Oscar Health’s Q1 2024 earnings flipped the script after years of losses, as they finally posted a profit. With $2.1 billion in revenue and bold tech bets, they’re not just surviving; they’re scaling. Here’s what really fueled their breakout quarter.
KEY TAKEAWAYS
- Oscar posted its first profit ever: $178M net income in Q1 2024.
- Revenue hit $2.1B, up 46% YoY.
- Membership grew to 1.4M members.
- MLR improved to 74.2% due to better pricing and AI tools.
- SG&A expenses dropped by 870 basis points.
- Oscar exited Cigna + Oscar and Medicare Advantage lines.
- Big bets on ICHRA and long-term ACA growth.
- The +Oscar platform is gaining traction with providers.
Table of Contents
Oscar Health Q1 2024 Performance: What’s Driving the Surge?
Oscar Health Q1 2024 earnings didn’t just meet expectations, they beat them by a mile. In a market full of big-name insurers, Oscar is standing out as a tech-first disruptor leading the way in the ACA insurance market.
The headline number? $2.1 billion in revenue, a huge 46% jump from last year. More importantly, Oscar posted $178 million in net income, its first-ever profitable quarter and a $217 million turnaround from Q1 2023.
That profit wasn’t luck. Oscar also reported $219 million in adjusted EBITDA, showing that its business is running efficiently and at scale.
So, what’s behind the momentum—and can they keep it up? The answers came through loud and clear on the recent Oscar Health investor call.
Oscar Health Q1 2024: Quick Facts and Fast Highlights
Oscar Health’s 2024 financial results tell a clear story: after years of building, their strategy is finally working.
They added over 1.4 million members, thanks to strong Affordable Care Act enrollment trends, especially during the Special Enrollment Period. Programs like HolaOscar, their Spanish-first outreach effort, drove huge gains, like a 247% increase in Spanish-speaking members in Georgia.
Their Medical Loss Ratio (MLR) improved to 74.2%, showing better control over care costs. This was supported by smarter pricing, better coding, and the use of AI in risk scoring—hallmarks of their tech-driven insurance model.
Oscar also brought down its SG&A expense ratio to 18.4%, showing they can grow while keeping operations lean.
Strategically, they’re focused. Oscar exited Medicare Advantage and the Cigna + Oscar small group plan to shift resources toward bigger opportunities, like ICHRA plans, which are set to expand in 2025.
Their +Oscar platform is also gaining ground. Every current client increased usage last quarter, pointing to long-term growth beyond insurance.
Oscar reaffirmed their full-year outlook: $8.3–$8.4 billion in revenue and up to $175 million in adjusted EBITDA. If they stay on track, Oscar Health profitability in 2024 could become the new standard—not just a milestone.
What Are the Big Wins in Oscar Health’s Q1 2024 Earnings Report?
Oscar Health’s Q1 2024 earnings were a turning point. For the first time ever, the company reported a profit—$178 million in net income.
They also added 1.4 million members, fueled by strong ACA enrollment and high retention. Programs like HolaOscar helped connect with Spanish-speaking communities, contributing to that growth.
On the financial side, Oscar’s Medical Loss Ratio (MLR) improved to 74.2%, thanks to tighter pricing, more accurate coding, and AI-powered risk tools.
Operating costs also dropped. Their SG&A expense ratio fell to 18.4%, showing that the company is becoming more efficient as it grows.
Oscar made bold strategic moves, leaving both Medicare Advantage and the Cigna + Oscar small group plan to focus on bigger opportunities like ICHRA plans, which are set to expand in 2025.
Their +Oscar platform continued to grow, with every current client increasing usage during the quarter.
Finally, Oscar reaffirmed its full-year guidance: $8.3–$8.4 billion in revenue and up to $175 million in adjusted EBITDA. More updates—including tech roadmap and growth strategy—are expected at Investor Day on June 7, 2024.
How Did Oscar Health Add 1.4M Members in Q1?
Membership is the core of any health insurance company, and Oscar’s growth shows they’re doing something right.
In Q1, Oscar Health added 1.4 million members, a 42% increase from last year. Most of that came during the ACA open enrollment period, where Oscar’s plans stood out in markets other insurers had pulled back from.
Their success wasn’t just about price. Oscar offered affordable ACA marketplace plans, solid benefits, and a smooth digital experience. They also launched HolaOscar, a Spanish-first program that helped build trust with Hispanic and Latino communities. In Georgia alone, Spanish-speaking membership grew by 247%, with a 93% retention rate.
