The visionary executive of a technology-oriented Medicare Advantage company outlines the future in this sector and the importance of being a leader of Asian descent in healthcare.
Editor's note: This article appears in the September/October 2021 edition of HealthLeaders magazine.
Andrew Toy, president and chief technology officer at Clover Health, the Franklin, Tennessee–based technology-oriented Medicare Advantage company, grew up in Hong Kong and says that he first developed an interest in technology as a child writing code at age 6. "I've always been obsessed with computers," he says.
Toy eventually moved to the U.S. to attend Stanford University, graduating with a bachelor's and master's in computer science.
Though he currently works in health insurance, Toy's executive career has been defined by his abilities and passion as a technologist, including service in leadership roles at Google, MTV Networks, and Morgan Stanley. "I've been in the technology [industry], but I wanted to do something that was both mission-oriented, to help people, and where I could build a great business. And so, healthcare really stood out there. … We need to bring great healthcare to more people, and we need to empower physicians more as well. There's a huge opportunity to use technology to do that."
In October 2020, Social Capital Hedosophia Holdings Corp. III, a Silicon Valley–based special purpose acquisition company (SPAC), announced a plan to merge with Clover Health in a reported $3.7 billion deal. In mid-January, Clover had its SPAC IPO on the Nasdaq.
The company has had a rollercoaster few months, facing sharp criticism by short-sellers in a public letter released in February while also seeing its stock price rise in June due to "meme stock" trading led by Reddit traders.
Beyond Clover's prospects, Toy delved into thought leadership in May by penning an essay on LinkedIn titled "I don't want to apologize for being Asian anymore," following an uptick in violence against the Asian American and Pacific Islander (AAPI) community.
Toy tells HealthLeaders, "What I want to emphasize to everybody is that there's a difference between having a society where everyone can have great opportunities and violence in the streets against Asians. While I do appreciate that we had AAPI month in May and I feel incredibly sympathetic about the violence, I do want to call out to everybody that it takes active violence in the streets to bring attention to the Asian community in particular. It underlies how early we are in the journey as a society against implicit and systematic biases."
"Having a distributed workforce is a great thing to do as a human and a business leader where you see talent, you value it, and it helps you provide better capabilities. For healthcare leaders, we should see our customers and patients the same way. Why wouldn't you want to help as many people as possible?"
Following are highlights from Toy's conversation with HealthLeaders about Clover's prospects in the Medicare Advantage sector.
"The reason I didn't found a technology company or a SaaS startup is because I thought it would be hard to make a lot of changes in healthcare as a technology vendor. Instead, what I said was, 'Let's build great technology but move it and build it within a managed care company.' By building it within the payer, there's a lot of interesting factors."
"We can hold the medical risk, focus on collecting a lot of data, and build it into our tool, Clover Assistant, which is used by primary care physicians to give better, personalized data-driven care. If we have a wide network, we can pay fairly. In fact, we pay more for primary care than the majority of payers, and we don't put our physician partners at downside risk. Because when physicians deliver data-driven, personalized primary care, they will look at our Medicare eligibles better."
"I took a bit of an unusual choice instead of founding a company that worked within Google Health, Amazon, or Microsoft. I truly believed you had to be within the healthcare industry, and specifically a payer, to then build great technology and have the fulcrum to make a difference."
"There's a lot of misaligned incentives that cause friction between payers and providers, between payers and members; it's difficult. But if you can align those incentives, if you can have dollars flow correctly, and we all want to deliver that personalized care, we think we can do things at scale, which has always been Clover's goal."
"We are certainly doing things differently, and that can be disconcerting to people who have done things another way. What I say is, we are making this work. I know this is not what the traditional path has been and it can seem threatening to people who say, 'I tried rolling out technology and it's hard.' Yes, it's hard, but we are focused on technology as an enabler."
"I think people in that retail environment support and are willing to believe and bet on a grand plan. They want something audacious, someone who's going out there saying, 'We're an incredible, $150 billion company.' They see Clover as being different, and we are different. That's a great thing as opposed to when people say, 'Oh, you're just a Medicare Advantage plan.' No, we're not."
Editor's note: This story was updated on October 18, 2021.
Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.
Photo credit: Pictured: Andrew Toy is the president and chief technology officer of Clover Health. Photo by Martin Klimek/Getty Images.