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Oscar Health (OSCR)
NYSE:OSCR
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Oscar Health
(NYSE:OSCR)
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Rating:61Neutral
Price Target:
$14.50
▲(6.30% Upside)
Action:ReiteratedDate:03/02/26
The score is driven primarily by strong recent operating/free cash flow and constructive 2026 profitability guidance. These positives are tempered by inconsistent GAAP profitability (2025 loss), ongoing risk-adjustment and membership churn uncertainty, and a weak-to-neutral technical setup with the stock still below key moving averages.
Positive Factors
Cash generation strength
Sustained positive operating and free cash flow in 2024–2025 provides durable funding for growth, capital actions and reserve builds. Strong cash generation cushions underwriting volatility, supports reinvestment in tech and network initiatives, and bolsters liquidity over the medium term.
Scale: membership and market share gains
Rapid membership scale and a large market share increase strengthen risk pooling, broaden premium base, and improve negotiating leverage with providers and brokers. Larger scale aids fixed-cost absorption and makes structural profitability gains more achievable as operations normalize.
SG&A and AI-driven efficiency gains
Meaningful SG&A ratio improvement driven by AI and tech is a durable margin lever: lower administrative costs per member and faster service automation can sustainably reduce expense ratios, enabling structural operating margin recovery as membership and revenue scale.
Negative Factors
Elevated MLR and risk-adjustment volatility
Persistently high and volatile medical loss ratios reflect unfavorable utilization and imperfect risk-adjustment mechanics. Structural MLR pressure undermines underwriting margins and makes earnings sensitive to population morbidity and third-party RA estimates over multiple quarters.
Uncertainty on paid membership / churn
Material uncertainty about which passively enrolled members remain paid after subsidy changes creates revenue and risk-pool unpredictability. Higher churn or adverse selection would impair unit economics, inflate acquisition costs, and complicate multi-quarter margin recovery plans.
Inconsistent GAAP profitability
Volatile GAAP results indicate underwriting and operating performance are not yet durable. Recurring losses erode retained earnings and capital cushions, raising financing dependency and making sustained investment and growth riskier unless structural underwriting improvements persist.
Oscar Health (OSCR) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$4.06B
Dividend YieldN/A
Average Volume (3M)8.06M
Price to Earnings (P/E)―
Beta (1Y)0.85
Revenue Growth37.38%
EPS Growth-912.18%
CountryUS
Employees2,400
SectorHealthcare
Sector Strength45
IndustryMedical - Healthcare Plans
Share Statistics
EPS (TTM)-1.24
Shares Outstanding262,157,000
10 Day Avg. Volume6,043,331
30 Day Avg. Volume8,058,793
Financial Highlights & Ratios
PEG Ratio<0.01
Price to Book (P/B)3.86
Price to Sales (P/S)0.32
P/FCF Ratio3.56
Enterprise Value/Market Cap0.31
Enterprise Value/Revenue0.11
Enterprise Value/Gross Profit0.76
Enterprise Value/Ebitda-3.27
Forecast
1Y Price Target
$14.88Price Target Upside9.09% Upside
Rating ConsensusHold
Number of Analyst Covering8
EPS Forecast (FY)0.38
Revenue Forecast (FY)$18.11B
Oscar Health Business Overview & Revenue Model
Company DescriptionOscar Health, Inc. provides health insurance products and services in the United States. The company offers Individual & Family, Small Group, and Medicare Advantage plans, as well as +Oscar, a technology driven platform designed to help providers and payor clients to engage with members and patients. It also provides reinsurance products. The company was formerly known as Mulberry Health Inc. and changed its name to Oscar Health, Inc. in January 2021. Oscar Health, Inc. was incorporated in 2012 and is headquartered in New York, New York.
How the Company Makes MoneyOscar Health generates revenue primarily through premiums collected from its members in exchange for health insurance coverage. Its key revenue streams include individual and family plans sold on the health insurance marketplaces established by the Affordable Care Act (ACA), Medicare Advantage plans for senior citizens, and small group health insurance products for businesses. Additionally, Oscar collaborates with healthcare providers and organizations to create value-based care arrangements that can lead to shared savings and improved patient outcomes. The company's focus on technology allows for efficient member engagement and care management, which can lead to cost savings and improved profitability over time.
