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What were the key takeaways from Oscar Health’s earnings call?

What does Oscar Health do and what are its main business segments?

What is Oscar Health's latest dividend and current dividend yield?

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- **Revenue surge**: 28% YoY growth to $11.7 billion, driven by 58% paid membership increase to 3 million.
- **Market dominance**: 30% market share in key markets, up from 17%, with 3.4 million total members.
- **Profitability turnaround**: 2026 earnings guidance of $250-450 million (vs. $396 million loss in 2025), enabled by 450 bps MLR improvement.
- **AI-driven efficiency**: Administrative costs down 160 bps YoY, with AI resolving 86% of member inquiries.
- **Innovation success**: New products like HelloMeno achieve 50% higher retention rates and 50% higher referral rates.
- **Risk management**: 20% risk adjustment allocation in 2026, with Wakely report to enhance market visibility.

**【CEO Summary Section】**
- Total revenue for 2025: $11.7 billion, up 28% YoY, driven by 58% YoY increase in paid membership to 3 million.
- Market share in key markets expanded to 30%, up from 17% in 2024, with 3.4 million members as of February 2026.
- Introduced innovative products like HelloMeno (menopause-focused plan) and Buena Salud (Spanish-first diabetes plan), which have 50% higher retention rates.
- AI initiatives reduced administrative costs by 160 basis points YoY, with Oswell (AI health agent) resolving 86% of member inquiries.
- 2026 outlook: Return to profitability with $250-450 million earnings from operations, up $750 million YoY.

**【CFO Financial Commentary】**
- 2025 financials: Loss from operations of $396 million (vs. $454 million prior year), adjusted EBITDA loss of $280 million.
- 2026 guidance: Revenue $18.7-19 billion (61% YoY growth), MLR 82.4-83.4% (down 450 bps YoY), SG&A expense ratio 15.8-16.3% (down 140 bps YoY).
- Risk adjustment as % of direct premiums: 20% in 2026 (vs. 18.5% in 2025), reflecting higher morbidity and new member mix.
- Capital position: $5.5 billion cash, $1 billion insurance capital surplus, $475 million revolving credit facility.

**【Q&A Highlights】**
- **Membership trends**: 400,000 passive renewals expected to churn by Q2 2026, reducing paid membership to 3 million (from 3.4 million enrolled).
- **MLR assumptions**: 2026 MLR improvement driven by 20-30% market contraction, higher deductible plans (Bronze/Gold mix up 39% and 25%), and fixed cost leverage.
- **Risk adjustment challenges**: 20% of direct premiums allocated to risk adjustment in 2026, with Wakely report to improve market visibility.
- **ICHRA growth**: Hy-Vee partnership doubled ICHRA membership, with 1-year retention rates exceeding 90%.
- **Market dynamics**: 5% YoY decline in overall market membership (23 million), but CMS data shows contraction may be at lower end of 20-30% range.

Oscar Health, Inc. (OSCR) Q4 2025 Earnings Call Transcript

- **Revenue & Growth**: Q3 2025 revenue up 23% YoY to $3B, with 2.1M members (+28% YoY). 
- **MLR Challenge**: Medical loss ratio rose to 88.5% due to higher market morbidity. 
- **2026 Pricing**: 28% rate increase to navigate 20-30% market contraction, targeting 2026 profitability. 
- **AI Innovation**: Launched Oswell AI agent and new health plans for underserved populations. 
- **Financial Strength**: $4.8B cash reserves, with $60M in 2026 cost cuts planned. 
- **Market Share**: Competitive in 30% of markets with lowest silver plan pricing.

**【CEO Summary Section】**
- **Revenue Growth**: Q3 2025 revenue reached $3 billion, a 23% year-over-year increase, driven by 2.1 million members (28% YoY growth). 
- **Market Dynamics**: MLR rose to 88.5% (380 bps YoY) due to higher market morbidity from Medicaid redeterminations and program integrity efforts. 
- **2026 Strategy**: Weighted average rate increase of 28% for 2026 plans, balancing share capture and profitability amid expected 20-30% market contraction. 
- **Innovation**: Launched Oswell AI agent for personalized health guidance, and new product lines (e.g., menopause-focused plans) to address underserved demographics. 
- **Profitability Outlook**: Targeting return to profitability in 2026 with disciplined pricing and AI-driven cost efficiencies.