That’s more than growth—it’s loyalty. Oscar’s Net Promoter Score (NPS) reached 66 overall, and an impressive 87 among Spanish speakers, far above the industry average.
What Does Oscar Health’s Improved Medical Loss Ratio Mean?
Let’s break it down: Medical Loss Ratio (MLR) is the percent of premium dollars spent on actual healthcare. The lower the MLR—without cutting care—the more profitable the company.
In Q1 2024, Oscar Health’s MLR dropped to 74.2%, improving by over two percentage points from last year. That might sound small, but in health insurance, it’s a big deal.
Why the improvement? Oscar used smarter pricing, AI-powered risk tools, and better coding to control costs. While some gains came from adjusting past claims, most reflect real, long-term improvements.
Here’s how that progress looks:
- MLR: 76.3% in Q1 2023 → 74.2% in Q1 2024
- Revenue: $1.44B → $2.1B
- Net Income: -$39M → $178M
Oscar’s tech backbone played a big role, using automation to track usage and make smarter care decisions in real time.
Here’s a quick breakdown:
| Metric | Q1 2023 | Q1 2024 | Change |
|---|---|---|---|
| Total Revenue | $1.44 billion | $2.1 billion | +46% |
| Net Income | -$39 million | $178 million | +$217 million |
| Adjusted EBITDA | $51 million | $219 million | +$168 million |
| Medical Loss Ratio (MLR) | 76.3% | 74.2% | -210 basis points |
| Membership | ~1.0 million | 1.4 million | +42% |
This performance didn’t come from luck. Oscar Health leaned heavily on its technology backbone, using AI and automation to monitor utilization and target care proactively.
Why Did Oscar Exit Medicare Advantage and the Cigna + Oscar Deal?
In a bold move, Oscar Health decided to exit Medicare Advantage and will end its Cigna + Oscar small group plan in 2025.
Why drop two major product lines?
According to CEO Mark Bertolini, it came down to focus and sustainability. Medicare Advantage wasn’t profitable—the cost of care was high, and the provider relationships didn’t work out the way Oscar had hoped.
As for the Cigna + Oscar partnership, the structure just didn’t make sense. Each company controlled different parts of the business, which made it hard to align on pricing or strategy. As Bertolini put it: “We just couldn’t rationalize it long term.”
This isn’t a step back, it’s a shift forward. Oscar is focusing on areas with better returns and clearer control.
Is ICHRA the Future of Oscar Health’s Employer Strategy?
Let’s break down ICHRA—short for Individual Coverage Health Reimbursement Arrangement. It’s a flexible benefit that lets employers give workers tax-free money to buy their own health insurance, usually through the ACA marketplace.
Oscar Health sees ICHRA plans as a major opportunity, especially for small and mid-sized businesses that want more control and predictability.
They estimate this model could reach up to 70 million people, and they’ve already launched pilot programs in 2024, with plans to expand in 2025. This shift is a big reason why they’re stepping away from the Cigna + Oscar partnership—they believe ICHRA is simply a better long-term fit.
Instead of supporting a joint product with limited flexibility, Oscar is leaning into what it does best: tech-driven insurance, consumer-first design, and ACA-aligned solutions.
How +Oscar Is Powering Oscar Health’s Long-Term Tech Play
Oscar still earns most of its revenue from selling insurance, but the +Oscar platform is quietly becoming a key part of its future.
+Oscar is a tech and services platform that lets hospitals and partners use Oscar’s tools to engage their own patients. It’s how Oscar is turning its member experience into something other organizations can use.
It’s still early. Services revenue grew 12% in Q1, and while that’s a small part of the business today, it’s growing. Every current client expanded their use of +Oscar last quarter. One large provider added 35,000 new lives to the platform.
It’s not just software—it’s a way to package Oscar’s best practices and sell them to others.
The company says +Oscar still has room to grow before it’s fully “client-ready at scale.” But they’re investing in it steadily, and we’ll likely get more updates during Investor Day on June 7.
Here’s a quick table to show the split:
| Business Segment | Focus | Q1 2024 Commentary |
|---|---|---|
| Core Insurance | ACA individual market | $2.1B revenue, 1.4M members, strong NPS |
| +Oscar Platform | Externalized tech for payers/providers | Modest revenue, 12% YoY growth, momentum |
| Services (incl. ICHRA) | Early-stage; employer-driven strategy | Piloting in 2024, growth expected in 2025 |
Can Oscar Health Ride ACA Growth for the Long Haul?
