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Oscar Health is making a big bet on personalized care that people traditionally spend as much as $40000 on

Oscar CenterOscar

  • Oscar Health, the $2.7 billion health insurance
    startup, wants to have all of its members using concierge
    medical care in 2018.
  • The plan to create ‘Concierge for All’ relies on teams
    of doctors and other healthcare professionals who work with
    Oscar to help you navigate everything from insurance benefits
    to questions about your health.
  • It’s something people often spend tens of thousands of
    dollars on every year in addition to their traditional

Oscar Health, the health insurance startup, is giving all of its
members access to a team of healthcare professionals they can
turn to for help navigating their healthcare.

The service is what’s known as concierge care, and it might seem
like a foreign concept to most Americans who struggle navigating
the often complex and frustrating healthcare market. But such
personalized care often comes at a high cost. Some
’boutique’ or high-end concierge services can cost as much as

$40,000 a year per family
, on top of the insurance premiums
that family pays.

Oscar is trying to change that. The $2.7 billion
health-insurance startup is making a big push to make concierge
care the centerpiece of their members’ healthcare experience,
with all its members using it. 

Here’s how it works

  • Oscar members are assigned a personalized concierge team of
    one nurse and three clinicians with specialized knowledge of the
    patient’s local healthcare networks. The idea is that teams with
    localized knowledge will be better informed when making
    recommendations and referrals.
  • Those healthcare professionals can answer any questions
    you have about your insurance benefits, or about that strange
    bump on your neck, help the member get a prescription or a
    referral to a specialist. 
  • While Oscar members don’t physically meet with their teams,
    they can contact them over the phone or through secure messaging
    on the company’s mobile app.
  • Concierge doctors will also be able to initiate contact with
    their patients with the help of clinical
    , which collect
    claims records and other data about the patients’ medical
    history to give doctors more context on a person’s health than
    what they might otherwise learn from electronic health

the inbox in the Oscar app looks like when members interact with
their concierge teams.


“One of the things that we are able to do because we have a lot
of data is to flag to care teams the defective conditions that
members may have in our clinical dashboard and say ‘hey, you
really should go in and see a doctor. We think you might have
something and you should get some medication for it,’” Chelsea
Cooper, Oscar’s Senior Vice President of Member Strategy
Operations, told Business Insider. “And that’s something we’re
able to do because we’re a tech company.”

Since launching its concierge services in full earlier this year,
Oscar says 70% of its roughly 90,000 members have interacted with
a concierge team, although those who engaged had an average of
only three interactions. The company says concierge care has even
helped its members save money on out-of-network costs. 

Now Oscar is trying to universalize the service with a “Concierge
for All” campaign to encourage 100% of its members to start using
it next year. 

“We think healthcare is very personal and that these changes
really matter,” Cooper said. “You want to know the [concierge
team] so that you can trust them and take their recommendations
about which doctor to go to and whether you should go to the
ER or an urgent care facility. We try to build that

Surviving as the market shifts

concierge healthcare
Winslow Murdoch of West Chester, PA, examines a patient, Joseph
Balinski, at his concierge practice in 2005.

C. Bower/AP

The future of American healthcare has taken on new dimensions
over the last year as President Donald Trump and Republicans in
Congress attempt to repeal Obamacare. But Oscar keeps pushing

Earlier this year, Oscar announced it would
start offering health insurance plans alongside the Cleveland
Clinic in Ohio for the first time. In 2018, it plans to expand
coverage from three states to six. 

Despite its optimism, Oscar is not immune to the financial
challenges of the turbulent healthcare market. 

Last month, Oscar reported a $96 million third quarter loss
across the three states where it currently sells coverage,
according to Forbes. Although
it was an improvement from the same quarter in 2016, it was in
line with a continuing losses the company
has experienced since its founding in 2012. 

But Oscar’s chief technology officer Alan Warren told Business Insider in June
that such challenges, including the political debate over
healthcare in Washington, will ultimately do little to deter the
company from carrying out its mission. When the Trump
administration slashed Obamacare advertising funding by 90%
earlier this year, for example, Oscar ratcheted up its own
advertising campaign in New York just in time for the most recent
open enrollment period, which ends on Friday. 

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