CMS Proposals Test Oscar Health’s Tech Heavy Insurance Model

Simply Wall St.01-29

The Centers for Medicare & Medicaid Services have proposed a smaller-than-expected payment rate increase for Medicare Advantage programs. CMS is also tightening risk-adjustment rules that affect how ...

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CMS is also tightening risk-adjustment rules that affect how ...</p>\n\n<a href=\"https://simplywall.st/stocks/us/insurance/nyse-oscr/oscar-health/news/cms-proposals-test-oscar-healths-tech-heavy-insurance-model\">Source Link</a>\n\n</div>\n","source":"simplywall_highlight","html":"<!DOCTYPE html>\n<html>\n<head>\n<meta http-equiv=\"Content-Type\" content=\"text/html; charset=utf-8\" />\n<meta name=\"viewport\" content=\"width=device-width,initial-scale=1.0,minimum-scale=1.0,maximum-scale=1.0,user-scalable=no\"/>\n<meta name=\"format-detection\" content=\"telephone=no,email=no,address=no\" />\n<title>CMS Proposals Test Oscar Health’s Tech Heavy Insurance Model</title>\n<style type=\"text/css\">\na,abbr,acronym,address,applet,article,aside,audio,b,big,blockquote,body,canvas,caption,center,cite,code,dd,del,details,dfn,div,dl,dt,\nem,embed,fieldset,figcaption,figure,footer,form,h1,h2,h3,h4,h5,h6,header,hgroup,html,i,iframe,img,ins,kbd,label,legend,li,mark,menu,nav,\nobject,ol,output,p,pre,q,ruby,s,samp,section,small,span,strike,strong,sub,summary,sup,table,tbody,td,tfoot,th,thead,time,tr,tt,u,ul,var,video{ font:inherit;margin:0;padding:0;vertical-align:baseline;border:0 }\nbody{ font-size:16px; line-height:1.5; color:#999; background:transparent; }\n.wrapper{ overflow:hidden;word-break:break-all;padding:10px; }\nh1,h2{ font-weight:normal; line-height:1.35; margin-bottom:.6em; }\nh3,h4,h5,h6{ line-height:1.35; margin-bottom:1em; }\nh1{ font-size:24px; }\nh2{ font-size:20px; }\nh3{ font-size:18px; }\nh4{ font-size:16px; }\nh5{ font-size:14px; }\nh6{ font-size:12px; }\np,ul,ol,blockquote,dl,table{ margin:1.2em 0; }\nul,ol{ margin-left:2em; }\nul{ list-style:disc; }\nol{ list-style:decimal; }\nli,li p{ margin:10px 0;}\nimg{ max-width:100%;display:block;margin:0 auto 1em; }\nblockquote{ color:#B5B2B1; border-left:3px solid #aaa; padding:1em; }\nstrong,b{font-weight:bold;}\nem,i{font-style:italic;}\ntable{ width:100%;border-collapse:collapse;border-spacing:1px;margin:1em 0;font-size:.9em; }\nth,td{ padding:5px;text-align:left;border:1px solid #aaa; }\nth{ font-weight:bold;background:#5d5d5d; }\n.symbol-link{font-weight:bold;}\n/* header{ border-bottom:1px solid #494756; } */\n.title{ margin:0 0 8px;line-height:1.3;color:#ddd; }\n.meta {color:#5e5c6d;font-size:13px;margin:0 0 .5em; }\na{text-decoration:none; color:#2a4b87;}\n.meta .head { display: inline-block; overflow: hidden}\n.head .h-thumb { width: 30px; height: 30px; margin: 0; padding: 0; border-radius: 50%; float: left;}\n.head .h-content { margin: 0; padding: 0 0 0 9px; float: left;}\n.head .h-name {font-size: 13px; color: #eee; margin: 0;}\n.head .h-time {font-size: 11px; color: #7E829C; margin: 0;line-height: 11px;}\n.small {font-size: 12.5px; display: inline-block; transform: scale(0.9); -webkit-transform: scale(0.9); transform-origin: left; -webkit-transform-origin: left;}\n.smaller {font-size: 12.5px; display: inline-block; transform: scale(0.8); -webkit-transform: scale(0.8); transform-origin: left; -webkit-transform-origin: left;}\n.bt-text {font-size: 12px;margin: 1.5em 0 0 0}\n.bt-text p {margin: 0}\n</style>\n</head>\n<body>\n<div class=\"wrapper\">\n<header>\n<h2 class=\"title\">\nCMS Proposals Test Oscar Health’s Tech Heavy Insurance Model\n</h2>\n\n<h4 class=\"meta\">\n\n\n2026-01-29 11:37 GMT+8&nbsp;&nbsp;&nbsp;<a href=https://simplywall.st/stocks/us/insurance/nyse-oscr/oscar-health/news/cms-proposals-test-oscar-healths-tech-heavy-insurance-model><strong>Simply Wall St.