One of the most important themes of the call was just how optimistic Oscar is about the ACA marketplace.
There are now over 21 million people enrolled in ACA plans, making it the fastest-growing health insurance segment in the U.S. This growth is powered by gig workers, freelancers, government subsidies, and rising consumer preference for flexible, self-managed coverage.
Mark Bertolini emphasized that the ACA isn’t a niche—it’s permanent. And Oscar is designing for it: high retention, modern interfaces, and localized engagement, like HolaOscar for Spanish-speaking members or diabetes screening campaigns tailored to at-risk populations.
So while Oscar Health may seem like a single-product company today, that product is growing, evolving, and opening new doors—from ICHRA and employer partnerships to technology licensing.
How Oscar Health Cut SG&A Costs by 870 Basis Points
Let’s talk about the behind-the-scenes stuff that really matters: SG&A costs. That stands for Selling, General, and Administrative expenses, basically, everything it takes to run the business outside of paying healthcare claims.
And Oscar Health nailed it.
In Q1 2024, the company brought its SG&A expense ratio down to 18.4%, a drop of 870 basis points from Q1 2023. That’s not a small improvement—it’s the kind of shift that gets investors’ attention.
So what made it happen?
A few key things:
- Better efficiency in day-to-day operations
- Stronger cost control as the company grows
- No repeat of the Founders Award, a one-time stock payout that made last year’s SG&A look higher
But this isn’t just about trimming expenses. Oscar is working to operate more like a mature company—with smarter systems, tighter budgets, and a long-term strategy to grow without waste.
How Risk Adjustment Helped Oscar Health Outperform in Q1 2024
Risk adjustment is one of the trickiest parts of the ACA insurance market. It’s designed to level the playing field between insurers, so companies don’t just sign up healthy members. **Sicker patients mean higher payments** but only if the coding and documentation are done right.
Oscar Health has put serious effort into building out its risk adjustment tools. They’ve added AI-powered systems, run internal coding audits, and improved how they capture member health data.
In Q1 2024, it paid off.
Oscar reported risk adjustment as a smaller share of premiums, which helped boost revenue. But they also warned that this could shift later in the year, especially if they keep enrolling more members during Special Enrollment Periods (SEP). SEP enrollees often have different risk profiles, which can raise costs.
Here’s a quick breakdown:
| Metric | Q1 2024 Impact |
|---|---|
| Risk Adjustment % of Premiums | Lower than prior year |
| Risk Pool Mix | More SEP members (slightly higher MLR) |
| Coding & Data Strategy | Supported by automation and AI |
| Outlook | Risk transfer expected to rise by Q4 |
Oscar CFO Scott Blackley emphasized that while per-member claim costs might change, the core unit economics—what Oscar earns per member after expenses—remain strong and steady.
Will Oscar Health Stay Profitable Through 2024—and Beyond?
Here’s the headline everyone’s been talking about: Oscar Health is finally profitable.
This isn’t just good news for investors, it’s a big moment for Oscar’s entire business model.
In Q1, the company reported $178 million in net income and $219 million in adjusted EBITDA. That second number is Oscar’s go-to metric for measuring day-to-day performance, since it removes one-time accounting factors.
And they’re confident about the rest of the year. Oscar is sticking with its full-year 2024 outlook:
| Metric | Full-Year 2024 Guidance |
|---|---|
| Total Revenue | $8.3B to $8.4B |
| Medical Loss Ratio (MLR) | 80.2% to 81.2% |
| SG&A Expense Ratio | 20.5% to 21% |
| Adjusted EBITDA | $125M to $175M |
Oscar says they’re prepared for normal ups and downs, like seasonal MLR changes and cost shifts from SEP enrollment, but still expect to hit their numbers.
And let’s be real: after eight years of losses, this return to black ink is a huge credibility boost.
CEO Mark Bertolini made it clear that Oscar’s tech-driven insurance model is now big enough, stable enough, and efficient enough to keep delivering results.
How Oscar Health Plans to Lead in a Growing ACA Marketplace
If there was ever doubt about the future of the ACA insurance market, Q1 2024 should put it to rest. The ACA now covers more than 21 million Americans, making it the fastest-growing and most active part of the U.S. health insurance space.
And Oscar Health isn’t just part of it, they’re helping shape it.
CEO Mark Bertolini summed it up well:
“The ACA market has reached a size that makes it a permanent, attractive option… filling a critical gap.”
