Payers, Startups

Oscar Health expands New York small group insurance offerings

The company has launched its Circle Plus product which adds three major New York providers – Northwell Health, Memorial Sloan Kettering, and Westmed Medical Group – to its network.

Oscar Health, the extremely well-capitalized insurance startup launched in 2012, is expanding its provider network for its small group practice in New York with a new product called Circle Plus.

The company, which initially started out by selling plans on the individual insurance exchanges created by the Affordable Care Act, entered the small group space last year by selling plans to small businesses in New York.

The Circle Plus product adds three major New York providers – Northwell Health, Memorial Sloan Kettering, and Westmed Medical Group – to the company’s existing network, which includes access to Mount Sinai Health System, Montefiore Health System and Catholic Health Services of Long Island.

Oscar is positioning Circle Plus as a more attractive option for small businesses looking to provide flexibility to employees with specific health needs or demands.

“The most important thing we’ve learned is employers need to be able to give their employees more choices. Unlike individuals who can shop for the insurance plan that work best for them, employees must rely on their employers to make this choice for them. This puts significant pressure on employers to look for plans with a more extensive network of doctors,” wrote Oscar Senior Vice President of Network Nick Weber in a blog post.

Oscar Health and a number of its venture-backed competitors including Clover Health and Devoted Health largely pursue a narrow network strategy, partnering with a smaller pool of selected providers to offer coverage at lower prices.

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As Oscar points out, that strategy is not as effective in the small group space where employers are looking to provide a range of options to cover their workforce.

In response, the company has modified their offerings for small groups by creating products like Circle Plus and partnering with larger payers with existing provider networks like its joint venture with Humana in Nashville.

Oscar’s experiments in the small group space are come amidst a larger planned geographic expansion. In 2019, the company is slated to offer its plans in three new states Arizona, Michigan and Florida.

Also on the horizon is an entrance into the Medicare Advantage market starting in 2020 aided by a $375 million cash infusion from Google parent company Alphabet earlier this year.

All of this points to the company’s organizing thesis around a larger trend toward the individualization of healthcare as laid out by Oscar CEO Mario Schlosser.

“I fully hope for society’s sake that the rest of the insurance market will individualized over time,” Schlosser said during an interview at the Rock Health Summit in October. “The more the system individualizes, the better it will be for all of us, the more competition there will be in the value chain and the more honesty and necessity there will be in tying what people pay out of pocket to getting better outcomes and lower costs.”

Photo: Pixtum, Getty Images