Oscar Health (OSCR) 7th Annual Healthcare Symposium summary

Key industry challenges and consumer empowerment

• U.S. healthcare spending continues to rise despite two decades of consumer-focused initiatives, driven by medical technology costs, aging, and chronic diseases.

• Consumer incentives like HSAs and price transparency have not kept pace with rising costs, but new models and digital tools show promise.

• Complexity and lack of true price transparency make healthcare difficult to shop for, with plan designs often adding confusion rather than reducing costs.

• Limited insurance choices and high baseline costs hinder the effectiveness of consumer-driven plan designs.

Policy, transparency, and industry collaboration

• Federal policies on price transparency and surprise billing are gradually breaking down data silos, but actionable information for consumers remains limited.

• Tools that translate raw data into understandable information are emerging, helping consumers make informed decisions.

• Drug pricing remains a challenge, with U.S. consumers subsidizing global pharmaceutical R&D; policy is shifting to address this imbalance.

• Industry collaboration is essential for simplifying choices and building trust, with a focus on both cost and quality transparency.

Technology, AI, and personalization

• Generative AI and digital tools are transforming consumer interactions, from claims processing to personalized care recommendations.

• AI-driven chatbots and digital navigation tools are being deployed to guide members to appropriate care and optimize plan selection.

• Personalization is key, with data-driven matching of consumers to providers and plans based on individual needs and preferences.

• Emotional and behavioral factors are considered in benefit administration, with AI helping to increase HSA contributions and support financial planning.