Oscar set to begin enrolling members in Florida after temporary pause on sign-ups

Oscar Health is now able to begin enrolling new members in Florida after pressing pause on sign-ups in December, executives said Tuesday.

Sid Sankaran, chief financial officer, said on Oscar's second-quarter earnings call that enrolling members in the Sunshine State again will amount to "standard business as usual." The company initially sought to limit growth in the state amid changing market dynamics and other carriers exiting various regions.

Sankaran added that working with Florida regulators to achieve this temporary pause on enrollment was smooth.

"We're very grateful for everyone's support as we have reentered Florida," he said.

The company reported Tuesday that it brought in $1.5 billion in revenue for the second quarter, up from $1 billion in the prior-year quarter. It also significantly slimmed it losses year over year, reporting a loss of $15.5 million in the second quarter of 2023 compared to $112.2 million in the second quarter of 2022.

Through the first half of 2023, Oscar reported $3 billion in revenue and a $55.3 million loss. In the first six months of last year, it posted $2.2 billion in revenue and a $187.3 million loss.

CEO Mark Bertolini, who stepped into the role in April, said he has spent the initial months in the chief executive's office taking a deep dive into its operations to identify where Oscar has the most potential for growth and value creation.

He said part of that process has led to multiple new hires at the company. Two new leaders at Oscar were not formally named on the call, but he said he "worked closely with both individuals" during his time at Aetna.

In addition, Sankaran will step down from the CFO position on Aug. 13, and Oscar will promote R. Scott Blackley, its current chief transformation officer, to the role. Bertolini said the insurer conducted a robust hiring process and determined the company already had "the best person to take on that role internally."

Bertolini said he would present a more thorough look at the company's long-term prognosis at its investor conference next year.

In addition to the news about enrollments restarting in Florida, Oscar executives offered a look at how the company is approaching the use of artificial intelligence. Mario Schlosser, co-founder and chief technology officer at Oscar, offered a few examples of where it's deploying the tech.

In one initiative, the company is using an AI bot to break down data from system logs and PDFs to track the cost of different procedures and how the claims were paid out. This enables its administrative teams to quickly identify any concerns and troubleshoot issues reported by providers or members.

"That's a very nifty example because it relies on the smart claims system," Schlosser said.

The company is also building automation tools in its Campaign Builder platform through GPT. That platform is the first under the insurers' relaunched +Oscar initiative, and Bertolini said it's drawn notable interested so far, with 235,000 unique patients active in the tool.

Expanding +Oscar's "modular approach" will be a key component of the company's long-term strategy, he said.