Oscar Health Announces Fourth Quarter and Full Year 2024 Results; Introduces Full Year 2025 Outlook
Oscar Health (NYSE: OSCR) reported its strongest financial performance in company history for 2024, achieving profitability for the first time. Total revenue reached $9.2 billion, up 56.5% year-over-year, driven by membership growth during Open Enrollment and Special Enrollment Period additions.
Key financial metrics include a Medical Loss Ratio of 81.7% (10 bps increase YoY), SG&A Expense Ratio of 19.1% (520 bps improvement YoY), and net income of $25.4 million ($0.10 per diluted share). Adjusted EBITDA was $199.2 million, improving by $244.5 million YoY.
For 2025, Oscar projects revenue between $11.2-11.3 billion, Medical Loss Ratio of 80.7-81.7%, and SG&A Expense Ratio of 17.6-18.1%. The company also announced Janet Liang will join as President of Oscar Health Insurance on February 24, 2025.
Oscar Health (NYSE: OSCR) ha riportato il suo miglior risultato finanziario nella storia dell'azienda per il 2024, raggiungendo per la prima volta la redditività. Il fatturato totale ha raggiunto i 9,2 miliardi di dollari, con un aumento del 56,5% rispetto all’anno precedente, trainato dalla crescita degli iscritti durante il periodo di Open Enrollment e dalle aggiunte nei Periodi di Iscrizione Speciale.
I principali indicatori finanziari includono un Medical Loss Ratio del 81,7% (un aumento di 10 punti base rispetto all'anno precedente), un SG&A Expense Ratio del 19,1% (un miglioramento di 520 punti base anno su anno) e un reddito netto di 25,4 milioni di dollari (0,10 dollari per azione diluita). L'EBITDA rettificato è stato di 199,2 milioni di dollari, migliorando di 244,5 milioni di dollari rispetto all'anno precedente.
Per il 2025, Oscar prevede un fatturato tra 11,2 e 11,3 miliardi di dollari, un Medical Loss Ratio tra l'80,7 e l'81,7% e un SG&A Expense Ratio tra il 17,6 e il 18,1%. L'azienda ha anche annunciato che Janet Liang entrerà come Presidente di Oscar Health Insurance il 24 febbraio 2025.
Oscar Health (NYSE: OSCR) reportó su mejor desempeño financiero en la historia de la empresa para 2024, logrando rentabilidad por primera vez. Los ingresos totales alcanzaron los 9.2 mil millones de dólares, un aumento del 56.5% interanual, impulsados por el crecimiento de la membresía durante el período de Inscripción Abierta y las adiciones durante los Períodos de Inscripción Especial.
Los principales métricas financieras incluyen una Tasa de Pérdidas Médicas del 81.7% (un aumento de 10 puntos básicos interanual), una Tasa de Gastos SG&A del 19.1% (mejora de 520 puntos básicos interanuales) y un ingreso neto de 25.4 millones de dólares (0.10 dólares por acción diluida). El EBITDA ajustado fue de 199.2 millones de dólares, mejorando en 244.5 millones de dólares interanuales.
Para 2025, Oscar proyecta ingresos entre 11.2 y 11.3 mil millones de dólares, una Tasa de Pérdidas Médicas del 80.7% al 81.7% y una Tasa de Gastos SG&A del 17.6% al 18.1%. La compañía también anunció que Janet Liang se unirá como Presidenta de Oscar Health Insurance el 24 de febrero de 2025.
오스카 헬스 (NYSE: OSCR)는 2024년 회사 역사상 가장 강력한 재무 성과를 보고했으며, 처음으로 수익성을 달성했습니다. 총 수익은 92억 달러에 달하며, 전년 대비 56.5% 증가했습니다. 이는 오픈 등록 기간 및 특별 등록 기간의 회원 수 증가에 힘입은 결과입니다.
주요 재무 지표로는 81.7%의 의료 손실 비율(전년 대비 10bp 증가), 19.1%의 SG&A 비용 비율(전년 대비 520bp 개선), 그리고 2540만 달러(희석 주당 0.10달러)의 순이익 등이 있습니다. 조정된 EBITDA는 1억 9920만 달러로, 전년 대비 2억 4450만 달러 개선되었습니다.
2025년 오스카는 112억에서 113억 달러 사이의 수익을 예상하며, 의료 손실 비율은 80.7%에서 81.7% 사이, SG&A 비용 비율은 17.6%에서 18.1% 사이가 될 것이라고 전망하고 있습니다. 회사는 또한 재닛 리앙이 2025년 2월 24일 오스카 헬스 보험의 사장으로 합류할 것이라고 발표했습니다.
Oscar Health (NYSE: OSCR) a annoncé sa meilleure performance financière de l'histoire de l'entreprise pour 2024, atteignant la rentabilité pour la première fois. Le chiffre d'affaires total a atteint 9,2 milliards de dollars, en hausse de 56,5 % par rapport à l'année précédente, grâce à la croissance des adhérents pendant la période d'inscription ouverte et aux ajouts lors des périodes d'inscription spéciales.
