Insurer Oscar's New Strategy Helps to Narrow Loss

Schlosser said Monday that the bill that passed the House “has a lot of flaws, and it needs to get fixed up.” He said lawmakers needs to work toward a solution that creates a “viable” individual market, which would include rules that push people to buy insurance, as well as money to help them afford it. And he said the country has a moral obligation to make sure people can afford vital care.

Even with the improvements to its bottom line, Oscar is facing challenges. The company’s membership fell this year to 90,171 people as of March 31 from 106,000 across the three states a year earlier, weighing on revenue. The decision to exit markets, including New Jersey and part of Texas, also slowed growth. 

A look at the New York results shows the lengths Oscar still needs to go. Each month, Oscar took in an average premium of about $280 from each member. The company then spent $307 per member on medical costs, and about $130 on administration, leaving it with a big loss. In Texas and California, Oscar is taking in more in premiums than it’s spending on medical costs, though it’s still posting losses after spending on items like salaries and rent.

A New Model

Oscar says it’s trying to reinvent medical insurance from the perspective of a technology company. That means using data to design insurance products and to help guide members to the right kinds of health care when they need it. At the TechCrunch event, Schlosser showed how a consumer can use Oscar’s app to schedule an appointment with a doctor suggested by the insurer.

“We’re encouraged by the modest improvement,” Anne Espiritu, an Oscar spokeswoman, said of the first-quarter results. The results show that efforts to cut back on outsourcing and build a more limited network of doctors and hospitals “are bearing fruit,” she said in a statement.

The New York-based company has garnered investors including Joshua Kushner’s Thrive Capital, Founders Fund, Fidelity Investments, and General Catalyst. Jared Kushner is not currently an investor in Oscar, the company spokeswoman said. When the startup insurer last raised money, it was valued at $2.7 billion, a person familiar with the matter said in early 2016.

— Read Startups ZocDoc, Oscar to Help Obama Advertise ACA Exchange Systemon ThinkAdvisor.