Latest news with #MarkBertolini
Axios
15-05-2025
- Health
- Axios
WATCH: Axios interviews Sen. Baldwin, Katie Couric and Calley Means
Tune into Axios' inaugural Future of Health Summit happening live from Washington, D.C. We are hosting conversations with Rep. Greg Murphy (R-N.C.), Oscar Health CEO Mark Bertolini, award-winning journalist Katie Couric, Zocdoc CEO and co-founder Oliver Kharraz, Hers chief medical officer Jessica Shepherd, Sen. Tammy Baldwin (D-Wis.), senior White House advisor on MAHA Calley Means and Children's National Hospital's Anthony David Sandler.
Yahoo
10-05-2025
- Business
- Yahoo
Why Oscar Health, Inc. (OSCR) Skyrocketed This Week
We recently published a list of . In this article, we are going to take a look at where Oscar Health, Inc. (NYSE:OSCR) stands against other stocks that moved the market this week. The stock market edged lower week-on-week, as cautious investors repositioned their portfolios ahead of the United States and China's high-stakes negotiations on trade policies that have for months dented global economies. On a week-on-week basis, the Dow Jones was down by 0.16 percent, the S&P 500 dropped 0.47 percent, while the Nasdaq dipped by 0.27 percent. Beyond the major indices, 10 companies bucked a wider market decline, with gains skyrocketing in just a week's trading. In this article, we name the 10 top-performing companies this week and the primary reasons that bolstered their gains. To come up with the list, we considered only the stocks with a $2-billion market capitalization and $5-million trading volume. The stocks were chosen based on the highest percentage increase in closing prices on May 9 as against their prices a week earlier, or on May 2. A close up of a patient and a healthcare professional engaging in conversation, showing the company's commitment to patient care. Oscar Health Inc. grew its share prices by 29.6 percent week-on-week to $17.11 last Friday from $13.20 a week earlier, following a strong earnings performance in the first three months of the year. During the period, Oscar Health, Inc. (NYSE:OSCR) said it achieved a 55-percent increase in net income attributable to the company, at $275 million versus the $177 million in the same period last year. Revenues were also higher by 42 percent to $3.05 billion from $2.14 billion year-on-year. Membership similarly grew by 40.8 percent to 2.039 million from 1.448 million in the same period a year ago. 'We continue to expect meaningful margin expansion this year as we deliver superior value to our members and partners,' said Oscar Health, Inc. (NYSE:OSCR) CEO Mark Bertolini, adding that the company has reaffirmed its full year 2025 outlook across all metrics. Oscar Health, Inc. (NYSE:OSCR) expects revenues between $11.2 billion and $11.3 billion and operational earnings of $225 million to $275 million. Overall, OSCR ranks 6th on our list of stocks that moved the market this week. While we acknowledge the potential of OSCR as an investment, our conviction lies in the belief that AI stocks hold greater promise for delivering higher returns and doing so within a shorter time frame. There is an AI stock that went up since the beginning of 2025, while popular AI stocks lost around 25%. If you are looking for an AI stock that is more promising than OSCR but that trades at less than 5 times its earnings, check out our report about this . READ NEXT: 20 Best AI Stocks To Buy Now and 30 Best Stocks to Buy Now According to Billionaires. Disclosure: None. This article is originally published at Insider Monkey. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
09-05-2025
- Business
- Yahoo
Aetna ACA exit is bad for marketplace, good for Oscar: CEO Bertolini
Oscar Health (OSCR) CEO Mark Bertolini has helped lead the insurance tech company into a period of consistent profitability after years of losses. The veteran health insurance executive has become an industry advocate for change, calling the existing employer-sponsored insurance market broken. He told Yahoo Finance in an interview Thursday that healthcare is the only place in the economy where individuals lack choice over decisions. "I know what my concerns are for my health, I know what I need, why am I having to go through the insurance company to get it approved?" Bertolini said. It's why Oscar has worked on accessing health services through its technology-enabled platforms. The company boasts a long-time relationship with OpenAI ( which has helped it create plans and products that are "frictionless," Bertolini said. "Those frictionless care models allow me to get what I need, on my terms, at my cost," he said. "Everywhere else