Dive Brief:
- Health insurance industry disruptor Oscar plans to cut its 2017 provider network in New York, where it does the bulk of its business, in half - from 40,000 to 20,000, Vox reported.
- The insurer will also slash its hospital network from 77 facilities to 31, focusing on three major systems: Mount Sinai, Montefiore, and the Long Island Health Network.
- Oscar says the change is not just about their bottom line, but about improving the patient experience by limiting it to a set of providers committed to the same vision of better end-to-end healthcare.
Dive Insight:
The question is whether patients will see it Oscar's way and stick around despite the significantly reduced options. Oscar is hedging its bets that they will because they will get an experience unlike any other.
Oscar is certainly not averse to risk, having quickly embraced a bold expansion approach and undertaken plans to launch its own New York health center. At the same time, the company has had to strategize to overcome its $105 million in 2015 ACA plan losses, as Bloomberg recently reported.
In addition, Vox reported the insurer is asking for "double-digit rate increases" next year.
Oscar's latest gamble in cutting its provider network will need to pay off in terms of user experience. One of the goals is to ensure patients will be able to see physicians' schedules and make appointments directly via the website and app--a feat that remains far from the industry standard in healthcare, as Vox's Sarah Kliff noted, pointing out that recent data on California health plans indicated 20% of providers listed in plans' directories are unreachable.
"We’re telling members watch it, see the doctors we recommend, let us make appointments for you and see how this works," Schlosser told Vox. "And if you don’t like it, we’ll help you switch out. But we’re going to be offering something very different from our competitors."