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

Sid Sankaran: Nothing in particular for the quarter. I think as we look at the year that the inpatient professional utilization, as I mentioned, came in better than expected. RX savings was came in for the year higher than we had anticipated in price for. So there’s been a lot of focus on our total cost of care around PBM and drug spend, which is why we’ve highlighted this other element of our renegotiating PBM contract, which we think is a nice tailwind for our results as we go forward.

Operator: Our next question will cut from the line of Nathan Rich with Goldman Sachs. Please go ahead.

Nathan Rich: Great, thanks for the questions. Maybe first just building on the MLR comments from the last question. I’d just be curious to get your view longer term where you think MLR needs to be to kind of reach the profitability path that you laid out for the business. And I guess as you look to potentially return to growth, would you kind of expect to keep MLR either in the range of the 10 or continue to improve it while also growing membership?

Sid Sankaran: Yes, I think as we sit here today, first off, I think we’re proud of all the progress that we’ve made with respect to MLR really as we look forward we would want to be targeting in below 80s. What are the implications for the business? Certainly that means as we look at 2024, there’s still more work to do on pricing for some margin expansion. And then again, our total cost of care savings program, I think has generated real benefits as we work with our actuaries. And so a big chunk of the resources and kind of human capital company is really focused there on all the components of better medical cost management. Now, sometimes that bit may sound unsexy to you, but it’s the meat and potatoes blocking and tackling of running a managed care company. And I think the team is entirely focused on that and that’s why we’re confident we think we can get there.

Mario Schlosser: Yes, I think that €“ it’s just €“ we’ve been this market now for the longest really of almost anybody else in this market, and it’s quite clear that’s purely leading with price. When you don’t have the unit cost, you don’t have the management and so on does not work. We’re not going to go back to those days, certainly from a pricing perspective, and don’t think the market will either, by the way. So for us, this is a matter of in which markets can we build networks and providers who will over time share risk with us. We can build the modes around longer retention, longer 10-year members who will want to be with those providers. And in those markets, I think we have a huge amount of growth potential still. And so therefore, MLR wise low-80s and not going back to the previous days of trying to somehow win on the price side there.

Nathan Rich: Great. And I just wanted to ask a quick follow-up if I could, I think following up on Gary’s questions on the risk adjustment payable. I guess, with the slower growth that you €“ within the business this year, I guess, would you expect to be in a receivable position for the current year? And I guess, when do you kind of feel like you’d get better visibility on that?

Sid Sankaran: Well, we wouldn’t anticipate being in a receivable position, but we would assume that the payable would be coming down modestly as we look forward. And risk adjustment is a pretty big focus area for us, given the nature of our membership and demographics are pretty similar, I mean, to point you to an important comment that may have been lost in our prepare remarks, which is this is really the first time that Oscar has had this level of stability in its membership. And so we know the membership population, we have strong data on that population. And so we actually think that’s beneficial from the perspective reducing volatility.