Counterpart Health

What Counterpart Health does

Counterpart Health, Inc. is a US-based private SaaS company and wholly-owned subsidiary of Medicare Advantage insurer Clover Health Investments, Corp. (NASDAQ: CLOV). Formally launched in 2024 after being incubated inside Clover Health since 2018 as 'Clover Assistant', the company sells Counterpart Assistant, an AI-powered physician enablement platform that ingests data from 100+ sources into a longitudinal patient record and applies 100+ proprietary machine learning models to surface real-time, dynamically prioritized clinical insights at the point of care. Core technology includes two granted patents covering ML-driven diagnosis suspecting and prospective medication fill management, plus multi-modal capabilities such as ambient AI scribing, generative AI chat for clinical information retrieval, and bidirectional EHR integration. Functionally, the platform targets earlier identification of chronic conditions (diabetes, CKD, CHF, COPD), reduced hospitalizations, and stronger HEDIS quality performance.

The company's product surface is organized into four go-to-market verticals: Solutions for Payors, Solutions for ACOs, Solutions for Practices, and Solutions for VBC Enablers. Revenue is generated through SaaS subscription agreements with Medicare Advantage plans, ACOs, IPAs, CINs, physician groups, integrated delivery networks, and value-based care technology enablers; pricing is not publicly disclosed and all engagement runs through a sales-assisted enterprise motion via 'Contact us' CTAs. Distribution leverages direct enterprise field sales, EHR embedding and OEM/white-label partnerships, and participation in federal interoperability initiatives: in March 2026 Counterpart's infrastructure powered Clover Health to become the first payer live on a CMS Aligned Network and TEFCA via a partnership with Kno2, followed by an April 2026 HealthEx partnership for patient-mediated data sharing. Operations are US-only, governed by New Jersey law, with a mailing address in Eagan, MN.

Quantified clinical evidence underpins the commercial narrative: 75% higher diabetes diagnosis rates, 89% higher CKD and CHF diagnosis rates, 7.6-21.2% fewer all-cause hospitalizations, 11.5-20.8% fewer 30-day readmissions, double-digit medical cost ratio differentials for returning members whose PCPs use the platform, and #1 nationwide Medicare Advantage PPO HEDIS ratings for two consecutive years. The company holds SOC 2 Type II and HITRUST CSF E1 certifications, employs 51-100 people, and is positioning itself as the technology and interoperability layer that converts AI-driven point-of-care insights into measurable value-based care outcomes for payers and providers.

Name

Counterpart Health

Legal name

Counterpart Health, Inc.

Website

https://counterparthealth.com

Company type

Private

Founded year

2024

Operating status

Operating

Headcount range

51–100 employees

Short description

Counterpart Health is a US-based AI-powered physician enablement SaaS subsidiary of Clover Health that serves Medicare Advantage payers, ACOs, physician practices, and value-based care enablers with a clinical-insights platform built on 100+ proprietary ML models.

Ownership category

akta.pro rank

Product category

Healthcare AI Clinical Decision Support

NAICS

Offices of Physicians (except Mental Health Specialists) (621111)

SIC

Services-Misc Health & Allied Services, Nec (8090), Services-Health Services (8000)

akta.pro primary industry

Adherence, Reminders & Engagement Automation (Medication/Follow-up) (HLACAEAJ)

akta.pro secondary industries

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK), Healthcare & Wellness Personalization (HDAAAGAI)

Keywords

• Physician enablement platform
• Value-based care software
• AI clinical decision support
• Medicare Advantage technology
• Healthcare interoperability solutions

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Marketing or Sales, Infrastructure, Operations

Revenue model

1. SaaS Subscription Services: Counterpart Health operates as a SaaS platform providing AI-powered physician enablement services to Medicare Advantage plans and healthcare organizations. Revenue is generated through subscription agreements with payers and healthcare providers for access to the Counterpart Assistant platform and interoperability infrastructure.

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

Counterpart Health sells Counterpart Assistant, a SaaS AI-powered physician enablement platform that unifies data from 100+ sources into a longitudinal patient record and uses 100+ proprietary machine learning models to deliver real-time, point-of-care clinical insights for earlier diagnosis and management of chronic conditions. It is offered in tailored editions for Payors, ACOs, Practices, and VBC Enablers, and supports ambient scribing, conversational clinical retrieval, preventive intelligence, and HEDIS quality performance.

Product overview

Counterpart Health offers Counterpart Assistant, a unified AI-powered physician enablement platform with specialized solutions for Payors, ACOs, Practices, and VBC Enablers. The platform integrates data from 100+ sources into a longitudinal patient record, using 100+ proprietary machine learning models to deliver real-time clinical insights at the point of care. Key modules include HEDIS Quality Performance tracking, Preventive Intelligence for recommended care interventions, Scribe for ambient audio recording and AI-generated documentation, and AI Chat for clinical information retrieval. The platform is offered as a SaaS solution with EHR integrations and a web-based application, originally incubated by Clover Health as Clover Assistant before launching as an independent subsidiary in 2024.

