Oscar Health Well-Positioned To Manage Market Reset, Eyes Profitability In 2026
The sales increase was primarily driven by higher membership, partially offset by an increase in net risk adjustment transfer accrual.
The healthcare technology company reported a loss of 89 cents per share, missing the consensus estimate of 86 cents.'We believe the individual market has long-term upside and is the future of healthcare,' said Mark Bertolini, CEO of Oscar Health. 'Oscar is well-positioned to manage through the market reset in 2025. We believe the market will stabilize next year, and expect to return to profitability in 2026.'
The medical loss ratio was 91.1% for the second quarter of 2025, compared to 79.0% for the same quarter in 2024, primarily driven by an increase in average market morbidity that led to a higher net risk adjustment transfer accrual.
The SG&A expense ratio was 18.7% as compared to 19.6%. The decrease was primarily due to lower exchange fee rates and greater fixed cost leverage, partially offset by the impact of higher risk adjustment as a percentage of premium.
Medical expenses jumped from $1.71 billion to $2.55 billion during the quarter.
Loss from operations was $230.5 million compared to a gain from operations of $67.8 million a year ago.
View more earnings on OSCR
Adjusted EBITDA loss was $199.4 million versus positive Adjusted EBITDA of $104.1 million for the second quarter of 2024.
Total membership jumped from 1.58 million to 2.03 million in the quarter.
The company reported an operating loss of $230.48 million and a net loss of $228.36 million, in line with preliminary loss from operations of approximately $230 million and a net loss of roughly $228 million for the second quarter of 2025.
'The individual market is a competitive healthcare marketplace that provides affordable, high-quality coverage for millions of consumers across the country. We are taking appropriate pricing actions for 2026 that reflect higher acuity in the individual market...,' Bertolini said in a July statement.
Guidance: Oscar Health reaffirms its fiscal 2025 sales guidance of $12 billion to $12.2 billion, compared to the Wall Street estimate of $11.32 billion.
The company expects a 2025 medical loss ratio of 86%-87%, an SG&A expense ratio of 17.1%-17.6%, and an operating loss of $ 200 million to $300 million.
The company expects an Adjusted EBITDA loss of approximately $120 million, less than the operating loss.
Price Action: OSCR stock is down 3.18% at $13.38 during the premarket session at the last check on Wednesday.
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This article Oscar Health Well-Positioned To Manage Market Reset, Eyes Profitability In 2026 originally appeared on Benzinga.com
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