Les principaux indicateurs financiers comprennent un ratio de pertes médicales de 81,7 % (augmentation de 10 points de base par rapport à l'année précédente), un ratio de dépenses SG&A de 19,1 % (amélioration de 520 points de base par rapport à l'année précédente) et un bénéfice net de 25,4 millions de dollars (0,10 dollar par action diluée). Le EBITDA ajusté s'élevait à 199,2 millions de dollars, en amélioration de 244,5 millions de dollars d'une année sur l'autre.
Pour 2025, Oscar prévoit un chiffre d'affaires entre 11,2 et 11,3 milliards de dollars, un ratio de pertes médicales de 80,7 à 81,7 % et un ratio de dépenses SG&A de 17,6 à 18,1 %. L'entreprise a également annoncé que Janet Liang rejoindra Oscar Health Insurance en tant que présidente le 24 février 2025.
Oscar Health (NYSE: OSCR) hat für das Jahr 2024 die beste finanzielle Leistung in der Unternehmensgeschichte gemeldet und zum ersten Mal Rentabilität erreicht. Der Gesamtumsatz betrug 9,2 Milliarden Dollar, was einem Anstieg von 56,5% im Vergleich zum Vorjahr entspricht, bedingt durch das Mitgliederwachstum während der offenen Einschreibung und zusätzliche Mitglieder während der Sonderanmeldungsperioden.
Wichtige finanzielle Kennzahlen umfassen eine Medical Loss Ratio von 81,7% (10 Basispunkte Anstieg im Jahresvergleich), eine SG&A Expense Ratio von 19,1% (520 Basispunkte Verbesserung im Jahresvergleich) und einen Nettogewinn von 25,4 Millionen Dollar (0,10 Dollar pro verwässerter Aktie). Das bereinigte EBITDA betrug 199,2 Millionen Dollar, was einer Verbesserung um 244,5 Millionen Dollar im Jahresvergleich entspricht.
Für 2025 prognostiziert Oscar einen Umsatz zwischen 11,2 und 11,3 Milliarden Dollar, eine Medical Loss Ratio zwischen 80,7% und 81,7% sowie eine SG&A Expense Ratio zwischen 17,6% und 18,1%. Das Unternehmen gab außerdem bekannt, dass Janet Liang am 24. Februar 2025 als Präsidentin von Oscar Health Insurance eintritt.
- First-time profitability with net income of $25.4 million in 2024
- Revenue grew 56.5% to $9.2 billion YoY
- Adjusted EBITDA improved by $244.5 million to $199.2 million
- SG&A Expense Ratio improved significantly by 520 bps to 19.1%
- Total membership increased to 1.67 million from 1.03 million YoY
- Projected revenue growth to $11.2-11.3 billion for 2025
- Medical Loss Ratio increased by 10 bps to 81.7%
- Q4 2024 showed net loss of $153.5 million
- Medicare Advantage membership dropped to zero from 1,781 members
- Cigna+Oscar partnership membership decreased to 40,570 from 67,500
Insights
Oscar Health's transformation from a loss-making insurtech to achieving profitability marks a pivotal moment in the company's evolution. The dramatic improvement in bottom-line metrics - including a
The company's operational excellence is evident in several key metrics:
- The significant reduction in SG&A Expense Ratio (520 basis points improvement) indicates successful scaling of operations and cost control measures
- Membership growth to 1.67 million members showcases strong market penetration while maintaining a stable Medical Loss Ratio
- The 2025 guidance projects continued momentum with an anticipated further improvement in the SG&A Expense Ratio to
17.6-18.1%
The appointment of Janet Liang as President of Oscar Health Insurance adds strategic depth to the leadership team. Her experience at Kaiser Foundation Health Plan brings valuable operational expertise in managing large-scale healthcare operations, which will be important for Oscar's next growth phase.
The company's ability to maintain profitability while growing rapidly is particularly impressive in the competitive health insurance market. The projected Earnings from Operations of
Oscar's performance metrics reveal sophisticated risk management capabilities that are increasingly rare in the health insurance sector. The stable Medical Loss Ratio of
- Effective actuarial pricing strategies that accurately predict healthcare utilization patterns
- Successful risk adjustment management, despite increased transfers affecting the MLR
- Strong member acquisition strategies that maintain a balanced risk pool
The company's strategic focus on the Individual and Small Group segment, which grew to 1.63 million members, while reducing Medicare Advantage exposure, demonstrates a clear understanding of market opportunities and core competencies. The decline in Cigna+Oscar membership suggests a deliberate portfolio optimization strategy.
The 2025 guidance targeting an MLR range of
Reports Adjusted EBITDA and Net Income Profitability for the First Time in Company History
-
For the year ended December 31, 2024:
-
Total Revenue of
$9.2 billion 56.5% increase year-over-year -
Medical Loss Ratio of
81.7% , a 10 bps increase year-over-year -
SG&A Expense Ratio of
19.1% , a 520 bps improvement year-over-year -
Net income attributable to Oscar of
$25.4 million $0.10 $296.2 million -
Adjusted EBITDA of
$199.2 million $244.5 million
-
Total Revenue of
“Oscar reported positive full year 2024 results, capping the strongest year of financial performance in Company history,” said Mark Bertolini, CEO of Oscar Health. “We reported both Adjusted EBITDA and net income profitability – two significant milestones. Our strong top and bottom line performance, all-time-high-membership, and consistent execution demonstrate our ability to deliver sustained profitable growth.”
