Oscar Health Insurance Company Details
Oscar Health Plans details Review
Oscar Health Insurance is a technology-focused health insurance company founded in 2012, and is headquartered in New York City. The company focuses on the health insurance industry through telemedicine, healthcare focused technological interfaces, and transparent claims pricing systems.
Oscar Health 2012–2015
The company was founded in 2012 by Mario Schlosser, Josh Kushner, and Kevin Nazemi, who were classmates at Harvard Business School. 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. Oscar began selling insurance for the same year 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.
Oscar Health 2016
In 2016, Oscar had 145,000 members in New York, New Jersey, California, and Texas. 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. 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.” 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.
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 has a primary care practice with a doctor, nurse practitioner, and a behavioral health specialist, and is only available to Oscar Members. It also hosts free classes for members, such as yoga classes or classes for expectant mothers.
Oscar Health 2017
On April 25, 2017, Oscar announced its entrance into the small group insurance market, offering health plans in New York. 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. 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.
As of September 2017, Oscar sells individual health insurance plans, both directly and through health insurance marketplaces, in New York, Texas and California. 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 he has “significant input in multiple aspects of the company like strategy, hiring, and marketing.”
Oscar Health Product and services
Oscar currently offers individual health plans in Ohio, Texas, New Jersey, Tennessee, and California. It offers small group health insurance plans in New York.
Oscar’s aim is to change Americans’ experience of engaging with the healthcare system by “redesign[ing] insurance to be geared toward the user experience.”
Oscar assigns each of its members to a “Concierge 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 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.”
Oscar offers direct appointment scheduling with a selection of its provider partners 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. 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, provider specialties
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.
Oscar Health Employees
In 2015, Nazemi left the Oscar leadership team, and Schlosser took over as sole CEO.
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, and Brian West, former COO and CFO at Nielsen, as Chief Financial Officer.
In March 2016, Sara Rowghani, former GM of Google UXA and VP of Marketing at Kickstarter, joined the team as VP of Marketing.
In 2016, Bloomberg News reported technology chief Fredrik Nylander’s departure in June was to be filled by Alan Warren from Google.
In August 2016, Anne Espiritu, former VP of Global PR and Comms at Yahoo!, joined as VP of Communications and Corporate Social Responsibility.
In October 2016, Deena Gianoncelli, former Chief People Officer at Jet.com, joined as Chief People Officer at Oscar.
In August 2017, Dennis Weaver, former chief medical officer at Advisory Board Co., was hired as the Chief Clinical Officer for Oscar.
Oscar Health Marketing and brand
Oscar Health has run marketing campaigns on the New York City Subway. 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.
Oscar Health 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.
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.
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. Series B investors included Formation 8, Horizons Ventures, Wellington Management Company, and Goldman Sachs.
In September 2015, Oscar announced a funding round with Google Ventures and Google Capital, valuing the company at $1.75 billion.
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. As of 2019, the company had raised $1.3 billion, and was valued at $3.2 billion.
Oscar Health 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. 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.
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.”
By 2016, Oscar Health had 135,000 subscribers, with roughly half residing in New York State.
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.” 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.
Oscar Health Headquarters and offices
Oscar’s headquarters are located in New York City. They also have a technology outpost in Los Angeles, an office in Dallas, and a member services operation in Tempe, Arizona.