Oscar Health

Oscar Health Insurance is a technology-focused[2] health insurance company founded in 2012, and is headquartered in New York City.[3][4] The company focuses on the health insurance industry through telemedicine, healthcare focused technological interfaces, and transparent claims pricing systems which would make it easier for patients to navigate.[5] By 2017, Oscar had expanded to markets in San Antonio, Los Angeles and Orange County in California, and San Francisco. In 2018, Oscar was named among CNBC's top 50 'disruptors'.[5]

Oscar Insurance Corporation
Oscar Insurance Corporation
Privately held company
IndustryHealth insurance
FoundedNovember 1, 2012 (2012-11-01) in New York City
FoundersMario Schlosser (CEO)
Kevin Nazemi
Josh Kushner
Area served
New York, California, Texas, New Jersey, Ohio, Tennessee, Arizona, Florida, Michigan, Pennsylvania, Virginia, Georgia, Kansas, Colorado, and Missouri
Members400,000 (2020)[1]
WebsiteHIOscar.com

History

2012–2015

The company was founded in 2012 by Mario Schlosser, Josh Kushner, and Kevin Nazemi, who were classmates at Harvard Business School.[4][6] Schlosser and Kushner were inspired to start the company after interacting with a complicated hospital billing system in 2012 (Schlosser for his wife's pregnancy, and Kushner for his sprained ankle). They named the company Oscar after Kushner's great-grandfather, in order to bring a human element to the ethos of the healthcare company.[7] Oscar began selling insurance for the same year[8] that the Affordable Care Act exchanges and individual mandate went into effect for the 2014 plan year. In its first year, Oscar secured 16,000 members. In 2015, Oscar expanded coverage to New Jersey and grew to about 40,000 members.[9]

2016

In 2016, Oscar had 145,000 members in New York, New Jersey, California, and Texas.[9] Oscar expanded its operations to Tempe, Arizona in August 2016, where it decided to locate its Concierge teams, their name for their member services model.[10] On August 23, 2016, Oscar announced it would be exiting the New Jersey Marketplace at the end of 2016, citing uncertainties in the market that would make it challenging to “to operate effectively and continue to deliver access to quality healthcare."[11] Oscar also announced that it would halve the size of its provider network in New York amidst rising premiums in order to “gain more control over pricing and patient experience.[12]

In November 2016, Oscar opened the Oscar Center in partnership with Mount Sinai Health System. Located in Brooklyn Heights, next to the Jay Street–MetroTech station, the Oscar Center had a primary care practice only available to Oscar policyholders, with a doctor, nurse practitioner, and a behavioral health specialist. It also hosted free classes for members, such as yoga classes or classes for expectant mothers.[13] On March 13th, 2020, Oscar closed the Oscar Center "until further notice."[14]

2017

On April 25, 2017, Oscar announced its entrance into the small group insurance market, offering health plans in New York.[15] On June 15, 2017, Oscar announced its partnership with Cleveland Clinic to offer individual health insurance plans to consumers in five counties in Northeastern Ohio.

On June 21, 2017, Oscar announced its intention to expand to additional markets in 2018 in areas of Tennessee, Ohio, Texas, New Jersey and California.[16] On July 12, 2017, Oscar announced that it would be selling small group insurance in the Nashville metro area to companies with up to 50 employees through a strategic partnership with Humana.[17]

2020

In January 2020, Oscar announced a partnership with Cigna to bring health insurance plans to small businesses. The partnership, Cigna + Oscar, will “launch in select markets in 2020 and plan to expand the partnership over time.”[18]

As of June 2020, Oscar sells individual health insurance plans, both directly and through health insurance marketplaces, in New York, Texas and California. Oscar sells Medicare Advantage plans in New York City and Houston, Texas.[19] Mario Schlosser is the company’s CEO, after serving as Co-CEO with Nazemi until the latter’s departure in early 2015. While Kushner does not hold a formal role in Oscar’s daily operations, he remains a major shareholder and Schlosser confirmed (as of 2017) that he has “significant input in multiple aspects of the company like strategy, hiring, and marketing."[20]

Product and services

Oscar currently offers individual health plans in Arizona, Colorado, Florida, Georgia, Kansas, Missouri, Michigan, New York, Pennsylvania, Virginia, Ohio, Texas, New Jersey, Tennessee, and California.[21] It offers small group health insurance plans in New York, New Jersey, California, and Tennessee.[22] Oscar also offers Medicare Advantage plans in New York City and Houston, Texas.[19]

Oscar assigns each of its members to a “Care Team” which is made up of a team of three Care Guides and a registered nurse that handle both traditional customer service questions as well as coordination of clinical care. In an interview with the Phoenix Business Journal in 2017, Oscar's former VP of Customer Care Paul Gazely said that Oscar's concierge model “helps to build a relationship and build trust with our members with their health care needs,” and that the model helps Oscar familiarize itself “with the member’s needs by looking at the entire member’s health history.[23]” As noted by Becker’s Hospital Review, Schlosser stated that "[the Care team helps connect] the dots better, making sure you stay up to date with how you best manage your health. They can see if you are filling [a prescription], and they will reach out to you if you are not."[24]

Oscar offers direct appointment scheduling with a selection of its provider partners[25] and (as of 2017) provides an application and tools to serve Oscar members, including a Clinical Dashboard that pulls Oscar members’ medical histories into a single platform.[26] According to WIRED, they built predictive models using purchased Medicare data and Oscar's own claims data to better optimize their patient and doctor provider network based on location and provider specialties. [27]

In 2018, Oscar began offering a wider network to its small business customers which it dubbed Circle Plus, as opposed to its original network which it calls Circle.[28]

Corporate affairs and culture

Employees

In 2015, Nazemi left the Oscar leadership team, and Schlosser took over as sole CEO.

