Oscar Health The company is reportedly looking to expand its presence in the employer market by offering more affordable health insurance plans to small and medium-sized businesses (SMBs).
Use that position Affordable Care Act In the market, Oscar Health aims to compete with big insurers and bring more transparency to pharmacy benefits, CNBC report Friday (June 7th).
CEO of Oscar Health Mark Bertolini He told CNBC that increasing transparency into pharmacy benefits is critical to containing costs for employers and patients, and by implementing plan design and underwriting groups, Oscar Health aims to ensure employees are enrolled in the plan that’s most appropriate for them.
The move into the employer market is part of Oscar Health’s strategy to grow its membership from 1.5 million to about 4 million by 2027, according to the report. Achieve The company expects annual revenue growth of about 20% over the next three years, leading to earnings of $2.25 per share in 2027.
Bertolini’s experience as former CEO Aetna He developed in-depth knowledge of how major insurers and pharmacy benefit managers (PBMs) operate, according to the report, and last year he played a key role in negotiating more favorable terms in Oscar Health’s PBM contracts. CVS Healthof Care Mark The deal gives CVS Caremark control over the cost of its plans, and runs through 2026.
Bertolini is also closely monitoring Health Insurance Companies Blue Shield of California The report said Blue Shield is implementing a potentially disruptive PBM model. Blue Shield contracts with smaller PBM companies to Mark Cubanof Cost Plus Medicine and Amazon Pharmacy It will be launched as a preferred pharmacy network from 2025. Mr. Bertolini said: PBMs are To stay competitive, they need to be more transparent with their customers and pass on savings directly to them.
In response to increased regulatory scrutiny, the three largest U.S. PBMs, CVS’s Caremark; Signaof Express Script and UnitedHealth Groupof OptumRxIt introduced a more transparent pricing model for its insurance company and employer customers, according to the report.
Oscar Health in May reported its first-ever net profit amid a record-breaking financial performance. Customer Registration In Affordable Care Act plans.
“The ACA now covers more than 21 million people and is the fastest growing health insurance segment, driven by the gig economy, consumerization and government policies,” Bertolini said during the company’s quarterly earnings call on May 7.