Oscar Health Earnings Call Summary
Earnings Call Date:Feb 10, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:May 12, 2026
Earnings Call Sentiment Positive
The call presented a mix of significant near-term challenges and clear strategic progress. Oscar reported strong top-line growth (11.7B revenue, +28% YoY), record enrollment and major market share gains (17% → 30%), meaningful SG&A and AI-driven efficiencies, and provided bullish 2026 guidance including a return to profitability (operating earnings $250–$450M and revenue guidance up ~61% at midpoint). Offsetting these positives, 2025 was loss-making with high MLRs (87.4% full year, 95.4% in Q4), sizable risk-adjustment volatility including a $275M Q4 accrual, and uncertainty about how many passively-enrolled members will remain paid after subsidy expirations. Management articulated concrete levers to improve margins (pricing, product design, broker expansion, AI) and enacted capital actions to support growth. On balance, the call emphasized recovery and strong operational momentum for 2026 while acknowledging material risk-adjustment, enrollment and utilization uncertainties carried over from 2025.Q4-2025 Updates
Positive Updates
Strong Revenue Growth
Total revenue of $11.7 billion in 2025, a 28% year-over-year increase; 2026 revenue guidance of $18.7–$19.0 billion (≈61% YoY growth at midpoint).
Large Membership and Market Share Gains
Company reported 3.4 million members as of Feb 1, 2026 and expects ~3.0 million paid members by start of Q2 (a 58% year-over-year increase in paid members); footprint market share rose from 17% in 2025 to 30% in 2026.
Clear Path to Profitability in 2026
Guidance expects earnings from operations of $250–$450 million in 2026 (midpoint implies ~ $750 million year-over-year improvement) and an operating margin ~1.9% at midpoint; adjusted EBITDA expected to be ~ $115 million above operating earnings.
Material SG&A Efficiency Improvements
Full year SG&A expense ratio improved to 17.5%, roughly 160 basis points better year-over-year; 2026 SG&A guidance 15.8%–16.3% (≈140 bps YoY improvement at midpoint) driven by scale, technology and AI.
AI and Technology-Driven Operational Gains
Administrative costs lowered ~160 basis points YoY due to AI; agentic AI care-guide reduced response times by 67% during peak/enrollment; Oswell handles 86% of member questions with high accuracy — cited as core efficiency driver.
Product & Distribution Momentum
Record open enrollment with product innovation (Hello Menno, A Salud, Hive Health with Oscar), broker partnerships expanded 60%, and lifestyle-product members showing stronger engagement (50% more likely to recommend and higher direct enrollment rates).
Balance Sheet and Capital Actions
Ended year with ~$5.5 billion cash and investments (including $414M at parent); completed $410M convertible offering (net $360M) and a new $475M 3-year revolver, and insurance subsidiaries had ~ $1.0B surplus (including $315M excess).
Negative Updates
Large 2025 Losses
Full-year loss from operations of ~$396 million; CFO cited a net loss of $443 million for 2025; adjusted EBITDA loss of ~$280 million (a $479 million YoY deterioration).
Elevated Medical Loss Ratios in 2025
Full-year MLR of 87.4% (up ~570 basis points YoY); Q4 MLR of 95.4% (up ~730 basis points YoY), driven primarily by higher market morbidity and risk-adjustment dynamics.
Risk Adjustment Volatility and Q4 True-Up
Q4 required a $275 million increase in risk adjustment accrual due to Oscar's membership skewing healthier relative to market expectations; 2025 risk transfer was ~18.5% of direct premiums (up ~390 bps YoY) and 2026 is expected around ~20%, highlighting continued RA pressure and volatility.
Uncertainty on Final Paid Membership and Churn
Company expects elevated churn as passively enrolled members face higher premiums after enhanced premium tax credit expiration — estimate of ~400k drop (3.4M to ~3.0M paid by end of Q1) and potential further contraction with final midyear CMS data; market contraction still projected in a 20%–30% range (company expects toward lower end).
Utilization Shifts and Pull-Forward Risk
Q4 saw modestly higher utilization than expected: inpatient moderated, outpatient and professional utilization rose (possible care acceleration as subsidies expired); company noted some mental health and SUD utilization increases — potential timing/seasonality risks for 2026.
Metal Mix Shift to Higher Deductible Plans
Material mix change: bronze increased (prior ~25% → ~39%), silver declined (prior ~71% → ~36%), gold rose from low-single digits to ~25%; greater bronze exposure implies higher deductibles and potential for higher churn/nonpayment among price-sensitive members.
Limited Visibility into Market Risk Dynamics
Management highlighted industry-level visibility gaps around risk adjustment and dependence on third-party/Wakely reporting; acknowledged forecasting risk adjustment is difficult and remains a key uncertainty.
GAAP Reconciliation Limitations
Company did not provide a quantitative reconciliation of estimated 2026 adjusted EBITDA to GAAP net income, stating it cannot calculate certain reconciling items with confidence — reduces transparency around 2026 earnings guidance.