Total Revenue for 2024 was
The Medical Loss Ratio for 2024 increased 10 bps year-over-year to
Adjusted EBITDA for 2024 of
The Company is introducing its outlook for 2025 including a new metric, Earnings from Operations. For 2025, the Company anticipates Total Revenue of
The Company also welcomes healthcare veteran Janet Liang, who will join Oscar Health in a newly created role of President, Oscar Health Insurance, effective February 24, 2025. Liang previously served as Group President & Chief Operating Officer, Care Delivery, for Kaiser Foundation Health Plan, Inc. and Hospitals. Liang will oversee all insurance functions, bringing strong operational expertise and a proven track record of growing markets to the role.
Key Metrics and Non-GAAP Financial Metrics |
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Three Months Ended December 31, |
|
Year Ended December 31, |
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(in thousands, except percentages) |
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Total Revenue |
$ |
2,392,436 |
|
|
$ |
1,431,658 |
|
|
$ |
9,177,564 |
|
|
$ |
5,862,869 |
|
Medical Loss Ratio |
|
88.1 |
% |
|
|
86.4 |
% |
|
|
81.7 |
% |
|
|
81.6 |
% |
SG&A Expense Ratio |
|
19.5 |
% |
|
|
25.4 |
% |
|
|
19.1 |
% |
|
|
24.3 |
% |
Net Income attributable to Oscar Health Inc. |
$ |
(153,547 |
) |
|
$ |
(150,030 |
) |
|
$ |
25,432 |
|
|
$ |
(270,728 |
) |
Adjusted EBITDA (1) |
$ |
(112,643 |
) |
|
$ |
(111,593 |
) |
|
$ |
199,234 |
|
|
$ |
(45,238 |
) |
(1) |
Adjusted EBITDA is a non-GAAP measure. See “Key Operating and Non-GAAP Financial Metrics - Adjusted EBITDA” in this release for a reconciliation to net loss, the most directly comparable GAAP measure, and for information regarding Oscar’s use of Adjusted EBITDA. |
|
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As of December 31, |
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Membership by Offering |
|
2024 |
|
2023 |
Individual and Small Group |
|
1,636,400 |
|
967,002 |
Medicare Advantage |
|
— |
|
1,781 |
Cigna+Oscar (1) |
|
40,570 |
|
67,500 |
Total Members (2) |
|
1,676,970 |
|
1,036,283 |
| (1) | Represents total membership for Oscar’s co-branded partnership with Cigna. |
|
| (2) | A member covered under more than one of our health plans counts as a single member for the purposes of this metric. |
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2025 Outlook and Supplemental Information
We regularly review a number of metrics to evaluate our business, measure our performance, identify trends in our business, prepare financial projections, and make strategic decisions. Beginning in 2025, the Company intends to provide guidance on four metrics: Total Revenue, Medical Loss Ratio, SG&A Expense Ratio and Earnings from Operations. The following table presents the Company’s 2025 financial outlook, along with full year 2024 results for such measures, calculated in accordance with the Company’s intended reporting approach for future periods.
The information included in this table below represents management's current estimates as of the date of this release. Actual results may differ materially depending on a number of factors. Investors are urged to read the Cautionary Note Regarding Forward-Looking Statements included in this release. Management does not assume any obligation to update these estimates. The historical financial information included in this table is unaudited and has no impact on the Company’s audited financial statements and results of operations to be included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2024.
Oscar Health, Inc. |
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2025 Financial Guidance Summary |
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Full Year 2025 Outlook |
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(in thousands, except percentages) |
Full Year 2024 Actual |
|
Low |
|
High |
||||||
Total Revenue (1) |
$ |
9,177,564 |
|
|
$ |
11,200,000 |
|
|
$ |
11,300,000 |
|
Medical Loss Ratio (2) |
|
81.7 |
% |
|
|
80.7 |
% |
|
|
81.7 |
% |
SG&A Expense Ratio (3) |
|
19.1 |
% |
|
|
17.6 |
% |
|
|
18.1 |
% |
Earnings from Operations (4) |
$ |
57,265 |
|
|
$ |
225,000 |
|
|
$ |
275,000 |
|
| (1) | Total revenue includes Premium revenue, Investment income, and Services and other revenue. We believe Total revenue is an important metric to assess the growth of our business, as well as the earnings potential of our investment portfolio. |
|
| (2) | Medical loss ratio (MLR) is a metric used to calculate medical expenses as a percentage of net premiums before ceded quota share reinsurance. We believe MLR is an important metric to demonstrate the ratio of our costs to pay for healthcare of our members to the net premiums before ceded quota share reinsurance. |
|
| (3) | The Selling, General, and Administrative (SG&A) Expense ratio is calculated as selling, general and administrative expenses as a percentage of Total Revenue. We believe the SG&A Expense ratio is a valuable metric to evaluate our ability to manage our overall selling, general, and administrative cost base. |
|
| (4) | Earnings from Operations is a new primary metric for assessing operating performance. Earnings from Operations is the Company's Total revenue less Total operating expenses. |
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Quarterly Conference Call Details
Oscar will host a conference call to discuss the financial results today, February 4, 2025, at 5:00 p.m. (ET). A live audio webcast will be available via the Investor Relations page of Oscar’s website at ir.hioscar.com. A replay of the webcast will be available for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days.
