Oscar Health reports first profitable year – Healthcare Dive

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The ACA insurer lost $153.5 million in the fourth quarter but still eked out a $25.4 million profit for the full year.
Oscar Health was founded more than one decade ago with the goal of using a technology-driven insurance platform to improve transparency and affordability, hopefully nabbing clients from more entrenched plans. The company has had success in the ACA exchanges, but struggled with some of its plans, leading Oscar to exit a number of states in the past few years. Oscar has also had difficultly implementing its tech platform on a broader scale and has lost clients as a result.
Despite some quarterly wins, Oscar had yet to turn a profit on an annual basis before 2024, according to financial documents. Recent losses reached $610 million in 2022 and $271 million in 2023.
During a call with investors Tuesday afternoon, Oscar CEO Mark Bertolini called 2024 — which also included a record $9.2 billion in revenue for Oscar — the “strongest year of financial performance in company history.”
Bertolini, the former CEO of massive insurer Aetna, joined Oscar in early 2023 to help the company reach profitability. Oscar expected that would happen last year after focusing on cost cutting and restricting major investments.
Oscar also benefited from snowballing enrollment in ACA coverage. Last year, 21.3 million Americans signed up for the plans, a record only surpassed at the start of this year when 24.2 million people elected into the coverage.
Oscar, which offers plans in 18 states, said its own enrollment growth outpaced the market by almost three times during open enrollment for 2025 coverage in the fall.
Enrollment in ACA plans grew about 13% overall compared to the prior year, per CMS data. Oscar’s enrollment grew 37%, Bertolini said on the Tuesday call.
Oscar expects that momentum to spur its revenue to at least $11.2 billion this year. 2025 should also be another year of positive profits, according to CFO Scott Blackley.
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Physician groups slammed Congress for allowing a 2.8% cut to their Medicare pay to go into effect.
Kennedy's views on vaccines in particular are causing alarm among some physicians and investors.
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