In August 2013, Isaac Councill, Oscar’s Chief Technology Officer, joined the team.

In September 2013, Sara Wajnberg, Oscar’s Chief Product Officer, joined the team.

At the beginning of 2016, the company named Joel Klein, former Assistant Attorney General and Chancellor of the New York City Department of Education, as Chief Policy and Strategy Officer.[29]

In August 2016, Cole Morris, Oscar’s VP of Data, joined the team.

In August 2017, Dennis Weaver, former chief medical officer at Advisory Board Co., was hired as the Chief Clinical Officer for Oscar.[30]

Since December 2017, Kerry Van Voris has served as Oscar’s Chief People Officer.

In March 2019, Sid Sankaran, former AIG executive, joined as Oscar’s Chief Financial Officer.[31]

In September 2019, Meghan Joyce, a former executive at Uber, joined as Chief Operating Officer.[32]

Marketing and brand

Oscar Health has run marketing campaigns on the New York City Subway.[33] Bloomberg News reported the advertising campaigns feature cartoons suggesting "an easier way of getting medical care." AdWeek described Oscar Health's print ads as featuring "whimsical, animated characters".

In 2015, AdWeek reported that Oscar was airing its first television campaign targeted at the demographics of "new parents who are too frazzled to shop for health insurance." The ad launched on network stations in New Jersey and New York areas, cable, movie theaters located in New Jersey and in advertising within the Spotify app.

In 2016, Oscar ran a subway ad campaign with an educational bent around what the problems are with the American healthcare system.[34]

Finances

Funding

Oscar has raised capital through a series of funding rounds. Its investors include Thrive Capital, General Catalyst Partners, Khosla Ventures, CapitalG, and Fidelity Investments.[3][6][7]

During the May 2014 Series A round, Peter Thiel's Founders Fund led the series investing $30 million. By the close of Series A, Forbes reported the valuation of the company at $800 million.[3]

During the 2015 Series B round, Oscar Health raised $145 million, bringing the total capital raised to $300 million, thus valuing the company at $1.5 billion.[3][35] Series B investors included Formation 8, Horizons Ventures, Wellington Management Company, and Goldman Sachs.[3]

In September 2015, Oscar announced a funding round with Google Ventures and Google Capital, valuing the company at $1.75 billion.[36][37]

During the 2016 Series C round, Oscar raised $400 million led by Fidelity Investments, with secondary participation from previous investors, with a reported valuation of $2.7 billion.[38] In 2018, Alphabet invested $375 million in Oscar Health.[39] As of 2019, the company had raised $1.3 billion, and was valued at $3.2 billion.[40]

In June 2020, Oscar raised $225 million in funding, in which the funding round saw participation from previous investors and also new investors, namely Baillie Gifford and Coatue.[41]

Revenue

In 2014, New York magazine reported that as of May 2014, Oscar Health had 16,000 subscribers enrolled in its insurance program producing an estimated $72 million.[42] In 2015, Forbes reported that Oscar Health had 40,000 subscribers with an average subscriber paying annual fees of $4,500, placing Oscar Health's revenue estimates at $180 million.[3]

Vox reported that in 2015, Oscar Health lost $92.4 million in New York as the firm's analytical models failed to accurately forecast "the people who signed up for coverage were sicker than the company had expected."[25]

By 2016, Oscar Health had 135,000 subscribers, with roughly half residing in New York State.[43]

In February 2017, Bloomberg reported that Oscar had lost $204.9 million in 2016.

In May 2017, Bloomberg reported that Oscar's first quarter loss had narrowed by nearly half, writing that the company was “beginning to get a handle on its medical costs."[44] In August 2017, Bloomberg also reported that Oscar had posted a $57.6 million loss in the first half of 2017, down from the $83 million lost posted the year prior.

In December 2017, TechCrunch reported that Oscar would expect to generate $1 billion in revenue and enroll 250,000 in 2018.[45]

In January 2020, TechCrunch reported that Oscar served 400,000 members and expected to bring in $2 billion by the end of the year.[46]

Headquarters and offices

Oscar's headquarters are located in Tribeca, New York City. They also have a technology outpost in Los Angeles,[47] an office in Dallas, and a member services operation in Tempe, Arizona.[48]

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References
  1. https://techcrunch.com/2020/01/13/oscar-health-now-has-400000-members-and-expects-to-bring-in-2-billion-by-the-end-of-2020/
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  3. "Obamacare Startup Oscar Health Hits A $1.5 Billion Valuation". Forbes.com. Retrieved April 14, 2017.
  4. Khouri, Andrew (October 18, 2015). "Insurance start-up Oscar seeks to shake up healthcare through its app". Los Angeles Times. ISSN 0458-3035. Retrieved April 14, 2017.
  5. "10 things to know about Oscar Health: A view of the company 6 years after its founding". www.beckershospitalreview.com. Retrieved July 15, 2020.
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  7. Inc (June 24, 2014) FennDonna-8
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  12. NewYorkTimes (August 30, 2016) AbelsonReed
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