Non-GAAP Financial Information
This release presents Adjusted EBITDA, a non-GAAP financial metric, which is provided as a complement to the results provided in accordance with accounting principles generally accepted in
Cautionary Note Regarding Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements other than statements of historical fact contained herein are forward-looking statements. These statements include, but are not limited to, statements about our financial outlook and estimates, including Total revenue, Medical Loss Ratio, SG&A Expense Ratio, Earning from Operations, and other financial performance metrics, and the related underlying assumptions, our profitability goals, our business and financial prospects, including potential future growth, and our management’s plans and objectives for future operations, expectations and business strategy. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “expects,” “plans,” “anticipates,” “could,” “intends,” “targets,” “projects,” “contemplates,” “believes,” “estimates,” “predicts,” “potential,” or “continue” or the negative of these terms or other similar expressions. Accordingly, we caution you that any such forward-looking statements are not guarantees of future performance and are subject to risks, assumptions, and uncertainties that are difficult to predict and generally beyond our control.
Although we believe that the expectations reflected in these forward-looking statements are reasonable as of the date made, there are or will be important factors that could cause our actual results to differ materially from those indicated in these forward-looking statements, including, but not limited to, the following: our ability to execute our strategy and manage our growth effectively; our ability to retain and expand our member base; our ability to accurately estimate our incurred medical expenses or effectively manage our medical costs or related administrative costs; our ability to maintain profitability in the future; unanticipated results of or changes to risk adjustment programs; our ability to arrange for the delivery of quality care and maintain good relations with the physicians, hospitals, and other providers within and outside our provider networks; changes in federal or state laws or regulations, including changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended (collectively, the “ACA”) and any regulations enacted thereunder; our ability to comply with ongoing regulatory requirements, including capital reserve and surplus requirements and applicable performance standards; changes or developments in the health insurance markets in
You are cautioned not to place undue reliance on any forward-looking statements made in this press release. Any forward-looking statement speaks only as of the date as of which it is made, and, except as otherwise required by law, we do not undertake any obligation to publicly update or review any forward-looking statement, whether as a result of new information, future developments or otherwise. New factors emerge from time to time, and it is not possible for us to predict which will arise.
About Oscar Health
Oscar Health, Inc. (“Oscar”) is a leading healthcare technology company built around a full stack technology platform and a relentless focus on serving our members. We have been challenging the status quo in the healthcare system since our founding in 2012, and are dedicated to making a healthier life accessible and affordable for all. Oscar offers Individual & Family plans and health technology solutions that power the healthcare industry through +Oscar. Our technology drives superior experiences, deep engagement, and high-value clinical care, earning us the trust of approximately 1.68 million members, as of December 31, 2024.
Oscar Health, Inc. |
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Consolidated Statements of Operations |
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Three Months Ended December 31, |
|
Year Ended December 31, |
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(in thousands, except per share amounts) |
|
2024 |
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2023 |
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|
2024 |
|
|
2023 |
|
|
|
(unaudited) |
|
(unaudited) |
|
(unaudited) |
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Revenue |
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|
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Premium |
$ |
2,345,204 |
|
|
$ |
1,390,395 |
|
|
$ |
8,971,259 |
|
$ |
5,686,069 |
|
|
Investment income |
|
42,420 |
|
|
|
35,539 |
|
|
|
185,729 |
|
|
155,447 |
