Oscar Health Bets On 2026 Profit Turnaround After Tough 2025

Oscar Health Inc. (NYSE: OSCR) on Tuesday reported fourth-quarter revenue of approximately $2.81 billion, compared to $2.39 billion a year ago, missing the consensus estimate of $3.12 billion.

Total revenue was approximately $11.7 billion for fiscal 2025 compared to $9.2 billion a year ago, driven by higher membership, partially offset by an increase in the net risk adjustment transfer accrual.

The medical loss ratio was 95.4% for the quarter compared to 88.1% a year ago. The increase was primarily driven by higher average market morbidity that resulted in an increase in the net risk adjustment transfer accrual, as well as higher utilization that was not fully offset by risk adjustment.

The health care technology company reported a loss of $1.24 per share, missing the consensus estimate of 89 cents.

The SG&A expense ratio was 18.2% compared to 19.5%. The decrease was primarily due to greater fixed cost leverage, lower exchange fee rates, and disciplined cost management, partially offset by the impact of higher risk adjustment as a percentage of premium.

Loss from operations was $333.75 million, higher than $147.73 million reported a year ago, primarily driven by higher average market morbidity that resulted in an increase in the net risk adjustment transfer accrual, as well as higher utilization that was not fully offset by risk adjustment.

Adjusted EBITDA loss was $101.5 million for the quarter, compared to Adjusted EBITDA loss of $307.78 million.

Total membership jumped from 1.68 million to 2.04 million in the quarter.

"2025 was a reset year for the individual market, and we took decisive actions to return to profitability in 2026," said Mark Bertolini, CEO of Oscar Health.

"Our new suite of affordable products, agentic AI features, and exceptional member experience drove record-high membership – positioning us to achieve significantly improved financial performance in 2026.

Financing Boost

Last week, Oscar announced a $475 million three-year revolving credit facility.

"We took opportunistic steps to strengthen our balance sheet and optimize our capital structure," said Scott Blackley, CFO of Oscar Health.

"The transaction was well supported by a strong syndicate of top-tier banks and completed on favorable terms, further enhancing our balance sheet and providing additional flexibility to fuel long-term growth and accelerate consumer and employer adoption of the individual market."

Guidance

Oscar Health sees fiscal 2026 sales between $18.7-$19 billion compared to the Wall Street estimate of $12.57 billion.

The company expects a 2025 medical loss ratio of 82.4%-83.4%, an SG&A expense ratio of 15.8%-16.3%, and operating earnings of $250 million to $450 million.

OSCR Price Action: Oscar shares are up 5.60% at $13.39 at the time of publication on Tuesday. The stock hit a high of $14.37 and dropped to a low of $13.01 during the day, according to Benzinga Pro data.