in our economy, we can get that." But not in healthcare, where insurance plans are designed by employers for maximum options to cater to the diverse needs of the employee population — which raises the overall cost of insurance. Bertolini, formerly the CEO of Aetna (CVS), said this is why the narrow networks and lower cost options in the Affordable Care Act marketplace are better for individuals. And why Aetna's exit isn't good for the market. "The more players in the market, the better, in large part because everyone has narrow networks ... [which] allow you to get a lower price point, because you're moving revenue to fewer players," Bertolini said. That also helps keep insurers profitable, as it balances the number of high-cost and low-cost patients in the mix at any given time. "Our view is we don't need to get all the members," Bertolini said. "We want the members that need our products and our networks. We want to serve them well at a price point that, for the last three years, has been at or below the cost of inflation." Still, Aetna's exit bodes well for Oscar, which had "significant overlap" with them, Bertolini said on an earnings call Wednesday. "We view that as an opportunity to help people maintain their coverage at a level of pricing that we find disciplined and competitive in the marketplace," he said. Anjalee Khemlani is the senior health reporter at Yahoo Finance, covering all things pharma, insurance, care services, digital health, PBMs, and health policy and politics. That includes GLP-1s, of course. Follow Anjalee as AnjKhem on social media platforms X, LinkedIn, and Bluesky @AnjKhem.
Forbes
07-05-2025
- Business
- Forbes
Oscar Health Profits Exceed $275 Million As Obamacare Enrollment Soars
Oscar Health reported a $275 million in first quarter profits as the health insurer's ... More enrollment hit yet another record, surpassing two million individual and small group members, the company said Wednesday May 7. Oscar Health Oscar Health reported a $275 million first quarter profit as the health insurer's enrollment hit yet another record, surpassing two million individual and small group members. The provider of individual coverage under the Affordable Care Act, also known as Obamacare, Wednesday reported net income of $275.3 million, or 92 cents a share, for the first quarter ended March 31 compared to $177.4 million, or 62 cents a share in the first quarter of last year. The continuing financial improvement of Oscar comes a little more than two years after the health insurer hired Mark Bertolini as chief executive officer. Founded in 2012, Oscar didn't become profitable until last year, but Bertolini – the former CEO of Aetna who was tapped as Oscar's top executive in March of 2023 – and his team have delivered on their promises as they remain bullish on the individual health insurance market. Oscar ended the first quarter with about 2 million total health plan members, which was up more than 40% over the year-ago quarter when the company had about 1.4 million individual and small group members. Oscar said the growth included both 'solid retention and new membership growth.' That big increase in growth contributed to a 42% increase in revenue to $3 billion in the first quarter compared to $2.1 billion in the year-ago period. 'Oscar reported strong financial results in the first quarter,' Bertolini said. Oscar, which benefited from the influx of Americans who signed up for Obamacare last year, provides health benefits in 18 states. 'We delivered continued top-line growth and bottom-line performance with significant year-over-year increases in revenue and net income,' Bertolini said. 'We continue to expect meaningful margin expansion this year as we deliver superior value to our members and partners.' Even as Oscar grows its membership, the company is also keeping its costs relatively in check at a time rivals have been struggling with rising medical expenses. Oscar's medical loss ratio, which is the percentage of premium revenue that goes toward medical costs, rose slightly to 75.4% in the first quarter compared to 74.2% in the year-ago period. Whether such Obamacare momentum and growth continues after this year in the broader market is uncertain. Enhanced subsidies many Obamacare enrollees used to buy coverage is set to expire at the end of this year, and Donald Trump and Republicans in Congress may be unwilling to spend the money to extend them. That debate is expected to take place in the coming weeks as Congress works on a budget.
Yahoo
05-02-2025
- Business
- Yahoo
Oscar Health Inc (OSCR) Q4 2024 Earnings Call Highlights: Record Revenue and First-Time ...