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|
Services and other |
|
4,812 |
|
|
|
5,724 |
|
|
|
20,576 |
|
|
21,353 |
|
|
Total revenue |
|
2,392,436 |
|
|
|
1,431,658 |
|
|
|
9,177,564 |
|
|
5,862,869 |
|
|
Operating Expenses |
|
|
|
|
|
|
|
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Medical |
|
2,065,114 |
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|
|
1,205,239 |
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|
|
7,332,589 |
|
|
4,642,024 |
|
|
Selling, general, and administrative |
|
465,820 |
|
|
|
364,154 |
|
|
|
1,755,565 |
|
|
1,425,766 |
|
|
Depreciation and amortization |
|
9,233 |
|
|
|
7,742 |
|
|
|
32,145 |
|
|
30,694 |
|
|
Total operating expenses |
|
2,540,167 |
|
|
|
1,577,135 |
|
|
|
9,120,299 |
|
|
6,098,484 |
|
|
Earnings (loss) from operations |
|
(147,731 |
) |
|
|
(145,477 |
) |
|
|
57,265 |
|
|
(235,615 |
) |
|
Interest expense |
|
6,026 |
|
|
|
6,217 |
|
|
|
23,734 |
|
|
24,603 |
|
|
Other expenses (income) |
|
(68 |
) |
|
|
(1,050 |
) |
|
|
105 |
|
|
7,082 |
|
|
Earnings (loss) before income taxes |
|
(153,689 |
) |
|
|
(150,644 |
) |
|
|
33,426 |
|
|
(267,300 |
) |
|
Income tax expense (benefit) |
|
(404 |
) |
|
|
(806 |
) |
|
|
7,305 |
|
|
3,294 |
|
|
Net income (loss) |
|
(153,285 |
) |
|
|
(149,838 |
) |
|
|
26,121 |
|
|
(270,594 |
) |
|
Less: Net income (loss) attributable to noncontrolling interests |
|
262 |
|
|
|
192 |
|
|
|
689 |
|
|
134 |
|
|
Net income (loss) attributable to Oscar Health, Inc. |
$ |
(153,547 |
) |
|
$ |
(150,030 |
) |
|
$ |
25,432 |
|
$ |
(270,728 |
) |
|
|
|
|
|
|
|
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Earnings (Loss) per Share |
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|
|
|
|
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Basic |
$ |
(0.62 |
) |
|
$ |
(0.66 |
) |
|
$ |
0.11 |
|
$ |
(1.22 |
) |
|
Diluted |
$ |
(0.62 |
) |
|
$ |
(0.66 |
) |
|
$ |
0.10 |
|
$ |
(1.22 |
) |
|
Weighted Average Common Shares Outstanding |
|
|
|
|
|
|
|
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Basic |
|
248,210 |
|
|
|
227,082 |
|
|
|
240,386 |
|
|
221,655 |
|
|
Diluted |
|
248,210 |
|
|
|
227,082 |
|
|
|
265,853 |
|
|
221,655 |
|
|
Oscar Health, Inc. |
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Consolidated Balance Sheets |
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(in thousands, except per share amounts) |
December 31, 2024 |
|
December 31, 2023 |
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(unaudited) |
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Assets |
|
|
|
||||
Current Assets: |
|
|
|
||||
Cash and cash equivalents |
$ |
1,527,186 |
|
|
$ |
1,870,315 |
|
Short-term investments |
|
624,461 |
|
|
|
689,833 |
|
Premiums and accounts receivable (net of allowance for credit losses of |
|
315,891 |
|
|
|
201,269 |
|
Risk adjustment transfer receivable |
|
64,779 |
|
|
|
51,925 |
|
Reinsurance recoverable |
|
291,537 |
|
|
|
241,194 |
|
Other current assets |
|
21,320 |
|
|
|
6,564 |
|
Total current assets |
|
2,845,174 |
|
|
|
3,061,100 |
|
Property, equipment, and capitalized software, net |
|
66,793 |
|
|
|
61,930 |
|
Long-term investments |
|
1,815,254 |
|
|
|
365,309 |
|
Restricted deposits |
|
30,878 |
|
|
|
29,870 |
|
Other assets |
|
82,397 |
|
|
|
83,271 |
|
Total assets |
$ |
4,840,496 |
|
|
$ |
3,601,480 |
|
|
|
|
|
||||
Liabilities and Stockholders' Equity |
|
|
|||||
Current Liabilities: |
|
|
|
||||
Benefits payable |
$ |
1,356,730 |
|
|
$ |
965,986 |
|
Risk adjustment transfer payable |
|
1,558,341 |
|
|
|
1,056,941 |
|
Premium deficiency reserve |
|
— |
|
|
|
5,776 |
|
Unearned premiums |
|
74,389 |
|
|
|
65,918 |
|
Accounts payable and other liabilities |
|
432,428 |
|
|
|
273,367 |
|
Reinsurance payable |
|
41,346 |
|
|
|
61,024 |
|
Total current liabilities |
|
3,463,234 |
|
|
|
2,429,012 |
|
Long-term debt |
|
299,555 |
|
|
|
298,777 |
|
Other liabilities |
|
61,282 |
|
|
|
67,574 |
|
Total liabilities |
|
3,824,071 |
|
|
|
2,795,363 |
|
Commitments and contingencies |
|
|
|
||||
Stockholders' Equity |
|
|
|
||||
Class A common stock, |
|
2 |
|
|
|
2 |
|
Class B common stock, |
|
— |
|
|
|
— |
|
Treasury stock (315 thousand shares as of December 31, 2024 and 2023) |
|
(2,923 |
) |
|
|
(2,923 |
) |
Additional paid-in capital |
|
3,869,617 |
|
|
|
3,682,294 |
|
Accumulated deficit |
|
(2,851,283 |
) |
|
|
(2,876,715 |
) |
Accumulated other comprehensive income (loss) |
|
(1,827 |
) |
|
|
1,309 |
|
Total Oscar Health, Inc. stockholders’ equity |
|
1,013,586 |
|
|
|
803,967 |
|
Noncontrolling interests |
|
2,839 |
|
|
|
2,150 |
|
Total stockholders’ equity |
|
1,016,425 |
|
|
|
806,117 |
|
Total liabilities and stockholders' equity |