**【CFO Financial Commentary】**
- **Financial Health**: $4.8 billion in cash and investments, including $541 million at parent level. Completed $410M convertible notes offering to strengthen capital position. 
- **Cost Management**: SG&A expense ratio improved to 17.5% (150 bps YoY), driven by fixed cost leverage and AI automation. 
- **Utilization Trends**: Inpatient utilization moderated, but outpatient and professional services remained elevated. 
- **2025 Guidance**: Full-year MLR expected 86.0-87.0%, with adjusted EBITDA loss of $120M. 
- **2026 Cost Actions**: $60M in administrative cost reductions planned to support margin expansion.

**【Q&A Highlights】**
- **Market Morbidity**: 2025 Wakely report showed 1.5-2% market morbidity increase, driven by FTR rechecks and Medicaid redeterminations. Company expects stable morbidity through Q4. 
- **Enrollment Early Signs**: Strong early OEP activity, with focus on $0 premium plans and broker education. 
- **Competitive Positioning**: In 30% of markets, Oscar is lowest or second-lowest silver plan, up from 15% in 2024. 
- **AI Impact**: 24 AI models in development, with first agnostic agent launched to reduce claims processing costs. 
- **Subsidy Extension**: If enhanced tax credits extended, Oscar would rebate excess profits per ACA minimum MLR rules.

Oscar Health, Inc. (OSCR) Q3 2025 Earnings Call Transcript

- **Revenue Surge**: 29% YoY growth to $2.9 billion, driven by 28% member expansion to 2 million.
- **MLR Challenge**: 91.1% MLR (up 12 pts YoY) due to higher morbidity, with $316M risk adjustment increase.
- **Cost Control**: SG&A ratio improved 90 bps to 18.7%, offsetting MLR pressure.
- **Strategic Expansion**: Acquired ICHRA assets and launched Hy-Vee-branded plan, positioning for 2026 profitability.
- **2025 Guidance**: Reaffirmed $12-12.2B revenue, MLR 86-87%, and $200-300M loss from operations.
- **2026 Outlook**: Double-digit rate increases, $60M cost savings, and return to profitability.


**【CEO Summary Section】**
- **Revenue Growth**: Q2 2025 revenue of $2.9 billion, up 29% YoY, driven by 28% YoY membership growth to 2 million members.
- **MLR Increase**: Medical loss ratio (MLR) rose to 91.1% (up 12 pts YoY) due to higher market morbidity, with risk adjustment payable increasing by $316 million.
- **SG&A Efficiency**: SG&A ratio improved to 18.7% (down 90 bps YoY) due to cost control and fixed cost leverage.
- **Strategic Acquisitions**: Acquired IHC Specialty Benefits, INSXCloud platform, and healthinsurance.org to expand ICHRA capabilities. Launched Hy-Vee-branded ICHRA plan in Iowa for 2026.
- **2026 Outlook**: Expect to return to profitability with rate increases reflecting morbidity trends and subsidy expiration. Projecting $60 million in 2026 administrative cost savings through workforce reduction.

**【CFO Financial Commentary】**
- **Financial Results**: Q2 loss from operations of $230 million (vs. $528 million YoY), adjusted EBITDA loss of $199 million (vs. $503 million YoY). Full-year 2025 guidance reaffirmed: $12-12.2 billion revenue, MLR 86-87%, SG&A 17.1-17.6%, and loss from operations $200-300 million.
- **Balance Sheet**: $5.4 billion total cash/investments, $579 million excess capital at subsidiaries. Parent cash of $205 million expected to decline in H2 due to capital contributions.
- **Risk Adjustment**: 2025 risk adjustment payable as % of premiums projected at mid-teens, consistent YoY. 2024 CMS true-up favorable by $23 million.