Why is it so important? Because the ACA works for people who often get left out—freelancers, gig workers, the self-employed, and anyone without job-based coverage.
Oscar’s bet is simple: these people aren’t going back to traditional insurance. So the company is building everything with them in mind.
While some insurers are still testing the waters, Oscar is going all in. They’re creating plans for real people—not big companies—with features like:
- HolaOscar, their Spanish-language platform
- Community outreach tailored to local needs
- Culturally specific health programs, like diabetes prevention and in-language coaching
Oscar isn’t just checking boxes. They’re trying to raise the bar for what ACA coverage can be. Learn more about Oscar Health’s plans to double its ACA footprint and expand ICHRA offerings in this Healthcare update.
What to Expect From Oscar Health’s June 2024 Investor Day
Investor Day is coming up on June 7, 2024, and it’s expected to bring some big updates.
CEO Mark Bertolini and CFO Scott Blackley have already hinted at what’s coming:
- A possible return to Medicare, but through a new model
- Progress updates on ICHRA pilots, with plans to scale in 2025
- A deeper look at +Oscar, including how the platform will expand
- Clearer long-term targets for margins, SG&A, and MLR
- A strategy to grow deeper into specific ACA market segments
Oscar has always marketed itself as a tech-first health insurer. But based on this year’s earnings call, it’s starting to look like something more.
The company is evolving into a platform business, with tools and services that could stretch well beyond health insurance. If Investor Day delivers on these themes, it could be the clearest sign yet of where Oscar is headed next.
Frequently Asked Questions About Oscar Health’s Q1 2024 Earnings
What was Oscar Health’s total revenue for Q1 2024?
Oscar Health reported $2.1 billion in total revenue for the first quarter of 2024—a 46% increase year-over-year. This growth was driven by strong ACA marketplace enrollment, high member retention, and a lower percentage of premiums tied to risk adjustment.
Did Oscar Health turn a profit in Q1 2024?
Oscar Health reported $2.1 billion in total revenue for the first quarter of 2024—a 46% increase year-over-year. This growth was driven by strong ACA marketplace enrollment, high member retention, and a lower percentage of premiums tied to risk adjustment.
What caused Oscar Health’s Medical Loss Ratio to improve?
Oscar’s Medical Loss Ratio (MLR) improved to 74.2%, down from 76.3% last year. This was due to disciplined pricing, strong care management, and improved risk adjustment practices, powered by internal data systems and AI tools that help ensure accurate member coding and risk scoring.
Why is Oscar Health exiting the Cigna + Oscar partnership?
Oscar is not renewing the Cigna + Oscar (C+O) partnership in 2025. The joint venture faced structural challenges and lacked unified financial alignment. Instead, Oscar is focusing on ICHRA plans, which they believe offer a stronger, more scalable solution for small businesses and middle-market employers.
What is ICHRA and why is Oscar Health investing in it?
ICHRA (Individual Coverage Health Reimbursement Arrangement) allows employers to fund employee premiums for ACA plans. Oscar Health sees this as a key growth area, estimating access to 70 million potential lives. Pilots are underway in 2024, with broader rollout expected in 2025.
What is the +Oscar platform?
Final Take: What Oscar Health’s Breakout Q1 2024 Really Tells Us
Oscar Health’s Q1 2024 earnings call wasn’t just about strong numbers—it was about reshaping what modern health insurance can look like.
They’re no longer a scrappy startup chasing attention. With $2.1 billion in revenue, $178 million in profit, and 1.4 million members, Oscar has reached a size where real margins and efficiency are showing up.
They’ve also shown they’re willing to make bold moves—dropping what doesn’t work, like the Cigna + Oscar partnership, and doubling down on what does: ACA individual plans, ICHRA, and the +Oscar platform.
Looking ahead, Oscar sees long-term growth in the ACA market, fueled by consumer demand, policy support, and a tech stack built for speed and personalization.
That combination puts them in a rare spot:
Profitable, focused, and flexible enough to keep evolving.
Follow the Story: Oscar Health Q2 2024 Earnings Recap →
Oscar’s breakout Q1 set the tone—but did they keep the momentum going in Q2?
From updates on ICHRA pilots to shifts in SEP enrollment and risk adjustment, we break down everything that came next.
👉 Catch up on Oscar Health’s Q2 2024 earnings here (coming soon).
This post is for informational and educational purposes only. It does not constitute financial, investment, or legal advice. Always do your own research or consult a licensed professional before making financial decisions.
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