In This Article:
-
Total Revenue: Increased 57% year-over-year to $9.2 billion.
-
Adjusted EBITDA: Achieved profitability at $100 million, a $245 million year-over-year improvement.
-
Net Income: Reached $25 million, a $296 million increase over the prior year.
-
Medical Loss Ratio (MLR): Stable year-over-year, increasing 10 basis points to 81.7%.
-
SG&A Ratio: Improved by more than 500 basis points year-over-year to 19.1%.
-
Fourth Quarter Revenue: Increased 67% year-over-year to approximately $4 billion.
-
Fourth Quarter Adjusted EBITDA Loss: Approximately $113 million, flat year-over-year.
-
Cash and Investments: Ended the year with $4 billion, including $190 million at the parent.
-
Capital and Surplus: Insurance subsidiaries had approximately $1.2 billion, including $774 million of excess capital.
Release Date: February 04, 2025
For the complete transcript of the earnings call, please refer to the full earnings call transcript.
Positive Points
-
Oscar Health Inc (NYSE:OSCR) reported its strongest financial performance in history, achieving adjusted EBITDA profitability of $100 million, a $245 million improvement year-over-year.
-
The company achieved net income profitability for the first time, with a net income of $25 million, marking a $296 million increase over the previous year.
-
Total revenue grew by 57% year-over-year to $9.2 billion, driven by record high membership and strong retention.
-
Oscar Health Inc (NYSE:OSCR) experienced significant market share gains, particularly in key states like Florida, Tennessee, and Texas, and performed well in new geographies such as North Carolina.
-
The company's technology platform, with AI integration, is enhancing operational efficiency and member engagement, reducing provider administrative tasks, and improving care delivery.
Negative Points
-
The fourth quarter medical loss ratio (MLR) increased by 170 basis points year-over-year, indicating some pressure on profitability.
-
Oscar Health Inc (NYSE:OSCR) faced challenges with risk adjustment settlements, which impacted both MLR and revenue.
-
The company anticipates a 9.1% impact of effectuation against actual paying members, reflecting potential enrollment declines.
-
There is a potential risk of attrition throughout the year as members may gain employment or stop paying premiums.
-
Oscar Health Inc (NYSE:OSCR) is making investments in SG&A to accelerate growth, which may impact short-term profitability despite long-term benefits.
Q & A Highlights
Q: Can you discuss the impact of payment integrity issues and reverification programs on enrollment and effectuation rates? A: Mark Bertolini, CEO, explained that Oscar Health is tracking actual numbers of members who have paid their premiums, which stands at 1.8 million. This reflects a 9.1% impact of effectuation against the gross number of 1.98 million members. Scott Black (Trades, Portfolio), CFO, added that the effectuation rates are consistent year-over-year, and the company has incorporated potential risks from payment integrity issues into their revenue guidance.