$ |
4,840,496 |
|
|
$ |
3,601,480 |
|
Oscar Health, Inc. |
|||||||
Consolidated Statements of Cash Flows |
|||||||
|
Year Ended December 31, |
||||||
(in thousands) |
|
2024 |
|
|
|
2023 |
|
|
(unaudited) |
|
|
||||
Cash Flows from Operating Activities: |
|
|
|
||||
Net income (loss) |
$ |
26,121 |
|
|
$ |
(270,594 |
) |
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: |
|
|
|
||||
Deferred taxes |
|
(2,338 |
) |
|
|
58 |
|
Net realized loss (gain) on sale of financial instruments |
|
(23 |
) |
|
|
70 |
|
Depreciation and amortization expense |
|
32,145 |
|
|
|
30,694 |
|
Amortization of debt issuance costs |
|
778 |
|
|
|
778 |
|
Stock-based compensation expense |
|
109,824 |
|
|
|
159,683 |
|
Investment amortization (accretion), net of accretion |
|
(26,877 |
) |
|
|
(29,374 |
) |
Change in provision for credit losses |
|
(300 |
) |
|
|
28,612 |
|
Changes in assets and liabilities: |
|
|
|
||||
(Increase) / decrease in: |
|
|
|
||||
Premium and other receivables |
|
(114,323 |
) |
|
|
(13,405 |
) |
Risk adjustment transfer receivable |
|
(12,854 |
) |
|
|
(2,063 |
) |
Reinsurance recoverable |
|
(50,343 |
) |
|
|
651,693 |
|
Other assets |
|
(11,547 |
) |
|
|
11,307 |
|
Increase / (decrease) in: |
|
|
|
||||
Benefits payable |
|
390,744 |
|
|
|
28,258 |
|
Unearned premiums |
|
8,472 |
|
|
|
(13,080 |
) |
Premium deficiency reserve |
|
(5,776 |
) |
|
|
1,562 |
|
Accounts payable and other liabilities |
|
152,768 |
|
|
|
(29,180 |
) |
Reinsurance payable |
|
(19,678 |
) |
|
|
(366,626 |
) |
Risk adjustment transfer payable |
|
501,400 |
|
|
|
(460,552 |
) |
Net cash (used in) provided by operating activities |
|
978,193 |
|
|
|
(272,159 |
) |
Cash Flows from Investing Activities: |
|
|
|
||||
Purchase of investments |
|
(2,133,510 |
) |
|
|
(836,982 |
) |
Sale of investments |
|
25,250 |
|
|
|
31,857 |
|
Maturity of investments |
|
744,794 |
|
|
|
1,410,166 |
|
Purchase of property, equipment and capitalized software |
|
(27,897 |
) |
|
|
(25,577 |
) |
Change in restricted deposits |
|
3,929 |
|
|
|
(2,277 |
) |
Net cash (used in) provided by investing activities |
|
(1,387,434 |
) |
|
|
577,187 |
|
Cash Flows from Financing Activities: |
|
|
|
||||
Proceeds from joint venture contribution |
|
— |
|
|
|
2,490 |
|
Proceeds from exercise of stock options |
|
68,388 |
|
|
|
3,956 |
|
Net cash provided by financing activities |
|
68,388 |
|
|
|
6,446 |
|
Increase (decrease) in cash, cash equivalents and restricted cash equivalents |
|
(340,853 |
) |
|
|
311,474 |
|
Cash, cash equivalents, restricted cash and cash equivalents—beginning of period |
|
1,891,971 |
|
|
|
1,580,497 |
|
Cash, cash equivalents, restricted cash and cash equivalents—end of period |
|
1,551,118 |
|
|
|
1,891,971 |
|
Cash and cash equivalents |
|
1,527,186 |
|
|
|
1,870,315 |
|
Restricted cash and cash equivalents included in restricted deposits |
|
23,932 |
|
|
|
21,656 |
|
Total cash, cash equivalents and restricted cash and cash equivalents |
$ |
1,551,118 |
|
|
$ |
1,891,971 |
|
Supplemental Disclosures: |
|
|
|
||||
Interest payments |
$ |
33,691 |
|
|
$ |
23,156 |
|
Income tax payments |
$ |
674 |
|
|
$ |
2,414 |
|
Key Operating and Non-GAAP Financial Metrics
We regularly review the following key operating and Non-GAAP financial metrics, to evaluate our business, measure our performance, identify trends in our business, prepare financial projections, and make strategic decisions. We believe these operational and financial measures are useful in evaluating our performance, in addition to our financial results prepared in accordance with GAAP.
Total Revenue
Total revenue includes Premium revenue, Investment income, and Services and other revenue. We believe Total revenue is an important metric to assess the growth of our business, as well as the earnings potential of our investment portfolio.
Medical Loss Ratio
Medical Loss Ratio is a metric used to calculate medical expenses as a percentage of net premiums before ceded quota share reinsurance. Medical expense primarily consists of both paid and unpaid medical expenses incurred to provide medical services and products to our members. Medical claims include fee-for-service claims, pharmacy benefits, capitation payments to providers, provider disputed claims and various other medical-related costs. The impact of the federal risk adjustment program is included in the denominator of our MLR. We believe MLR is an important metric to demonstrate the ratio of our costs to pay for healthcare of our members to the net premium before ceded quota share reinsurance. MLR in our existing products are subject to various federal and state minimum requirements.