Company Guidance
Oscar guided 2026 to revenues of $18.7–$19.0 billion (≈61% YoY growth at the midpoint), driven by membership of roughly 3.0 million paid members at the start of Q2 (3.4M enrolled as of Feb 1; +58% YoY) and a ~28% weighted average rate increase, and expects a 2026 medical loss ratio of 82.4%–83.4% (≈450 bps improvement YoY at the midpoint) with risk adjustment ~20% of direct premiums, an SG&A expense ratio of 15.8%–16.3% (≈140 bps improvement), earnings from operations of $250–$450 million (nearly $750 million improvement YoY, implying ~1.9% operating margin at the midpoint), adjusted EBITDA about $115 million higher than operating income, plus a strengthened balance sheet (year-end cash & investments ~$5.5 billion including $414 million at the parent, ~$1.0 billion insurance subsidiary surplus including $315 million excess, $360 million net proceeds from a $410 million convertible and a $475 million revolver); management also noted market context of 23 million overall ACA lives (−5% YoY) and expects market contraction to track toward the lower end of its prior 20%–30% range.Oscar Health Financial Statement Overview
Summary
Strong recent cash generation (operating cash flow ~$1.0B–$1.1B and robust free cash flow in 2024–2025) supports resilience, and revenue has scaled meaningfully over time. Offsetting this, profitability is volatile (back to a sizable net loss in 2025 after a modest 2024 profit) and balance sheet strength is adequate but not exceptionally deep relative to business scale.Income Statement
Revenue scale and growth are strong (up from ~$0.6B in 2020 to ~$11.7B in 2025, with 2025 growth of ~3.7%), showing meaningful expansion. Profitability, however, remains inconsistent: the company turned modestly profitable in 2024, but swung back to a sizable net loss in 2025 (about -3.8% net margin) and operating profitability is negative again, indicating volatility in underwriting/operating performance and limited earnings durability today.48
Neutral
Balance Sheet
Leverage appears manageable with total debt of ~$430M against ~$978M of equity in 2025, and equity remains positive across recent periods (2021–2025), supporting financial flexibility. That said, equity is not large relative to the growing business and profitability has been uneven (including negative returns on equity in loss years), which can pressure capital strength if losses persist.62
Positive
Cash Flow
Cash generation is a clear strength: operating cash flow was strongly positive in 2024–2025 (about ~$1.0B to ~$1.1B), and free cash flow was also robust (~$0.95B to ~$1.06B) with strong 2025 free cash flow growth (~44%). The main weakness is variability earlier in the period (negative operating/free cash flow in 2021 and 2023) and the fact that strong cash flow is occurring alongside a 2025 net loss, which warrants monitoring for sustainability.78
Positive
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 11.70B | 9.18B | 5.86B | 4.13B | 1.92B |
| Gross Profit | 1.68B | 1.84B | 1.22B | 4.13B | 1.92B |
| EBITDA | -391.05M | 89.31M | -212.00M | -572.17M | -551.25M |
| Net Income | -443.15M | 25.43M | -270.73M | -606.27M | -572.61M |
Balance Sheet | |||||
| Total Assets | 6.33B | 4.84B | 3.60B | 4.53B | 3.32B |
| Cash, Cash Equivalents and Short-Term Investments | 3.99B | 2.15B | 2.56B | 2.96B | 1.69B |
| Total Debt | 430.10M | 299.56M | 298.78M | 298.00M | 0.00 |
| Total Liabilities | 5.34B | 3.82B | 2.80B | 3.63B | 1.93B |
| Stockholders Equity | 977.65M | 1.01B | 803.97M | 890.38M | 1.39B |
Cash Flow | |||||
| Free Cash Flow | 1.06B | 950.30M | -297.74M | 351.34M | -207.63M |
| Operating Cash Flow | 1.09B | 978.19M | -272.16M | 380.35M | -181.75M |
| Investing Cash Flow | -241.06M | -1.39B | 577.19M | -226.52M | -774.51M |
| Financing Cash Flow | 399.21M | 68.39M | 6.45M | 301.11M | 1.24B |
Oscar Health Technical Analysis
Neutral
13.64
Price Trends
14.71
Negative
16.12
Negative
16.36
Negative
Market Momentum
-0.40
Negative
51.32
Neutral
90.35
Negative
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For OSCR, the sentiment is Neutral. The current price of 13.64 is above the 20-day moving average (MA) of 13.26, below the 50-day MA of 14.71, and below the 200-day MA of 16.36, indicating a neutral trend. The MACD of -0.40 indicates Negative momentum. The RSI at 51.32 is Neutral, neither overbought nor oversold. The STOCH value of 90.35 is Negative, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for OSCR.
