Oscar Health is rapidly deploying artificial intelligence in more areas of its business, CEO Mark Bertolini told investors during its fourth-quarter earnings call.
He said last year the company activated AI in 11 new use cases. For the first quarter of 2025, 10 more use cases are already in the pipeline.
The insurer, which serves more than 1.8 million members across 18 states, stressed it is able to integrate large language models to monitor follow-up care. One major health system saw its readmission rates dip by nearly 10%.
Individual and small group membership increased by more than 600,000 people year over year.
Oscar turned its first profitable year in 2024, recording a net profit of $25.4 million and bringing in $9.2 billion in revenue, a 57% increase year over year.
As the individual market grew 13% year over year, now covering 24 million Americans, Oscar grew even faster.
“Our growth outpaced the market by close to three times at 37%,” said Bertolini.
Market share in Florida, Tennessee and Texas increased, while ICHRA membership improved in Atlanta, Columbus, Kansas City, Miami and New Jersey.
The company's quarterly earnings per share was a net loss of $0.62, slightly worse than analysts with Zacks Investment Research anticipated.
During an investor day last year, the company outlined its goals of achieving 20% revenue CAGR and 5% operating margin by 2027. Leadership said Oscar is on track to reach these targets.
In the fourth quarter, Oscar posted a medical loss ratio of 88.1% and SG&A expenses of 19.5%. The company is aiming for around $11.5 billion in revenue and $275 million in earnings from operations, a new metric similar to adjusted EBITDA.
Oscar also hired Janet Liang as president of Oscar Health Insurance, starting Feb. 24. She recently served at Kaiser Foundation Health Plan as group president and chief operating officer of care delivery. Liang will also serve as principal operating officer.
Alessa Quane, the insurer’s executive vice president and chief insurance officer, will leave the company, according to an 8-K filing. Steven Wolin, executive vice president and chief operating officer, resigned.
Executive Vice President and Chief Legal Officer Ranmali Bopitiya will change roles to executive vice president of public affairs. New hire Adam McAnaney will assume Bopitiya’s former position.