**【Q&A Highlights】**
- **Cash Flow & Capital**: 2025 losses expected to be absorbed by subsidiaries' excess capital. Parent cash sufficient for holding company expenses. Revolver extension underway.
- **Market Morbidity**: 2025 morbidity increase driven by Medicaid redeterminations and program integrity efforts. 2026 rate filings reflect double-digit increases to offset trends.
- **ICHRA Growth**: Hy-Vee partnership targets employers and employees in Iowa. ICHRA assets position for long-term growth despite minimal near-term impact.
- **Fraud & Utilization**: Q2 utilization moderated sequentially, with inpatient elevated but pharmacy favorable. 2026 guidance includes potential Q4 utilization spike if enhanced subsidies lapse.
- **Long-Term Targets**: Maintain 5% margin and $2.25 EPS targets for 2027, pending 2026 pricing and membership trends.


Oscar Health, Inc. (OSCR) Q2 2025 Earnings Call Transcript

- **Record Growth**: Q1 2025 revenue up 42% YoY to $3B, net income $275M (57% YoY), driven by 41% member growth to 2M.
- **Cost Efficiency**: SG&A ratio hits 15.8% (260bps YoY improvement), lowest in company history.
- **Policy Risk**: CMS rule changes may reduce 2026 enrollment by 3-9%, but Oscar maintains 2025 targets with disciplined pricing.
- **Competitive Edge**: Exiting competitor's 2026 withdrawal creates opportunity to attract members with better pricing and coverage.
- **Market Resilience**: Despite fraud concerns, strong payment rates and CMS measures suggest sustainable individual market growth.

**【CEO Summary Section】**
- **Revenue Growth**: Q1 2025 total revenue reached $3 billion, a 42% year-over-year increase, driven by 41% membership growth to 2 million effectuated members.
- **Profitability**: Net income of $275 million (up 57% YoY), operating margin improved 110bps to 9.8%, and SG&A ratio hit a record low of 15.8% (down 260bps YoY).
- **Market Dynamics**: Advocated for policy changes to sustain individual market growth, noting CMS's proposed integrity initiatives may constrain enrollment but support long-term market health.

**【CFO Financial Commentary】**
- **Financial Highlights**: Adjusted EBITDA of $329 million (up 56% YoY), with MLR at 75.4% (120bps YoY increase due to $31 million risk adjustment true-up).
- **Guidance**: Full-year 2025 revenue expected $11.2-11.3 billion, MLR 80.7-81.7%, and SG&A ratio 17.6-18.1%.
- **Balance Sheet**: $4.9 billion in cash and investments, with subsidiaries holding $1.5 billion capital (including $907 million excess capital).

**【Q&A Key Takeaways】**
- **Membership Trends**: Q1 ended with 2 million members (41% YoY growth), expecting mid-year peak before potential decline post-SEP changes.
- **Regulatory Impact**: CMS's shortened enrollment windows may reduce shopping time, but Oscar plans disciplined pricing for 2026 despite potential 3-9% enrollment drop.
- **Competitive Landscape**: Exiting competitor's 2026 withdrawal presents opportunity to attract members with disciplined pricing, while ICRA market shows early employer interest.
- **Cost Management**: 40% of SG&A improvement from fixed cost leverage, with 15% from variable efficiency, positioning for gradual quarterly SG&A increases.
- **Fraud Mitigation**: Strong payment rates (minimal churn) and CMS's new integrity measures (e.g., attestations) suggest market stabilization, though 2026 uncertainty remains.

Oscar Health, Inc. (OSCR) Q1 2025 Earnings Call Transcript

- **2024 Record Year**: $9.2B revenue (+57%), $199M EBITDA, $25M net income, 1.8M members (+37%).
- **AI-Driven Efficiency**: 520bps SG&A ratio improvement, 10+ new AI use cases cutting admin tasks by 50%.
- **2025 Targets**: 20%+ CAGR, 5% margin by 2027, $11.2-11.3B revenue, $225-275M earnings from ops.
- **Risk Management**: 1.8M paid members, 9.1% gap vs effectuated; 2025 MLR to improve 50bps YoY.
- **Growth Engine**: Employer group expansion, tech-first plans, and AI-powered care coordination.