</strong></a>\n\n\n</h4>\n\n</header>\n<article>\n<div>\n<p>The Centers for Medicare & Medicaid Services have proposed a smaller-than-expected payment rate increase for Medicare Advantage programs. CMS is also tightening risk-adjustment rules that affect how ...</p>\n\n<a href=\"https://simplywall.st/stocks/us/insurance/nyse-oscr/oscar-health/news/cms-proposals-test-oscar-healths-tech-heavy-insurance-model\">Source Link</a>\n\n</div>\n\n\n</article>\n</div>\n</body>\n</html>\n","isBrief":false,"type":0,"news_type":1,"symbol":"BK4208","symbol_name":"复合型公用事业","start_time":0,"source_url":"https://simplywall.st/stocks/us/insurance/nyse-oscr/oscar-health/news/cms-proposals-test-oscar-healths-tech-heavy-insurance-model","article_id":"2607070619","we_media_id":null,"thumbnails":["https://images.simplywall.st/asset/industry/7212000-choice1-main-header/1585186806799"],"rights":{"source":"simplywall_highlight","url":"https://simplywall.st/stocks/us/insurance/nyse-oscr/oscar-health/news/cms-proposals-test-oscar-healths-tech-heavy-insurance-model","rn_cache_url":null,"directOrigin":true},"url":"https://stock-news.laohu8.com/highlight/detail?id=2607070619","pubTimestamp":1769657824,"columns":[],"sourceInfo":{"source_id":"simplywall_highlight","name":"Simply Wall St."},"weMediaInfo":null,"summary":"The Centers for Medicare & Medicaid Services have proposed a smaller-than-expected payment rate increase for Medicare Advantage programs.\nCMS is also tightening risk-adjustment rules that affect how plans are paid based on members' health status.\nThese proposals may influence Oscar Health's use of virtual care and data-driven coding, with potential effects on its cost structure.\n\nOscar Health (NYSE:OSCR) is in focus as investors weigh how these CMS proposals could interact with its tech...","collect":0,"end_time":0,"defaultTopTitle":"simplywall.st","property":[],"viewcount":null,"language":"en","relate_stocks":{"BK4208":"复合型公用事业","LU0553294199.USD":"BGF GLOBAL EQUITY INCOME \"A5G\" (USD) INC","BK4162":"人寿与健康保险","LU1894683348.USD":"AMUNDI FUNDS US EQUITY RESEARCH VALUE \"A2\" (USD) INC","LU2637428348.USD":"NORDEA 1 GLOBAL SUSTAINABLE LISTED REAL ASSETS \"MP\" (USD) INC","BK4551":"寇图资本持仓","LU0661504455.SGD":"Blackrock Global Equity Income A5 SGD-H","LU0545039389.USD":"BGF GLOBAL EQUITY INCOME \"A2\" ACC","LU2500361329.USD":"NORDEA 1 GLOBAL SUSTAINABLE LISTED REAL ASSETS \"B\" (USD) ACC","OSCR":"Oscar Health, Inc.","LU0949170772.SGD":"Blackrock Global Equity Income A6 SGD-H","LU1894683264.USD":"AMUNDI FUNDS US EQUITY RESEARCH VALUE \"A2\" (USD) ACC","LU2346227817.USD":"BGF SUSTAINABLE GLOBAL INFRASTRUCTURE \"A2\" (USD) ACC","BK4588":"碎股","LU0738911758.USD":"Blackrock Global Equity Income A6 USD","BK4585":"ETF&股票定投概念","LU1003077747.HKD":"BGF GLOBAL EQUITY INCOME \"A6\" (HKDHDG) INC"},"translate_title":"CMS提案测试Oscar Health的科技重保险模式","themeId":null,"isJumpTheme":false,"ttsUrl":null,"symbols_score_info":{"OSCR":1.98},"content_text":"The Centers for Medicare & Medicaid Services have proposed a smaller-than-expected payment rate increase for Medicare Advantage programs. CMS is also tightening risk-adjustment rules that affect how plans are paid based on members' health status. These proposals may influence Oscar Health's use of virtual care and data-driven coding, with potential effects on its cost structure.  