Adding to the intrigue is Oscar's profile is high in health care circles. A computer scientist by training, Oscar CEO and co-founder Mario Schlosser was inspired to launch Oscar after his wife's pregnancy, during which he struggled to understand his choices, their costs and how to get the information he needed to make decisions. Schlosser launched the company with Josh Kushner — the younger brother of Jared Kushner and brother-in-law of Ivanka Trump.
In December, it was reported that nationally Oscar enrolled more than 250,000 individual products under the Affordable Care Act for 2018, putting its growth at 150% ahead of 2017's totals despite the Trump administration slashing the enrollment period. At the time, Oscar credited strategic ventures with the likes of the Clinic and Humana as part of that surge in business.
Looking toward open enrollment for 2019, Sears said Oscar and the Clinic are "evaluating very carefully" any opportunities for expansion.
Thorsten Wirkes, vice president of strategic operations at Oscar, said they should "certainly" see more growth next year.
J.B. Silvers, a health care finance professor at Case Western Reserve University and former insurance executive, agrees, noting that the two will likely try to get more market penetration.
"As a startup plan going from ground zero with no former enrollment at all, that's probably pretty good," said Silvers, about the partnership's early numbers.
Silvers also said, "The scaling of it would be pretty easy to do. It wouldn't be hard to expand it to a larger population. The big issue that they're going to have to wrestle with is did they get a good, sort of adequate distribution of signups or did they get people that are lower health status, higher need?"
The 50/50 shared upside/downside risk arrangement between Oscar and the Clinic is a unique partnership and a "fascinating experiment," Silvers said.
The Clinic and Oscar have spent the past year working to integrate their data and backend systems. The new "Cleveland Clinic | Oscar" individual health plans offer a tech-driven product that strives to deliver an integrated, seamless health care experience.
"We've been working tremendously closely with a broad range of stakeholders at the Clinic and really trying to make sure we integrate the key processes to make this an exceptional member experience," Wirkes said.
So far, members are already engaging with the platform the two offer. One in three members have chosen a Clinic primary care physician through Oscar's online onboarding platform. And 70% of the members have created a health profile on Oscar's web app, which helps the Clinic care teams proactively help members manage their health, according to information from Oscar.
"We have been very pleased to date with the way the Oscar platform enables us to understand who has enrolled, to be able to connect that information, to determine what kind of health care needs our Oscar members and patients may have and to be able to prepare early on to meet those needs," Sears said.
Sears said he remains confident that narrow networks like this one will be the predominant network available in the individual market. The success of the joint product affirms the Clinic's strategy to focus on narrow network plans.
"I think that trend will continue for the foreseeable future," he said. "And I think what it tells us is, for the right network, for a network that is adequate both in terms of geographic presence and access, and that is composed of high-quality providers, people are willing to choose narrow network products."
"Clinic's co-branded product with Oscar Health has exceeded hopes" originally appeared in Crain's Cleveland Business.