|
Three Months Ended December 31, |
|
Year Ended December 31, |
||||||||||||
(in thousands, except percentages) |
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Medical |
$ |
2,065,114 |
|
|
$ |
1,205,239 |
|
|
$ |
7,332,589 |
|
|
$ |
4,642,024 |
|
Less: Ceded quota share reinsurance claims (1) |
|
849 |
|
|
|
(3,278 |
) |
|
|
(2,029 |
) |
|
|
2,057 |
|
Net claims before ceded quota share reinsurance (A) |
$ |
2,064,265 |
|
|
$ |
1,201,961 |
|
|
$ |
7,334,618 |
|
|
$ |
4,639,967 |
|
|
|
|
|
|
|
|
|
||||||||
Premiums |
$ |
2,345,204 |
|
|
$ |
1,390,395 |
|
|
$ |
8,971,259 |
|
|
$ |
5,686,069 |
|
Less: Ceded quota share reinsurance premiums (2) |
|
984 |
|
|
|
(80 |
) |
|
|
(881 |
) |
|
|
(2,211 |
) |
Net premiums before ceded quota share reinsurance (B) |
$ |
2,344,220 |
|
|
$ |
1,390,475 |
|
|
$ |
8,972,140 |
|
|
$ |
5,688,280 |
|
Medical Loss Ratio (A divided by B) |
|
88.1 |
% |
|
|
86.4 |
% |
|
|
81.7 |
% |
|
|
81.6 |
% |
| (1) | Represents prior period development for claims ceded to reinsurers pursuant to quota share treaties accounted for under reinsurance accounting, which are in runoff. |
|
| (2) | Represents prior period development for premiums ceded to reinsurers pursuant to quota share treaties accounted for under reinsurance accounting, which are in runoff. |
|
SG&A Expense Ratio
The SG&A Expense Ratio reflects the Company’s selling, general and administrative ("SG&A") expenses, as a percentage of Total revenue. Selling, general and administrative expenses primarily include distribution expenses, wages, benefits, costs of software and hardware, the impact of quota share reinsurance, stock-based compensation, and other administrative costs. We believe the SG&A Expense ratio is a valuable metric to evaluate our ability to manage our overall selling, general, and administrative cost base.
Earnings from Operations
Earnings from Operations is a new primary metric for assessing operating performance. Earnings from Operations is the Company's Total revenue less Total operating expenses.
Net Income (loss) attributable to Oscar Health, Inc.
Net Income (loss) attributable to Oscar Health, Inc. is Net earnings (loss) allocated to the Company after income (loss) attributable to noncontrolling interests. It is a key indicator of the Company’s profitability and operational efficiency, allowing management to evaluate performance and make informed decisions on strategic planning, cost management, and resource allocation.
Adjusted EBITDA
Adjusted EBITDA is defined as Net income (loss) for the Company and its consolidated subsidiaries before interest expense, income tax expense (benefit), and depreciation and amortization, as further adjusted for stock-based compensation and other items that are considered unusual or not representative of underlying trends of our business, where applicable for the period presented. We present Adjusted EBITDA, as we consider it to be an important supplemental measure of our performance and believe it is frequently used by securities analysts, investors, and other interested parties in the evaluation of companies in our industry. Adjusted EBITDA is a non-GAAP measure. Management believes that investors’ understanding of our performance is enhanced by including this non-GAAP financial measure as a reasonable basis for comparing our ongoing results of operations.
We caution investors that amounts presented in accordance with our definition of Adjusted EBITDA may not be comparable to similar measures disclosed by our competitors, because not all companies and analysts calculate Adjusted EBITDA in the same manner.
Management uses Adjusted EBITDA:
- as a measurement of operating performance because it assists us in comparing the operating performance of our business on a consistent basis, as it removes the impact of items not directly resulting from our core operations;
- for planning purposes, including the preparation of our internal annual operating budget and financial projections;
- to evaluate the performance and effectiveness of our operational strategies; and
- to evaluate our capacity to expand our business.
By providing this non-GAAP financial measure, together with a reconciliation to the most comparable
|
Three Months Ended December 31, |
|
Year Ended December 31, |
||||||||||||
(in thousands) |
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
2023 |
|
|
Net Income (loss) |
$ |
(153,285 |
) |
|
$ |
(149,838 |
) |
|
$ |
26,121 |
|
$ |
(270,594 |
) |
|
Interest expense |
|
6,026 |
|
|
|
6,217 |
|
|
|
23,734 |
|
|
24,603 |
|
|
Other expenses (income) |
|
(68 |
) |
|
|
(1,050 |
) |
|
|
105 |
|
|
7,082 |
|
|
Income tax expense (benefit) |
|
(404 |
) |
|
|
(806 |
) |
|
|
7,305 |
|
|
3,294 |
|
|
Depreciation and amortization (“D&A”) |
|
9,233 |