Oscar Health (NYSE:OSCR) is in focus as investors weigh how these CMS proposals could interact with its tech driven insurance model. Shares recently closed at $14.87, with a 3 year return of about 3x and a 10.9% decline over the past year, highlighting how sentiment on the name has swung over different time frames. That mix of outcomes sets the backdrop for assessing how new regulation could affect the company. For investors, the key question is how a smaller payment rate change and tighter risk adjustment might influence Oscar Health's margins, pricing decisions, and appetite to expand in Medicare related offerings. The proposals are still subject to review and comment, so it will be important to track how any final rules compare with the current draft and what management says about potential operational adjustments. Stay updated on the most important news stories for Oscar Health by adding it to your watchlist or portfolio. Alternatively, explore our Community to discover new perspectives on Oscar Health. NYSE:OSCR 1-Year Stock Price Chart Is Oscar Health financially strong enough to weather the next crisis? The CMS proposals matter for Oscar Health because they directly touch two areas where the company tries to stand out: virtual care and data driven coding. Tighter risk adjustment rules could limit how much value Oscar captures from detailed health data, while a smaller Medicare Advantage payment rate change may pressure margins for any Medicare related products, especially when peers like UnitedHealth Group, Humana and CVS Health are already talking about higher medical costs. AdvertisementHow This Fits Into The Oscar Health Narrative Existing narratives around Oscar already highlight policy risk, higher medical costs and questions about whether technology led efficiency can offset those pressures. These CMS proposals sit squarely in that debate, because they test whether Oscar’s tech heavy model can still support its revenue mix and cost structure when regulators scrutinize coding practices more closely. Oscar Health: Risks And Rewards In Focus  ⚠️ Stricter risk adjustment could reduce revenue tied to documented member complexity and make it harder for Oscar to earn returns on its data and AI tools. ⚠️ A smaller payment rate change, combined with rising care costs flagged by larger insurers, may squeeze Oscar’s margins if pricing and benefit design do not keep pace. 🎁 If Oscar can adapt its coding and virtual care model to new rules efficiently, it may show investors that its tech platform is resilient under tighter regulation. 🎁 Clear communication around any product or pricing tweaks could help investors judge whether the CMS changes are a temporary headwind or a manageable ongoing cost.  What To Watch Next From here, the key things to watch are any revisions CMS makes before finalizing the rules, plus Oscar’s commentary on how it might reshape benefits, coding workflows and Medicare related ambitions in response. If you want to see how different investors are framing these regulatory shifts against Oscar’s long term story, check what the community narratives are saying about OSCR.  This article by Simply Wall St is general in nature. We provide commentary based on historical data\n    and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your\n    financial situation. We aim to bring you long-term focused analysis driven by fundamental data.\n    Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material.\n    Simply Wall St has no position in any stocks mentioned.New: AI Stock Screener & AlertsOur new AI Stock Screener scans the market every day to uncover opportunities.• Dividend Powerhouses (3%+ Yield)• Undervalued Small Caps with Insider Buying• High growth Tech and AI CompaniesOr build your own from over 50 metrics.Explore Now for FreeHave feedback on this article? Concerned about the content? Get in touch with us directly. 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