Oscar Health, Inc. (NYSE:OSCR) Q4 2022 Earnings Call Transcript

Mario Schlosser: Yes, Jonathan, maybe I’ll take the first part, Sid, if you want to add anything feel free. So two levers there of course. One is premium growth, the other one is medical costs. Overall on both of these, we have made assumptions around redeterminations in the estimates in pricing and also in the guidance for 2023. I would not call the material to either premiums €“ neither premiums nor medical loss ratio. Generally, I would say in anything that increases the ACA market size is a great thing. We’ll have side effects in making the market even more stable and attractive and so on. So I think long-term this is clearly a great thing. When it comes to growth, we expect like everybody else obviously needs to start in April.

It is still not quite clear over what timeframe they will come in. The states have not given clear guidance. Some states will go population based, others time based. When we look at when those members rolled into the Medicaid roles, actually quite linear, I would say over each month of the year. So we won’t see potentially any kind of bulk coming in any particular month there, but Texas has said they think it’s going to happen in six months to nine months and Florida said it’s going to happen in 12 months. So quite differently in terms of what we could expect in different states there. In Florida as Sid said, we don’t expect to participate in this in the first six months of the year because the membership and limitation for brains in place until then.

And so when we then have participates on the medical loss ratio sides, we share what others have seemed to pick up on the market, which is that the acuity these numbers will likely be higher than the risks that’s already in the ACA. And clearly, members who come in special enrollments as we know have the headwind of partially risk adjustments. But they come with as well. As we talk about in the past, and we’ve reaffirmed this again throughout the 2022 results, members who get in special enrollments, you’ll come with that sort of MLR penalty then do look like pretty much everybody else in the year after that. So again, long-term great for the markets, short-term with MLR headwinds, but I’ll close out by saying both on the growth sides and on the MLR sides quite likely €“ quite immaterial to the projections for 2023 for us.

Jonathan Yong: Okay. Great. And then just on some of the automation that you were talking about in order to improve your operating efficiency, would that require any further investments on that would be needed for 2023 or does your current capital planning account for all that and there’s no need for extra investments? Thanks.

Mario Schlosser: No extra investments, really our current capital planning is based on us essentially following the plan we laid out and everything Sid talked about in terms of base case cash plan InsureCo profitability 23, total profitability 24 is all very consistent with us. And so we really expect in fact to be at the tail end of a whole bunch of multi-year investments. For example, the claim system we’ve been building internally it’s really kind of the last sort of component still being fine tunes essentially at the end of the investment cycle there. And that to us is very exciting because that system is the one that’s already answering. We have some questions on eligibility and claims and stuff like that and various provider facing and member facing service lines and look more automation. I think we can get in all of these aspects.

Jonathan Yong: Thanks.

Operator: Your next question comes from the line of Gary Taylor with Cowen. Please go ahead.

Gary Taylor: Hi, good evening. Couple questions. First one I just wanted to start with if you could tell us, I mean, where do you see enrollment landing at 1Q and year-end? I didn’t see any enrollment guidance in the release.

Mario Schlosser: Yes, Sid.