The U.S. healthcare system is a thorny, complex and at times highly inefficient ecosystem.
Against this backdrop, new disruptive healthcare technologies and platforms are stepping in to make a healthier life accessible and affordable — a group of digital-first businesses among which Oscar Health counts itself.
On Wednesday (Aug. 7), during Oscar’s earnings call for the second quarter ended June 30, executives stressed to investors that the company’s focus on features aimed at improving the user experience, increasing efficiency and providing value-added services is paying off.
“Oscar reported strong second quarter results, closing out the best six months in the company’s history,” said Mark Bertolini, CEO of Oscar Health. “We continued to report robust revenue growth, improved operating margin, and strong bottom line performance. Based on our outperformance in the first half of the year, we updated our full year 2024 guidance. We are well-positioned to deliver on our target for Adjusted EBITDA profitability this year.”
The company’s total revenue was $2.2 billion in the most recent quarter, up 46% year over year (YoY), driven primarily by higher membership and rate increases, and partially offset by higher risk adjustment as a percentage of premiums.
The results represented Oscar Health’s second consecutive quarterly net profit in the company’s 12-year history as it pushes further into the individual and small group health insurance market.
Although Oscar lost its 1,800 Medicare Advantage members as a result of leaving the market, the company has been able to gain more than half a million (600,000) in its individual and small group offering YoY, bringing the total in that segment to 1,522,432.
The total membership for Oscar’s co-branded partnership with Cigna fell by just under 10,000 members YoY.
Read more: Oscar Health Aims to More Than Double Membership by 2027
Bertolini emphasized to investors on Wednesday’s earnings call that Oscar witnessed growth in 80% states in which it operates. He reiterated that Oscar’s growth strategy is focused on doubling its market footprint — but not necessarily its state footprint.
To do so, Oscar is leaning on automation and digital tooling to surface and activate insights.
One campaign that executives highlighted is a model that leveraged information from Oscar member search terms and records in order to locate platform members who could potentially require immediate care. The result of the campaign was $18 million saved for Oscar via lowered emergency room admission rates.
Oscar leadership also cited the fact that the campaign also worked to drive an 18% YoY increase in annual wellness visits for people with chronic conditions through an engagement campaign.
PYMNTS Intelligence’s “2024 Women’s Wellness Index” drew on survey insights with more than 10,000 U.S. consumers to come up with a clearer picture of the various factors shaping women’s finances and their health and well-being. The survey found that women are 11% more likely than men to research aspects of health and wellness on their own and are 19% more likely to grasp how to determine the best medical and wellness providers.
“The healthcare consumer is a smarter consumer today than ever before, they’re shopping around and they want to work with providers that not only deliver a solid healthcare experience, but also [work with] them on managing what the costs are going to be,” Erin Gadhavi, senior vice president, general manager, wellness at Synchrony, told PYMNTS.
Read also: New Study Looks at Economic Factors That Define Women’s Health
Oscar executives also reiterated the company’s focus on individual coverage health reimbursement arrangements (ICHRA).
Bertolini on Wednesday called the company “bullish” on the ICHRA segment, adding that “the ICHRA value proposition is resonating in the market and at state policy levels … States including Indiana and Texas are enacting laws and considering legislation to make it easier for small businesses to adopt ICHRA. We expect other states to follow suit.”
For the second quarter, Oscar reported net income of $56.2 million, or 20 cents a share, compared to a loss of $15.5 million, or 7 cents a share in the year ago quarter. The company announced it was updating its full year 2024 outlook to reflect first half outperformance.