Oscar Health Risk Analysis
Oscar Health disclosed 46 risk factors in its most recent earnings report. Oscar Health reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Oscar Health Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
61 Neutral | $4.06B | ― | -44.51% | ― | 37.38% | -912.18% | |
60 Neutral | $4.01B | -2,135.87 | -0.52% | ― | 47.39% | 85.35% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
51 Neutral | $21.93B | -3.27 | -28.79% | ― | 14.92% | -286.72% | |
50 Neutral | $1.05B | -12.27 | -26.33% | ― | 15.23% | 38.79% | |
49 Neutral | $7.85B | 17.82 | 11.02% | ― | 13.71% | -18.02% | |
47 Neutral | $22.59B | 19.38 | 6.98% | 1.38% | 9.87% | -5.58% |
* Healthcare Sector Average
OSCR
Oscar Health
13.98
-1.11
-7.36%
CNC
Centene
44.60
-13.99
-23.88%
HUM
Humana
187.28
-70.66
-27.39%
MOH
Molina Healthcare
152.42
-150.42
-49.67%
CLOV
Clover Health Investments
2.04
-1.60
-43.96%
ALHC
Alignment Healthcare
19.65
4.13
26.61%
Oscar Health Corporate Events
Business Operations and StrategyFinancial Disclosures
Oscar Health Reaffirms 2026 Outlook at Investor Conference
Positive
Mar 2, 2026
Oscar Health, Inc. announced it will participate in the 2026 Raymond James Institutional Investors Conference on March 2, 2026, engaging with institutional investors about its business and outlook. At the event, the company plans to reaffirm its previously issued full-year 2026 financial guidance, signaling continuity in its expectations and providing additional visibility and reassurance to investors and other stakeholders about its near-term performance trajectory.
The most recent analyst rating on (OSCR) stock is a Sell with a $11.00 price target. To see the full list of analyst forecasts on Oscar Health stock, see the OSCR Stock Forecast page.
Business Operations and StrategyFinancial DisclosuresPrivate Placements and Financing
Oscar Health Projects 2026 Growth Despite 2025 Loss
Neutral
Feb 10, 2026
Oscar Health entered into a $475 million secured revolving credit facility on February 6, 2026, providing three-year funding capacity, expandable by an additional $100 million, to support general corporate purposes and bolster liquidity. The facility, backed by guarantees from its subsidiaries and subject to leverage, coverage, premium and liquidity covenants, strengthens the company’s financial flexibility as it manages growth and risk in the competitive health insurance market.
Separately, on February 10, 2026, Oscar reported full-year 2025 revenue of about $11.7 billion, up from $9.2 billion in 2024, on the back of record membership of roughly 3.4 million but swung to a $396.4 million operating loss as higher market morbidity and utilization drove its medical loss ratio to 87.4%. The insurer ended 2025 with 2.0 million individual and small group members, discontinued its Cigna+Oscar small-group partnership, and issued 2026 guidance calling for $18.7–$19.0 billion in revenue and improved profitability, signaling a reset year aimed at returning to positive earnings.
The most recent analyst rating on (OSCR) stock is a Hold with a $14.50 price target. To see the full list of analyst forecasts on Oscar Health stock, see the OSCR Stock Forecast page.
Business Operations and StrategyExecutive/Board Changes
Oscar Health Extends CEO Bertolini Contract and Compensation
Positive
Dec 29, 2025
On December 22, 2025, Oscar Health, Inc. and Oscar Management Corporation amended and restated the employment agreement with Chief Executive Officer Mark T. Bertolini, extending his term from the effective date through April 1, 2029, with automatic one-year renewals thereafter unless either party opts out. The revised agreement raises Bertolini’s annual base salary to $1.3 million, increases his target annual bonus to 150% of base salary starting in 2026, and provides him with a $45 million equity package in the first quarter of 2026 split evenly between time-based RSUs and performance-based PSUs, while generally excluding him from other long-term incentive or equity awards until 2029. The contract also enhances severance protections in cases of termination without cause or for good reason, including a 1.5x cash severance and 18 months of subsidized healthcare, and sets detailed vesting and acceleration mechanics for the 2026 awards in scenarios such as qualifying terminations, death or disability, and change in control, underscoring the company’s intent to secure leadership continuity and align the CEO’s compensation with long-term performance and potential transaction outcomes.
The most recent analyst rating on (OSCR) stock is a Sell with a $12.00 price target. To see the full list of analyst forecasts on Oscar Health stock, see the OSCR Stock Forecast page.
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.