Total Revenue: Increased 57% year-over-year to $9.2 billion. Adjusted EBITDA: Achieved profitability at $100 million, a $245 million year-over-year improvement. Net Income: Reached $25 million, a $296 million increase over the prior year. Medical Loss Ratio (MLR): Stable year-over-year, increasing 10 basis points to 81.7%. SG&A Ratio: Improved by more than 500 basis points year-over-year to 19.1%. Fourth Quarter Revenue: Increased 67% year-over-year to approximately $4 billion. Fourth Quarter Adjusted EBITDA Loss: Approximately $113 million, flat year-over-year. Cash and Investments: Ended the year with $4 billion, including $190 million at the parent. Capital and Surplus: Insurance subsidiaries had approximately $1.2 billion, including $774 million of excess capital. Warning! GuruFocus has detected 5 Warning Sign with ASX:BWP. Release Date: February 04, 2025 For the complete transcript of the earnings call, please refer to the full earnings call transcript. Oscar Health Inc (NYSE:OSCR) reported its strongest financial performance in history, achieving adjusted EBITDA profitability of $100 million, a $245 million improvement year-over-year. The company achieved net income profitability for the first time, with a net income of $25 million, marking a $296 million increase over the previous year. Total revenue grew by 57% year-over-year to $9.2 billion, driven by record high membership and strong retention. Oscar Health Inc (NYSE:OSCR) experienced significant market share gains, particularly in key states like Florida, Tennessee, and Texas, and performed well in new geographies such as North Carolina. The company's technology platform, with AI integration, is enhancing operational efficiency and member engagement, reducing provider administrative tasks, and improving care delivery. The fourth quarter medical loss ratio (MLR) increased by 170 basis points year-over-year, indicating some pressure on profitability. Oscar Health Inc (NYSE:OSCR) faced challenges with risk adjustment settlements, which impacted both MLR and revenue. The company anticipates a 9.1% impact of effectuation against actual paying members, reflecting potential enrollment declines. There is a potential risk of attrition throughout the year as members may gain employment or stop paying premiums. Oscar Health Inc (NYSE:OSCR) is making investments in SG&A to accelerate growth, which may impact short-term profitability despite long-term benefits. Q: Can you discuss the impact of payment integrity issues and reverification programs on enrollment and effectuation rates? A: Mark Bertolini, CEO, explained that Oscar Health is tracking actual numbers of members who have paid their premiums, which stands at 1.8 million. This reflects a 9.1% impact of effectuation against the gross number of 1.98 million members. Scott Black (Trades, Portfolio), CFO, added that the effectuation rates are consistent year-over-year, and the company has incorporated potential risks from payment integrity issues into their revenue guidance. Q: Why did the Medical Loss Ratio (MLR) come in above the high end of guidance, and are there any changes to interest expenses with the shift to earnings from operations? A: Mark Bertolini noted that utilization was as expected, and the MLR increase was due to risk adjustment settlements. Scott Black (Trades, Portfolio) added that the MLR pressure was driven by updated accruals based on risk reports, and the biggest difference between adjusted EBITDA and earnings from operations will be stock compensation and depreciation, with interest expenses expected to remain consistent. Q: Can you clarify the 2025 guidance for earnings from operations and its relation to EBITDA? A: Scott Black (Trades, Portfolio) confirmed that the top end of the guidance for earnings from operations is $275 million, with an additional $140 million leading to an adjusted EBITDA of around $415 million. This aligns with the Street's expectations. Q: What is the retention rate for SEP lives, and are there any dynamics that might affect the expected MLR improvement in 2025? A: Scott Black (Trades, Portfolio) stated that retention was solid, and the company expects the SEP cohort to have an MLR in 2025 similar to the rest of the open enrollment. The risk scores for the SEP population will mature, contributing to the expected MLR improvement. Q: How does Oscar's pricing strategy ensure enrollment of active and intentional premium-paying members? A: Scott Black (Trades, Portfolio) explained that Oscar maintains a disciplined pricing strategy to balance growth and margin creation. The company works with CMS to ensure valid member enrollment and actively monitors brokers for irregularities, reporting any concerns to CMS. For the complete transcript of the earnings call, please refer to the full earnings call transcript. This article first appeared on GuruFocus. Sign in to access your portfolio
