Oscar Health

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Oscar Insurance Corporation
Oscar Insurance Corporation
Privately held company
IndustryHealth insurance
FoundedNovember 1, 2012; 8 years ago (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
RevenueIncrease$2.0 Billion(2020)[1]
Members400,000 (2020)[2]
WebsiteHIOscar.com

Oscar Health Insurance is a technology-driven[3] health insurance company founded in 2012, and is headquartered in New York City.[4][5] 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.[6] 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'.[6]

History[edit]

2012–2015[edit]

The company was founded in 2012 by Mario Schlosser, Josh Kushner, and Kevin Nazemi, who were classmates at Harvard Business School.[5][7] Schlosser and Kushner's inspirations were drawn from their experience 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.[8] Oscar began selling insurance for the same year[9] 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.[10]

2016[edit]

In 2016, Oscar had 145,000 members in New York, New Jersey, California, and Texas.[10] 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.[11] 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 operate effectively and continue to deliver access to quality healthcare."[12] 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.[13]

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.[14] On March 13th, 2020, Oscar closed the Oscar Center "until further notice."[15]

2017[edit]

On April 25, 2017, Oscar announced its entrance into the small group insurance market, offering health plans in New York.[16] 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.[citation needed]

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.[17] 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.[18]

2020[edit]

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.”[19]

As of June 2020, Oscar had sold 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.[20] 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."[21]

Product and services[edit]

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.[22] It offers small group health insurance plans in New York, New Jersey, California, and Tennessee.[23] Oscar also offers Medicare Advantage plans in New York City and Houston, Texas.[20]

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.[24][25]

Oscar offers direct appointment scheduling with a selection of its provider partners[26] 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.[27] 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. [28]

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.[29]

Marketing and brand[edit]

Oscar Health has run marketing campaigns on the New York City Subway.[30] 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."[verify] 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.[31]

Finances[edit]

Funding[edit]

Oscar has raised capital through a series of funding rounds. Its investors include Thrive Capital, General Catalyst Partners, Khosla Ventures, CapitalG, and Fidelity Investments.[4][7][8]

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.[4]

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.[4][32] Series B investors included Formation 8, Horizons Ventures, Wellington Management Company, and Goldman Sachs.[4]

In September 2015, Oscar announced a funding round with Google Ventures and Google Capital, valuing the company at $1.75 billion.[33][34]

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.[35] In 2018, Alphabet invested $375 million in Oscar Health.[36] As of 2019, the company had raised $1.3 billion, and was valued at $3.2 billion.[37]

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.[38]

Revenue[edit]

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.[39] 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.[4]

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."[26]

By 2016, Oscar Health had 135,000 subscribers, with roughly half residing in New York State.[40]

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

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."[41] 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.[42]

In January 2020, TechCrunch reported that Oscar served 400,000 members and expected to bring in $2 billion by the end of the year.[43]

Headquarters and offices[edit]

Oscar's headquarters are located in Tribeca, New York City. They also have a technology outpost in Los Angeles,[44] an office in Dallas, and a member services operation in Tempe, Arizona.[45]

References[edit]

