Oscar expands into 4 new states, touts new virtual primary care option

By | July 31, 2020

Dive Brief:

  • Startup payer Oscar announced a major expansion of both its national presence and virtual healthcare services Thursday, the latter spurred on by the COVID-19 pandemic.

  • New York City-based Oscar said it is expanding into four new states in 2021: Oklahoma, Iowa, North Carolina and Arkansas. It is also expanding into new counties in Arizona, Florida, Pennsylvania, California and Ohio. Altogether, it will be in 19 states and 47 separate markets next year.

  • The health plan will also sell a low-cost virtual primary care option to many of its enrollees in response to COVID-19. It includes unlimited no-cost virtual visits with a primary care physician and urgent care.

Dive Insight:

With about 420,000 enrollees nationwide, Oscar Health is a dwarf compared to UnitedHealthcare, Anthem or the other national health plans.

But flush off raising $ 225 million in late stage funding last month and a new initiative with Cigna to sell coverage to small businesses, eight-year-old Oscar is looking to grow throughout the United States. Oklahoma City, Little Rock and Fayetteville, Ark., Asheville, N.C. and all the major cities in Iowa are on its expansion list for next year. In states where Oscar is already selling health coverage, it plans to expand into Boulder, Colo., six cities in Florida, and three cities in Pennsylvania.

The company is also pushing more virtual delivery of healthcare services. Known as Virtual Primary Care, it will be sold in its 10 largest markets next year, including New York City, Los Angeles, Dallas and Houston.

As part of the Virtual Primary Care product, Oscar enrollees will be able to engage in unlimited virtual visits with a primary care physician for no out-of-pocket costs. Urgent care visits are covered as well. Many prescriptions, durable medical equipment, laboratory testing, diagnostic imaging and referrals to specialists will also be included free of charge. Patients will also be provided with a “care guide” to better coordinate visits and treatments.

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The service could provide a boost to primary care physicians, many of whom have seen their practices teetering on the brink of financial ruin due to COVID-19.

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