Though insurance technology company Oscar Health posted a loss in the first quarter of this year, its leaders are optimistic about the future, especially with the launch of the company’s technology and services platform +Oscar.
In Q1 of fiscal year 2021, New York City-based Oscar Health saw some wins, including a year-over-year membership growth of 28.9% and a medical loss ratio that improved by 670 basis points compared to the same quarter last year. But the company still experienced a significant net loss of $87.4 million, though this was an improvement from the $96.8 million net loss Oscar Health posted in Q1 of 2020.
Behavioral Health, Interoperability and eConsent: Meeting the Demands of CMS Final Rule Compliance
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The current financial statement is the first the company has released since going public earlier this year.
Looking ahead, the +Oscar platform business will occupy a key spot in the company’s growth strategy, said CEO Mario Schlosser, in a May 13 earnings call transcribed by Seeking Alpha. The platform business generates revenue by making Oscar Health’s technology stack available to providers and third-party payers.
Essentially, partners can use the technology stack to develop an efficient health plan infrastructure, drive growth and retention through enhanced member experience and route members to the appropriate type of care at the right time, according to a news release.
+Oscar is also expected to drive the company’s insurance business through the creation of new services. For example, the +Oscar technology stack enabled Oscar Health to establish its virtual primary care service, which is now available in 82 counties.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“Those members who used virtual primary care in 2020 were actually about 10% more likely to stay with Oscar, the insurance company, year-over-year, than those who are not using Oscar Virtual Primary Care,” Schlosser said.
The next phase of growth for the platform business will involve establishing risk-based arrangements with providers.
For now, Oscar Health is on track to transition around 37,000 Medicare Advantage lives and 20,000 individual market lives on to the +Oscar platform for 2022 through its agreement with Health First Health Plans. This will bring total number of MA members using +Oscar to more than 41,000.
“We expect +Oscar to be a meaningful growth driver for Oscar in the years to come with long-term target EBITDA margins reaching 20% plus,” Schlosser said.
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