|
|
|
7,742 |
|
|
|
32,145 |
|
|
30,694 |
|
|
Stock-based compensation (1) |
|
25,855 |
|
|
|
26,142 |
|
|
|
109,824 |
|
|
159,683 |
|
|
Adjusted EBITDA |
$ |
(112,643 |
) |
|
$ |
(111,593 |
) |
|
$ |
199,234 |
|
$ |
(45,238 |
) |
|
| (1) |
Represents non-cash expenses related to equity-based compensation programs, which vary from period to period depending on various factors including the timing, number, and the valuation of awards. Additionally, these expenses are reported net of any stock-based compensation that has been capitalized for software development costs. Year ended December 31, 2023 includes a non-recurring charge of |
|
Appendix
Reinsurance Impact
|
Three Months Ended December 31, |
|
Year Ended December 31, |
||||||||||||
(in thousands) |
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Quota share ceded premiums |
$ |
50 |
|
|
$ |
222 |
|
|
$ |
(3,070 |
) |
|
$ |
7,329 |
|
Quota share ceded claims |
|
(850 |
) |
|
|
(3,277 |
) |
|
|
2,029 |
|
|
|
(2,056 |
) |
Deposit Accounting impact, net of ceding commission |
|
(14,103 |
) |
|
|
(7,023 |
) |
|
|
(53,376 |
) |
|
|
(30,454 |
) |
Experience refund |
|
933 |
|
|
|
(302 |
) |
|
|
2,188 |
|
|
|
(9,540 |
) |
Net quota share impact |
$ |
(13,970 |
) |
|
$ |
(10,380 |
) |
|
$ |
(52,229 |
) |
|
$ |
(34,721 |
) |
The Company records Premium revenue net of reinsurance. The following table reconciles total reinsurance premiums ceded and reinsurance premiums assumed, which are included as components of total Premium revenue in the Consolidated Statements of Operations:
|
Three Months Ended December 31, |
|
Year Ended December 31, |
||||||||||||
(in thousands) |
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Direct policy premiums |
$ |
2,750,027 |
|
|
$ |
1,622,053 |
|
|
$ |
10,292,125 |
|
|
$ |
6,418,872 |
|
Assumed premiums |
|
46,438 |
|
|
|
54,620 |
|
|
|
219,572 |
|
|
|
228,786 |
|
Risk adjustment transfers |
|
(449,327 |
) |
|
|
(285,480 |
) |
|
|
(1,526,448 |
) |
|
|
(950,680 |
) |
Reinsurance premiums ceded |
|
(1,934 |
) |
|
|
(798 |
) |
|
|
(13,990 |
) |
|
|
(10,909 |
) |
Premium |
$ |
2,345,204 |
|
|
$ |
1,390,395 |
|
|
$ |
8,971,259 |
|
|
$ |
5,686,069 |
|
The Company records Medical expenses net of reinsurance recoveries. The following table reconciles total Medical expenses to the amount presented in the Consolidated Statement of Operations:
|
Three Months Ended December 31, |
|
Year Ended December 31, |
||||||||||||
(in thousands) |
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Direct claims incurred |
$ |
2,088,366 |
|
|
$ |
1,158,278 |
|
|
$ |
7,278,267 |
|
|
$ |
4,459,702 |
|
Ceded reinsurance claims |
|
(68,309 |
) |
|
|
(10,903 |
) |
|
|
(159,132 |
) |
|
|
(44,736 |
) |
Assumed reinsurance claims |
|
45,057 |
|
|
|
57,864 |
|
|
|
213,454 |
|
|
|
227,058 |
|
Medical expenses |
$ |
2,065,114 |
|
|
$ |
1,205,239 |
|
|
$ |
7,332,589 |
|
|
$ |
4,642,024 |
|
The Company records Selling, general and administrative ("SG&A") expenses net of reinsurance ceding commissions and assumed SG&A expenses. The following table reconciles total Selling, general and administrative expenses to the amount presented in the Consolidated Statement of Operations:
|
Three Months Ended December 31, |
|
Year Ended December 31, |
||||||||||||
(in thousands) |
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Selling, general and administrative expenses, gross |
$ |
466,580 |
|
|
$ |
364,127 |
|
$ |
1,755,942 |
|
|
$ |
1,424,763 |
||
Reinsurance ceding commissions |
|
(760 |
) |
|
|
27 |
|
|
(377 |
) |
|
|
1,003 |
||
Selling, general and administrative expenses |
$ |
465,820 |
|
|
$ |
364,154 |
|
$ |
1,755,565 |
|
|
$ |
1,425,766 |
||
The Company classifies Reinsurance recoverable within current assets on its Consolidated Balance Sheets. The composition of the Reinsurance recoverable balance is as follows:
|
|
As of December 31, |
||||||
(in thousands) |
|
|
2024 |
|
|
|
2023 |
|
Reinsurance premium and claim recoverables |
|
$ |
288,878 |
|
|
$ |
224,837 |
|
Reinsurance ceding commissions |
|
|
6,996 |
|
|
|
7,054 |
|
Experience refunds on reinsurance agreements |
|
|
(4,338 |
) |
|
|
9,303 |
|
Reinsurance recoverable |
|
$ |
291,537 |
|
|
$ |
241,194 |
|
View source version on businesswire.com: https://www.businesswire.com/news/home/20250204240394/en/
Investor Contact:
Chris Potochar
VP of Investor Relations
ir@hioscar.com
Media Contact:
Kristen Prestano
VP of Communications
press@hioscar.com
Source: Oscar Health, Inc.
FAQ
What was Oscar Health's (OSCR) revenue growth in 2024?
How much profit did OSCR make in 2024?
What is Oscar Health's (OSCR) revenue guidance for 2025?
How did OSCR's membership numbers change in 2024?
What was OSCR's Medical Loss Ratio in 2024?
Who is joining Oscar Health as President in 2025?