Differentiator

Problem solved

Functional benefit

Products and services

• Counterpart Assistant AI-powered physician enablement SaaS platform that unifies data from 100+ sources into a longitudinal patient record and uses 100+ proprietary machine learning models to surface real-time clinical insights at the point of care for earlier diagnosis and management of chronic conditions in value-based care arrangements. Sold to enterprise healthcare buyers including Medicare Advantage payors, ACOs, physician groups, and VBC technology enablers.
• Solutions for Payors Counterpart Assistant edition tailored for Medicare Advantage and other health plan payors seeking to improve plan performance, align incentives, and equip network clinicians with AI-driven, point-of-care insights for earlier identification and management of chronic conditions, including HEDIS performance and medical cost ratio improvement.
• Solutions for ACOs Counterpart Assistant edition for Accountable Care Organizations, IPAs, CINs, and physician networks to improve value-based care performance through AI-driven clinical workflows, consistent decision support across diverse EHR systems, and network-wide risk adjustment and quality measure performance.
• Solutions for Practices Counterpart Assistant edition for large multi-specialty groups, primary care groups, and integrated delivery networks seeking to succeed in value-based care arrangements via EHR-integrated clinical enablement tools, with simple implementation, minimal training, and bidirectional EHR write-back.
• Solutions for VBC Enablers Counterpart Assistant edition for value-based care technology enablers, MSOs, and healthcare IT companies to supplement or replace parts of their stack with proven AI capabilities, flexible workflows, and high clinician adoption, with co-development and integration partnership models.

Quantifiable outcome

• 7.6-21.2% fewer all-cause hospitalizations and 11.5-20.8% fewer 30-day readmissions
• +5 more outcomes

Named customers7 records

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability9 records

Feature5 records

Partnerships

Seven partnerships are on record, tiered core and minor.

• HealthExcoreStrategic or Co-development Partner · 7 April 2026Partnership enabling Clover Health members to access, verify, and share their clinical and claims data across healthcare providers. Leverages Counterpart Health's interoperability infrastructure to empower patients with more control over their health information and streamline data sharing processes.
• Kno2coreTechnology or Integration · 4 March 2026Collaboration enabling Clover Health (powered by Counterpart Health infrastructure) to become the first payer live on a CMS Aligned Network and TEFCA. Kno2's communication network securely routes patient-directed requests across the network using standardized FHIR (USCDI v3) formats, enabling real-time interoperable exchange of clinical and claims data.
• The Heart HouseminorImplementation/ SI/ Consulting PartnerCardiology practice customer utilizing Counterpart Assistant for AI-powered physician enablement in value-based care arrangements.
• Ascend MedicalminorImplementation/ SI/ Consulting PartnerHealthcare provider customer leveraging Counterpart Assistant platform for chronic disease management.
• Vanguard Health SystemsminorImplementation/ SI/ Consulting PartnerHealth system customer utilizing Counterpart Health solutions for value-based care performance.
• Duke Connected CareminorImplementation/ SI/ Consulting PartnerAccountable Care Organization using Counterpart Assistant for network-wide clinical performance improvement.
• The Iowa ClinicminorImplementation/ SI/ Consulting PartnerMulti-specialty clinic customer utilizing Counterpart Health solutions for value-based care delivery.

Scale indicators8 records

Recent moves7 records

Expansion highlights6 records

Broad incumbents

• Optum (UnitedHealth Group): Largest healthcare analytics and care enablement incumbent offering population health, risk adjustment, and AI clinical decision support at scale; bundles these capabilities into enterprise payer contracts that compete for the same budget as Counterpart.
• Epic Systems (Care Everywhere / Cosmos): Dominant EHR vendor whose Cosmos analytics, Care Everywhere interoperability, and embedded AI decision-support increasingly overlap with Counterpart Assistant; represents a major platform-level competitive threat to standalone physician enablement tools.

Direct peers

• Cohere Health: AI-powered clinical intelligence platform for payer-provider collaboration, prior authorization, and care management; targets the same MA payer segment as Counterpart with similar point-of-care workflow integrations.
• Arcadia: Healthcare data platform providing population health management, risk adjustment, and value-based care enablement for ACOs, health systems, and payers; comparable SaaS model and customer overlap.
• Innovaccer: Unified health data platform with AI-driven physician enablement and value-based care analytics; competes directly with Counterpart Assistant in payer/ACO/provider segments and similarly ingests fragmented data sources to surface point-of-care insights.
• Health Catalyst: Healthcare data and analytics platform serving health systems, ACOs, and payers with population health, risk adjustment, and quality measurement modules that overlap with Counterpart's risk-adjustment and HEDIS capabilities.
• Aledade: Value-based care enablement platform partnering with independent primary care practices and ACOs; competes for the same ACO/practice customer segment with technology plus network enablement services.
• Datavant: Health data exchange and interoperability platform connecting payers, providers, and life sciences; comparable TEFCA-adjacent positioning and serves similar payer data-sharing use cases as Counterpart's TEFCA infrastructure.

Emerging players

• Particle Health: API-based clinical data exchange platform built on TEFCA-aligned networks; competes in the payer-provider data interoperability layer where Counterpart has also positioned via the Kno2 partnership.
• Health Gorilla: Health information network and interoperability vendor with QHIN/TEFCA participation enabling clinical data exchange; comparable in the payer-provider data exchange layer that underpins Counterpart's clinical insights.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/counterpart-health

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Counterpart Health