  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/
  2. ^ https://techcrunch.com/2020/01/13/oscar-health-now-has-400000-members-and-expects-to-bring-in-2-billion-by-the-end-of-2020/
  3. ^ "Oscar uses tech to improve health care". USA Today. Retrieved April 10, 2017.
  4. ^ a b c d e f "Obamacare Startup Oscar Health Hits A $1.5 Billion Valuation". Forbes.com. Retrieved April 14, 2017.
  5. ^ a b 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.
  6. ^ a b "10 things to know about Oscar Health: A view of the company 6 years after its founding". www.beckershospitalreview.com. Retrieved July 15, 2020.
  7. ^ a b Mangan, Dan (December 11, 2014). "Prix Fixe Obamacare: Deductible-Only Plans Keep It Simple". CNBC.com. Retrieved January 18, 2017.
  8. ^ a b Inc (June 24, 2014) FennDonna-8
  9. ^ "Can three technologists, $40 million, and Obamacare change health insurance forever?". Washington Post. Retrieved September 10, 2017.
  10. ^ a b "How Health Insurance Startup Oscar Is Going to Get to 1 Million Members". Bloomberg.com. February 19, 2016. Retrieved September 10, 2017.
  11. ^ "New York-based tech-driven health insurance startup hiring 150 in Tempe". www.bizjournals.com. Retrieved September 10, 2017.
  12. ^ "Oscar will leave 2 markets as insurance startup finds similar challenges as national payers – MedCity News". medcitynews.com. Retrieved September 10, 2017.
  13. ^ NewYorkTimes (August 30, 2016) AbelsonReed
  14. ^ "Take a look inside the doctor's office of the future, created by a $2 billion startup that's shaking up healthcare". Business Insider. Retrieved September 10, 2017.
  15. ^ "Oscar | Smart, simple health insurance". www.hioscar.com.
  16. ^ Buhr, Sarah. "Oscar Health rolls out its small business product Oscar for Business". TechCrunch. Retrieved September 10, 2017.
  17. ^ Buhr, Sarah. "Oscar Health is headed back to New Jersey and branching out to Ohio and Tennessee". TechCrunch. Retrieved September 10, 2017.
  18. ^ Merced, Michael J. De La (July 12, 2017). "Oscar Health to Join Humana in Small-Business Venture". The New York Times. ISSN 0362-4331. Retrieved September 10, 2017.
  19. ^ Japsen, Bruce. "Cigna And Oscar To Launch Health Plans For Small Business". Forbes. Retrieved July 13, 2020.
  20. ^ a b "Oscar Health to launch Medicare Advantage plans in New York, Houston in 2020". FierceHealthcare. Retrieved July 13, 2020.
  21. ^ "Oscar is Disrupting Health Care in a Hurricane". WIRED. Retrieved September 10, 2017.
  22. ^ "Looking ahead to our 2018 map" (Press release). Oscar. October 5, 2017.
  23. ^ Buhr, Sarah. "Oscar Health rolls out its small business product Oscar for Business | TechCrunch". Retrieved September 10, 2017.
  24. ^ "Ney York-based Oscar Health hiring 150 in Tempe". bizjournals.com. Retrieved March 8, 2019.
  25. ^ "Oscar Health CEO: Insurers are ultimately responsible for patients' end-to-end care". www.beckershospitalreview.com. Retrieved July 13, 2020.
  26. ^ a b Sarah Kliff (July 26, 2016). "A Google-backed health insurer wants to disrupt insurance by ... limiting patient choice?". Vox.
  27. ^ "Health insurance startup Oscar has a new way to get all your medical details in one place for your doctor". Business Insider. Retrieved September 10, 2017.
  28. ^ "HOW ONE STARTUP BUILT BETTER HEALTH INSURANCE WITH THE MAGIC OF DATA". WIRED. Retrieved May 12, 2017.
  29. ^ Truong, Kevin (November 27, 2018). "Oscar Health expands New York small group insurance offerings". MedCity News. Retrieved June 22, 2019.
  30. ^ Meghan Daum (February 7, 2016). "Returning to a Gentler Gotham". New York Times.
  31. ^ "Brooklyn commuters encounter 'broken' health care system". Metro US.
  32. ^ Michael Merced (April 20, 2015). "Oscar, a Health Insurance Start-Up, Valued at $1.5 Billion". New York Times.
  33. ^ Douglas MacMillan (September 16, 2015). "Google Backs Startup Oscar Health Insurance". Wall Street Journal.(subscription required)
  34. ^ Xu Rena (October 29, 2015). "Can Selling Insurance to Patients Transform Health Care?". New Yorker.
  35. ^ Bertoni, Steven. "Oscar Health Gets $400 Million And A $2.7 Billion Valuation from Fidelity". Forbes. Retrieved September 10, 2017.
  36. ^ D'Onfro, Jillian (August 14, 2018). "Alphabet puts another $375 million into Josh Kushner's Oscar Health, just months after previous investment". CNBC. Retrieved July 13, 2020.
  37. ^ Loeb, Steven. "Top startups disrupting the healthcare insurance industry". Vator. Retrieved October 28, 2019.
  38. ^ "Oscar's health insurance platform nabs another $225 million". TechCrunch. Retrieved July 13, 2020.
  39. ^ Shaer, Matthew (June 9, 2014). "Does Oscar Sound Cooler Than Aetna?". New York Magazine. Retrieved October 30, 2019.
  40. ^ Reed Abelson (June 20, 2016). "Health Insurer Hoped to Disrupt the Industry, but Struggles in State Marketplaces". New York Times.
  41. ^ Zachary Tracer (May 16, 2017). "Obamacare Insurer Oscar's New Strategy Helps to Narrow Loss". Bloomberg.
  42. ^ "Oscar Health expects to generate $1 billion in revenue and sign up 250,000 members in 2018". TechCrunch. Retrieved July 13, 2020.
  43. ^ "Oscar Health now has 400,000 members and expects to bring in $2 billion by the end of 2020". TechCrunch. Retrieved July 13, 2020.
  44. ^ Health, Oscar (June 30, 2017). "Announcing Oscar's first engineering outpost: Los Angeles". Medium. Retrieved September 10, 2017.
  45. ^ "Oscar Expands Operations in Tempe". azcommerce.com. Retrieved September 10, 2017.