supervision), and interaction ( Patients, doctors, hospitals, carers, etc. all coordinate and follow up, participate in the management of the ex ante) and persistence (health is a 24/7 thing, not finished after reading the doctor). These changes naturally lead to medical insurance shifting from medical treatment to preventive health care, putting physical health first, not medicine or healing. This is a fundamental change in goals and ideas.
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