This conference call transcript was computer generated and almost certianly contains errors. This transcript is provided for information purposes only.EarningsCall, LLC makes no representation about the accuracy of the aforementioned transcript, and you are cautioned not to place undue reliance on the information provided by the transcript.

Oscar Health, Inc.
11/7/2024
You will have the opportunity to ask questions during the Q&A session. And if you would like to ask a question, please press star 1 on your telephone keypad to raise your hand and join the queue. If you would like to withdraw your question, press star 1 again. Thank you. I will now turn the conference over to Chris Potichar, Vice President of Treasury and Investor Relations.
Good morning, everyone. Thank you for joining us for our third quarter 2024 earnings call. Mark Bertolini, Oscar's Chief Executive Officer, and Scott Blackley, Oscar's Chief Financial Officer, will host this morning's call. This call can also be accessed through our investor relations website at ir.highoscar.com. Full details of our results and additional management commentary are available in our earnings release, which can be found on our investor relations website at ir.highoscar.com. Any remarks that Oscar makes about the future constitute forward-looking statements within the meaning of safe harbor provisions under the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors, including those discussed in our quarterly report on Form 10-Q for the period ended June 30, 2024, filed with the Securities and Exchange Commission, and other filings with the SEC, including our quarterly report on Form 10-Q for the quarterly period ended September 30, 2024, to be filed with the SEC. Such forward-looking statements are based on current expectations as of today. OSCAR anticipates that subsequent events and developments may cause estimates to change. While the company may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so. The call will also refer to certain non-GAAP measures. A reconciliation of these measures to the most directly comparable GAAP measures can be found in the third quarter earnings press release available on the company's investor relations website at ir.highoscar.com. With that, I would like to turn the call over to our CEO, Mark Berlini.
Good morning. Thank you, Chris, and thank you all for joining us. This morning, Oscar reported positive third quarter results. Our strong results were driven by above-market growth disciplined execution, and improved financial performance. Underlying our third quarter results, we reported revenue of $2.4 billion, a 68% increase year over year. Our medical loss ratio increased 80 basis points to 84.6%, with overall utilization modestly favorable relative to our expectations. We achieved total company-adjusted EBITDA of $312 million year to date, representing a $246 million increase year over year. In addition, we reported a year-to-date profit of $179 million, a $300 million improvement over the same period of last year. Oscar is executing against our plan and driving profitable growth. We remain on track to deliver total company adjusted EBITDA profitability and also expect to achieve net income profitability this year. Our strong momentum sets a solid foundation for 2025 and positions us to achieve at least 20% revenue CAGR and 5% operating margin by 2027. Scott will review our third quarter results in a few moments. First, I will cover key business highlights. Oscar closed the first nine months of 2024 with approximately 1.65 million members, a 68% increase year over year. We added more than 73,000 members in the quarter as SEP additions further decelerated. We continue to expect MLR performance of SEP members to be a tailwind in 2025 as we retain these members and engage them through our technology. Our technology is also further optimizing our operations as we grow. In the quarter, we prototyped an AI tool that extracts data to prevent fraud, waste, and abuse. We also launched AI programs for OSCAR providers to enhance member speed to care, including a clinical intake bot that gathers information for quicker diagnoses, and a feature that pre-populates preventative screening recommendations based on medical history. Our technology continues to enhance our growth and position us to efficiently scale the business. We continue to expect double-digit ACA market growth through the 2025 open enrollment period year over year. The OSCQR experience will now be available to more individuals, families, and businesses in new markets across our 18 state footprint. OSCAR's expansion increases our total addressable lives to approximately 11 million, an increase of 700,000 lives year over year. Our average rate increase is approximately 6%, compared to 7% for the overall market. We priced for trend and expect that our discipline pricing strategy and total cost of care initiatives will drive meaningful margin expansion next year. OSCAR is giving our fast-growing and diverse member base more health insurance choices in this open enrollment. First, we launched a new multi-condition plan that helps members manage diabetes, pulmonary, and cardiovascular diseases together, which can save members 25% or more. The solution builds from our diabetes care plan, which has reduced member costs and is a strong performer in our book. Second, we introduced a tech-first HMO that delivers frictionless experiences. Our technology addresses known pain points for members and providers. like no other HMOs before it. The product gives us an opportunity to access new member segments across markets. Third, we rolled out a new Spanish first solution, Buena Salud, which builds on the success of our Hola Oscar program. The solution prioritizes the preferences of Hispanics and Latinos who make up nearly one-third of our member base, connecting them to a healthcare community that shares their cultural heritage. Finally, we are making OSCQR the carrier of choice for employers through ICRA. Employers can now offer defined contributions to their employees to access OSCQR's suite of products. We are working with a variety of ICRA platforms to transition mid- and large-size employers to the individual market. Industries with large populations of part-time independent and gig workers are prime candidates. In addition, our team is partnering with Stretch Dollar to help small businesses with fewer than 50 employees access the ACA and drive employee sign-ups during open enrollment. Most of this group is either new to insurance or is facing double-digit rate increases on their small group plans. The ACA has created the largest risk pool in the industry with significantly lower cost trend and is an attractive option for businesses of all sizes. In summary, our plan is working. OSCAR is on a clear path to sustainable growth and profitability. Our consistent execution positions us to achieve our 2024 targets. OSCAR has multiple pathways to achieve our long-term strategic goals, and we are becoming a large-scale player. We are maturing our markets, strategically growing in new markets, and attracting new consumer segments. I am confident in our growth. I am confident in the OSCAR team. I am confident about the future of the individual market. OSCAR's continued expansion underscores the value of the ACA for Americans across party lines. We are building a consumer marketplace that meets expectations for choice, quality, and affordability. People want the freedom to buy and use health insurance products tailored to their needs, like they do in every other part of their lives. That is what the OSCAR experience is all about and what our steps toward a larger individual market creates for individuals, families, and businesses. Before I close, I want to thank the OSCQR team for their hard work in kicking off what I am sure will be a successful open enrollment. We look forward to continuing to deliver strong results. I will now turn the call over to Scott. Scott?
You're reading a preview of the OSCR Q3 2024 earnings call.
Free account.