Oscar Health's Q4 2024: Membership Growth, Pricing Strategies, and MLR Trends Under Scrutiny

These are the key contradictions discussed in Oscar Health, Inc.'s latest 2024Q4 earnings call, specifically including Membership Growth and Enrollment Dynamics, Pricing Strategy and Market Stability, and MLR Trends:



Financial Performance and Profitability:
- Oscar Health reported total company adjusted EBITDA profitability of $199 million, a $245 million year-over-year improvement, and net income of $25 million, a $296 million increase over the prior year.
- The growth was driven by strong revenue growth of 57% year-over-year to $9.2 billion, a stable medical loss ratio of 81.7%, and improved efficiency with the SG&A ratio improving by more than 500 basis points to 19.1%.

Membership Growth and Market Share:
- Oscar achieved record membership, with 1.8 million members as of February 1, 2025, up from 1.2 million members the previous year, marking a 37% increase.
- The growth was fueled by competitive pricing, technology, and superior member experience, leading to market share gains in states like Florida, Tennessee, and Texas.

Retention and Enrollment Strategy:
- Oscar maintained solid retention across its 18-state footprint, with strong enrollment in new plans like the tech-first HMO and multi-condition plan.
- The retention was supported by the company's strategic pricing and product innovation, including Spanish-first solutions that attracted more Hispanic and Latino members.

Operational Efficiency and AI Integration:
- Oscar's SG&A ratio improved by 520 basis points year-over-year to 19.1%, driven by higher fixed cost leverage and variable cost efficiencies.
- AI integration played a significant role in improving operational efficiency, with AI handling more than 50% of onboarding and post-care instructions in Oscar Urgent Care, reducing provider paperwork and speeding up care.