Oscar Health CEO explains how AI push paid off in Q1


00:00 Speaker A

Oscar Health and Insurance Technology Company soaring over the last two days after topping earnings estimates on the top and bottom line. Joining us now, Mark Bertolini, Oscar Health CEO to break down the numbers as well as our health care reporter, uh, Angeli Camlani. Mark, thank you so much for being with us. It is fantastic to see you, first of all. Um, and, and your numbers, really interesting. In particular, I saw a lot of commentary around your costs being better than estimated. So, first, I just wanted to kick us off, uh, with you telling us a little bit about that, how you, um, sort of got costs down to beat the street and what contributed to that.

01:09 Mark Bertolini

Well, there are two pieces to it. One is the leverage of growth. Um, so you know we’ve grown since I joined by almost a million members, um, in the last two years. So that’s part one, but part two is that we have been using large language models for a number of years now. Um, our founders have a relationship with OpenAI. Um, Josh Kushner, who’s one of our founders actually had, um, was one of the first investors in OpenAI. And so we’ve been using these models and prior to this year, we had implemented 20 large language models and then we’re implementing 10 so far this year, um, where we have reduced our operating costs by 1,660 basis points.

02:43 Angelika Camlani

Mark, it’s Angelika. Really good to see you again. Uh, talk to me about that and how Oscar is really doing this, you know, in a field where you’re competing with some of the larger insurers. I know, you know, they’re there aren’t as many competing in the ACM marketplace as before, but you have been focusing a lot on technology. Oscar’s reputation started there. So how does what Oscar is doing? Is it, is it scalable? Is it something that we can see, you know, some of these large vertically integrated organizations kind of mimic considering that they are struggling with costs right now?

03:47 Mark Bertolini

Well, Angelika, the biggest part about implementing AI at scale is that you have to have a single version of the truth in the data set. And so Oscar by its history is the first new insurance health insurance platform to be built in the industry since 1972, and we have a single source of truth on the data. So we don’t have multiple versions of Mark Bertolini running around, thank God. Um, and, and so the whole idea is is if we have a single version of the truth, we can use that data effectively. Now, we didn’t start on the clinical side right away. We started in the back office, um, and we started on things like making information available for members. So in 2024 in January, we grew by 600,000 lives. We did that with 200 less people and better service standards than we did the year before when we grew by 100,000 lives. So the model is is what can we do to get people information more quickly? How can we support our brokers and enrolling members into our plan? All those sort of backroom kind of things that make it simpler and easier to do business with us. This year, we’ve implemented some interesting models. We have one that intakes people and gets us a sense of their conditions that they want to address and allows us then to provide support through our virtual medical group to help them get that care. The other is sort of what I would call a system, a symptom checker. So think of back in the day, WebMD and others coming forward with all this online information. We now have a chatbot that allows you to take you through the symptom checker and a way to say, okay, where, what do I do next? What do I need to do? What do I need to understand?


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