**【CEO Summary Section】**
- **Record Financial Performance**: 2024 revenue grew 57% YoY to $9.2 billion, with adjusted EBITDA of $199 million (up $245 million YoY) and net income of $25 million. Membership reached 1.8 million, up 37% YoY.
- **Market Leadership**: Outpaced ACA individual market growth (13% YoY) with 37% YoY enrollment, driven by competitive pricing, AI-powered products (e.g., tech-first HMO, condition-focused plans), and strong retention.
- **AI Innovation**: Deployed 11 new AI use cases in 2024, reducing administrative tasks (e.g., 50% AI-powered onboarding in Urgent Care) and improving efficiency. AI tools lowered hospital readmissions by ~10% for a client.
- **2025 Outlook**: Target 20%+ CAGR and 5% operating margin by 2027, with focus on employer group penetration and scaling technology-driven growth.

**【CFO Financial Commentary】**
- **Q4 2024 Results**: Revenue $2.4 billion (+67% YoY), MLR 81.7% (+10bps YoY), adjusted EBITDA loss $113 million (flat YoY). Full year MLR stable at 81.7%, SG&A ratio improved 520bps to 19.1%.
- **2025 Guidance**: Revenue $11.2-11.3 billion (+23% YoY), MLR 80.7-81.7% (50bps YoY improvement), SG&A ratio 17.6-18.1% (125bps YoY improvement). Earnings from operations $225-275 million (+$193M YoY).
- **Balance Sheet Strength**: $4 billion cash/investments as of Dec 31, 2024, with $1.2 billion capital surplus in insurance subsidiaries.

**【Q&A Key Points】**
- **Payment Integrity Risks**: 1.8 million paid members as of Feb 1, 2025 (9.1% gap vs effectuated). Built-in risk from CMS file-to-reconcile process, but 2025 revenue guidance assumes 23% YoY growth despite potential lapses.
- **MLR Drivers**: 2024 MLR stable due to favorable utilization and prior period development ($126M full year). Q4 risk adjustment true-up added $113M to MLR.
- **AI Cost Savings**: SG&A ratio improved 520bps YoY, driven by AI initiatives (e.g., 10+ new use cases in 2025 pipeline) and operating leverage.
- **Pricing Strategy**: Disciplined approach balances growth and margin, with silver plans priced to ensure profitability. Zero-premium plans attract risk-averse consumers with low utilization.
- **2025 Growth**: Expect above-market enrollment growth (23% YoY revenue) and 50bps MLR improvement, supported by retained SEP members and maturing risk scores.

Actual	-0.98	-0.35	-1.02	-0.95	-0.36	-0.53	-0.91	-1.05	-0.18	-0.07	-0.29	-0.66	0.62	0.2	-0.22	-0.62	0.92	-0.89	-0.53	-1.24
Forecast	-0.5343	-0.468	-0.7264	-0.9785	-0.2136	-0.4787	-0.719	-1.1353	-0.0605	-0.2215	-0.4725	-0.7225	0.272	0.1617	-0.1714	-0.5901	0.7927	-0.8092	-0.5439	-0.8947
Surprise	-83.42%	+25.21%	-40.42%	+2.91%	-68.54%	-10.72%	-26.56%	+7.51%	-197.52%	+68.40%	+38.62%	+8.65%	+127.94%	+23.69%	-28.35%	-5.07%	+16.06%	-9.99%	+2.56%	-38.59%

OSCR

OSCR fundamentals

OSCR Q4 2025 Earnings

Earnings Call

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OSCR

OSCR fundamentals

OSCR Q4 2025 Earnings

Earnings Call

OSCR Earnings Call Summary for Q4/20258:00 AM on Feb 10, 2026

OSCR Earnings Call Summary for Q3/20258:00 AM on Nov 6, 2025

OSCR Earnings Call Summary for Q2/20258:00 AM on Aug 6, 2025

OSCR Earnings Call Summary for Q1/20258:00 AM on May 7, 2025

OSCR Earnings Call Summary for Q4/20245:00 PM on Feb 4, 2025

You can ask Aime