SC

Strategy Canon

Oscar Health: sourced choices

39 product and go-to-market choices, oldest first. Back to the case study

  1. 2013-08-19Product · Care access Telemedicine through a TeleDoc partnership promised a doctor by phone within 20 minutes with no co-pay, alongside online price comparisons. OS17
  2. 2013-08-19Go_To_Market · Target buyer Targeted young, healthy and uninsured New Yorkers through traditional and nontraditional media. OS17
  3. 2013-10-03Product · Entry product Launched on New York's exchange with four plan tiers, unlimited telephone access to doctors, free generic drugs on select plans and a search tool matching symptoms to appropriate doctors. OS16
  4. 2013-10-03Go_To_Market · Channel and capital Sold first through New York's state exchange; $29 million of a $40 million round was held in state-required reserves. OS16
  5. 2014-02-24Product · Member tools Members had a timeline of visits, symptom search with cost estimates and zero-copay generics; nearly all members had used the website and 5% used it daily. OS19
  6. 2016Product · Price position New York City silver premium averaged $449 a month over 2014 to 2016, 8.6% above the $414 market median, on a rented MagnaCare network. OS59
  7. 2016-02-24Product · Provider network Dropped Memorial Sloan Kettering, NewYork-Presbyterian affiliates including Weill Cornell, and New York Methodist from the New York network, keeping NYU- and Mount Sinai-affiliated hospitals. OS30
  8. 2016-02-24Product · Provider network Built Texas networks around Tenet and Baylor Scott & White in Dallas and Tenet's Baptist Health System in San Antonio. OS30
  9. 2016-02-24Product · Provider contracting Formed a risk-sharing network with Providence Health in Los Angeles in which both parties share costs and profits. OS30
  10. 2016-02-24Go_To_Market · Pricing Schlosser: in California 'we don't underprice. We price for a good margin'; Oscar's LA mid-level plan was $23 a month above Anthem's while its San Antonio plan was the cheapest mid-level option. OS30
  11. 2016-08-24Go_To_Market · Geography Exited Dallas and New Jersey exchanges for 2017 (33,000 enrollees) and raised New York premiums 16%. OS5
  12. 2017Go_To_Market · Segment Entered the small-group market in 2017. OS4
  13. 2017-06-21Product · Provider partnership Partnered with the Cleveland Clinic to sell individual plans in Ohio for 2018. OS29
  14. 2017-06-21Go_To_Market · Geography Filed for 2018 entry into Ohio and Tennessee, expansion in Texas and California, and a return to New Jersey; raised New York prices up to 30%. OS29
  15. 2018-11-13Go_To_Market · Broker channel Entered Florida in 2018 in four counties with 1,600 appointed agents and sued Florida Blue over exclusive broker contracts. OS18
  16. 2020Product · New line Launched Medicare Advantage plans in 2020. OS4
  17. 2020Go_To_Market · Partnership Launched co-branded Cigna + Oscar small-group plans, sold by Cigna and partially reinsured by Oscar. OS4
  18. 2021-02Product · Member service Each member assigned a Care Team, typically five Care Guides and a registered-nurse Case Manager. OS4
  19. 2021-02Product · Virtual care In-house virtual care used by 37% of members in 2020; it accounted for 19% of primary, urgent and outpatient emergency visits in Q4 2019. OS4
  20. 2021-02Product · Architecture Founders state they chose from the start to build a full-stack platform controlled end-to-end, knowing it made the startup harder. OS4
  21. 2021-03-03Go_To_Market · Capital IPO of 37 million shares at $39, raising about $1.4 billion at a $7.9 billion valuation. OS26
  22. 2022Go_To_Market · Geography Exited Arkansas and Colorado exchanges in 2022. OS37
  23. 2022-04-05Go_To_Market · Broker commissions Joined Bright, Molina and some Blue plans in stopping broker commissions on new enrollees during the 2022 low-income special enrollment period. OS57
  24. 2022-11-09Product · Retirement Exited Medicare Advantage in New York and Texas for 2023 (4,577 MA members), keeping one partner plan in Broward County, Florida. OS7
  25. 2022-11-09Product · Platform Paused new +Oscar technology-platform deals after Health First abandoned the platform over rollout problems. OS7
  26. 2022-12-21Go_To_Market · Growth control Paused new ACA enrollment in Florida for 2023 to manage growth. OS20
  27. 2023-05-10Go_To_Market · Geography Paused participation in California's individual market for 2024 because the plan had not met targets. OS24
  28. 2023-09Product · Architecture Schlosser says the company spent more time building its own claims system than on the member experience, to fix larger sources of error and friction. OS10
  29. 2024-01-10Go_To_Market · Segment Bertolini named ICHRA, employer-funded individual coverage, as Oscar's first market opportunity. OS25
  30. 2025-08-06Product · ICHRA product Launched a Hy-Vee Health-branded ICHRA plan in Des Moines with concierge care through Hy-Vee clinics. OS38
  31. 2025-08-06Go_To_Market · Acquisitions Acquired INSXCloud, IHC Specialty Benefits and healthinsurance.org to support ICHRA and individual distribution. OS38
  32. 2026-02-10Product · AI service An agentic AI assistant for care guides cut peak response times by 67%, and the Oswell member agent answers 86% of member questions. OS15
  33. 2026-02-10Product · Plan design For 2026 the membership mix shifted from 71% silver to 39% bronze, 36% silver and 25% gold after a new suite of lower-cost products. OS15
  34. 2026-02-10Go_To_Market · Pricing Weighted average 2026 rate increase of about 28%, refiled in states covering 99% of membership, assuming subsidy expiry. OS15
  35. 2026-02-13Product · Platform +Oscar's Campaign Builder engagement platform serves nearly 0.6 million client lives. OS8
  36. 2026-02-13Go_To_Market · Broker channel The vast majority of members are acquired through brokers, who typically enroll them on enhanced direct enrollment platforms; some come directly through marketplaces and Oscar's site. OS8
  37. 2026-05-06Go_To_Market · Broker enablement Gave brokers lists of affected members and product recommendations ahead of the 2026 subsidy expiry. OS39
  38. 2026-05-06Go_To_Market · ICHRA distribution Bertolini described the Lucie ICHRA marketplace as earning margin without putting up risk capital. OS39
  39. 2026-06-11Go_To_Market · Geography Offered exchange plans in 20 states for 2026, newly entering Alabama. OS21