Interconnectivity as an asset

Simple. Easy. Understandable.

These are not words most people would use to describe their health insurance. But New York-based health insurance startup Oscar Health wants to see those words used to characterize its customers’ experience. And soon the unusually user-friendly health insurance experience the company offers will be available to some Nashvillians through Oscar’s new partnership with Humana.

“Oscar has had the opportunity to start in an era where we can build from the ground up without a lot of the legacy issues that have unfortunately plagued health care,” says Elliott Green, Oscar’s vice president of expansion and strategic partnerships.

Green is spearheading Oscar’s partnership with Humana to offer plans for businesses in Nashville. He says interconnectivity is one of Oscar’s key product assets.

Conventional health insurance companies primarily concern themselves with managing their customers’ data, including medical information and claims, but don’t emphasize making that information easily accessible to providers or patients. Oscar, on the other hand, is designed to connect patients directly with their providers and with their own data. And that data flow goes both directions: The providers on the platform also have easy access to their patients’ full medical history — freeing those patients from the burden of managing and sharing that set of information with every clinician they see. Remarkably, this system obviates much of the need for an electronic health record integration.

This openness toward data puts an inherent limit on the providers Oscar can work with. The company spins this limited set of providers as a “curated” list.

“Do you want to innovate?” Green says Oscar asks its potential provider partners. “Do you want to open your scheduling systems to our members? Do you want to look into whether or not you can exchange clinical notes so [that] your physicians are able to receive more information before the patient even arrives?”

Austin Madison, vice president and partner of Nashville-based insurance agency The Crichton Group, says Oscar’s fresh approach to health insurance is exciting.

“What’s intriguing about their program,” Madison says, “is that they’re trying to do what everybody’s been talking about for a while: to reach the consumer where they are. To provide transparency, providing concierge help, explaining how their plans work.”

Green says most customers use the company’s concierge system, which consists of a team of a nurse practitioner plus three “care guides” who are intimately familiar with each Oscar user’s account. When you contact Oscar for customer support, you talk to one of the same four folks every time.

Though the company is tech-focused — with its high levels of transparency and its ergonomic mobile app — Green says Oscar sees itself as “age-agnostic.”

“In the individual age brackets, our biggest segment is 56-64,” he says. “We’re not just technology; we also want to help.”

Oscar’s insurance plans will be available for individuals and small businesses in Nashville to purchase this fall, with coverage starting in early 2018.

“Nashville is one of the most exciting [U.S.] cities,” Green says. “It’s a hotbed of entrepreneur activity. When you start talking about health care, people will usually tell you to be quiet. But in Nashville, people ask you more questions — which is very odd for us, but very exciting.”

Still, Green admits that it would be premature to declare Oscar’s model the future of the health insurance sector. It’s an industry that is difficult to break into. It’s expensive. And under the current federal administration, the industry is particularly volatile. After five years in existence, Oscar’s leaders are not sure when the company might become profitable.

“We raise a lot of money because it’s an expensive business,” Green says. “We’re investing a lot in the future. We’re a growing business so…we’re not concerned.”

The Crichton Group’s Madison wonders whether Oscar could maintain its character if it were bought by a larger company.

“In a town like Nashville, everybody’s trying to figure out that [health care] solution,” Madison says. “It’s an interesting time to buckle your seatbelts.”

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