Oscar Health Announces Renewed Agreement With Pharmacy Benefit Manager CVS Caremark

Rhea-AI Summary

Oscar Health, Inc. (NYSE: OSCR) has renewed its Pharmacy Benefit Manager agreement with CVS Caremark, aiming to enhance cost efficiency for its members. The new agreement, effective from 2023 and extending through 2026, focuses on continued access to CVS Caremark's pharmacy network while allowing Oscar to shape formulary design. Scott Blackley, Chief Transformation Officer, highlighted that CVS Caremark's offer aligns with Oscar's strategic goals of lower costs and enhanced service. This partnership, ongoing since 2012, aims to optimize Oscar's tech-enabled business model and improve member healthcare experience.

Positive

• Renewed agreement with CVS Caremark expected to lower costs for Oscar.
• Agreement extends engagement through 2026, ensuring continued access to a vast pharmacy network.
• Oscar retains control over formulary design, enhancing member-centric services.

Negative

• None.

NEW YORK--(BUSINESS WIRE)-- Oscar Health, Inc. (“Oscar”) (NYSE: OSCR), the first health insurance company built on a full stack technology platform, today announced that it has renewed its Pharmacy Benefit Manager agreement with CVS Caremark to provide Oscar members with continued access to CVS Caremark’s pharmacy network.

The agreement between the two organizations is expected to substantially lower costs for Oscar over the course of the contract period, beginning in 2023. As a part of the renegotiation, Oscar will continue to drive formulary design, with CVS Caremark providing pharmacy and health engagement services to complement Oscar’s innovative member-focused approach to healthcare.

"CVS Caremark provided an attractive offer that not only supports our strategic business imperatives but also provides continuity for our members,” said Scott Blackley, Chief Transformation Officer of Oscar Health. "Ultimately, CVS Caremark proved to be best situated to support our increased scale and tech-enabled business and provide superior service, lower cost, and higher value.”

Oscar first engaged CVS Caremark to administer and manage its pharmacy benefits in 2012. The new agreement extends the relationship through 2026. Through their agreement, Oscar members will retain access to CVS Caremark’s extensive network of pharmacies across the country.

About Oscar Health

Oscar Health, Inc. (“Oscar”) is the first health insurance company built around a full stack technology platform and a relentless focus on serving its members. At Oscar, our mission is to make a healthier life accessible and affordable for all. Headquartered in New York City, Oscar has been challenging the health care system's status quo since our founding in 2012. The company’s member-first philosophy and innovative approach to care has earned us the trust of over one million members as of December 31, 2022. We offer Individual & Family, Small Group and Medicare Advantage plans, and +Oscar, our full stack technology platform. Our vision is to refactor health care to make good care cost less. Refactor is a term used in software engineering that means to improve the design, structure, and implementation of the software, while preserving its functionality. At Oscar, we take this definition a step further. We improve our members’ experience by building trust through deep engagement, personalized guidance, and rapid iteration.

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 business and financial prospects, 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: the impact of COVID-19 on global markets, economic conditions, the healthcare industry and our results of operations, and the response by governments and other third parties; our ability to retain and expand our member base; our ability to execute our growth strategy and scale our operations; our ability to meet increased capital requirements as a result of expanding membership; our ability to maintain or enter into new partnerships, service arrangements or collaborations with healthcare industry participants; negative publicity, unfavorable shifts in perception of our digital platform or other member service channels; our ability to achieve and/or maintain profitability in the future; 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 accurately estimate our incurred claims expenses or effectively manage our claims costs or related administrative costs, including as a result of fluctuations in medical utilization rates due to the impact of COVID-19; our ability to comply with ongoing regulatory requirements and applicable performance standards, including as a result of our participation in government-sponsored programs, such as Medicare, and as a result of changing regulatory requirements; changes or developments in the health insurance markets in the United States, including the passage and implementation of a law to create a single-payer or government-run health insurance program; our ability to comply with applicable privacy, security, and data laws, regulations, and standards; our ability to maintain key in-network providers and good relations with the physicians, hospitals, and other providers within and outside our provider networks, or to arrange for the delivery of quality care; unfavorable or otherwise costly outcomes of lawsuits, regulatory investigations and audits and claims that arise from the extensive laws and regulations to which we are subject; unanticipated results of risk adjustment programs; delays in our receipt of premiums; disruptions or challenges to our relationship with the Oscar Medical Group; cyber-security breaches of our and our partners’ information and technology systems; unanticipated changes in population morbidity and large-scale changes in health care utilization; and the other factors set forth under the caption “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2022, filed with the Securities and Exchange Commission (“SEC”), and our other filings with the SEC.

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.

View source version on businesswire.com: https://www.businesswire.com/news/home/20230306005267/en/

MEDIA:

JoAnna DiTullio

310.592.8046

jditullio@hioscar.com

Source: Oscar Health, Inc.

FAQ

What is the significance of Oscar Health's renewed agreement with CVS Caremark?

The renewal is expected to substantially lower costs for Oscar, enhancing service continuity for members.

How long is Oscar Health's agreement with CVS Caremark effective?

The renewed agreement is effective from 2023 and extends through 2026.

What are the expected benefits of the CVS Caremark partnership for Oscar Health?

The partnership aims to lower costs, improve member service, and allow Oscar to maintain control over formulary design.

Since when has Oscar Health been partnered with CVS Caremark?

Oscar Health has been partnered with CVS Caremark since 2012.

What technological advancements does Oscar Health focus on?

Oscar Health is built on a full stack technology platform aimed at enhancing member experience and accessibility.