Taking an honest look at our members’ pain points

Oscar was founded to address a well-established issue: the U.S. healthcare system is broken.

It’s filled with complicated, disconnected, and inefficient practices and systems. At best these create a consumer experience filled with confusion – and at worst it leaves people with inaccessible, unaffordable options that result in them even sicker than when they entered.

We started Oscar to make health care easy. We are the first health insurance company pairing engagement with our own full-stack technology. Oscar is centered around our members – engaging them, guiding them to the right care, and empowering them to take charge of their own health care.

But - we know we can do many things better. As a company, we are constantly looking at our data to understand where we can improve. Some of these gaps are because the healthcare system around us has a particular gap, and we haven’t found a way to fix it yet. Other gaps are due to our own shortcomings.

Starting today, we’ll be doing two things. One, we will start sharing publicly the systematic tracking that we generate internally, which helps us track the pain points our members experience, and which constantly informs our work. This establishes an unprecedented level of transparency into the areas where we’re falling short in making healthcare easier. Two, we will take you through a series of LinkedIn posts where we dive deeper into each category of issues, and connect the dots to the larger issues in the healthcare system. We hope this gives other organizations data and ideas on where to look for improvements as well.

Why are we doing this?

We take every piece of member feedback seriously. And at Oscar, one of our long-standing values is: “publish, even when it hurts.”

We want our members to know that we recognize areas where they need us to do better.

How did we do this?

We track every single instance where members have expressed dissatisfaction, and we organize feedback into two categories*:

• Complaints: Instances where the member’s primary reason for contacting Oscar was to express dissatisfaction, such as submitting formal complaints through member support channels like our team or tools, or commentary on social media.
• Annoyances: Any instances where the member did not explicitly contact Oscar because of dissatisfaction, but we identified a degree of dissatisfaction in a conversation or ticket related to the primary reason they contacted Oscar.

Below, you’ll find our overall complaints and annoyances trend charts, which we will continue to track and share publicly.

Fortunately, both of these charts show consistent improvement over time in making our members happy. (Our net promoter score this year is at 40, significantly above the individual market average of -12). You can also see that each new year brings a temporary increase in annoyances. There are a number of drivers of this spike - including longer wait times at the beginning of the year and frustrations from people who don’t engage often with the healthcare system. We will spend some time looking into these - and what we can do to fix them - in subsequent posts.

We’ve categorized thousands of pieces of feedback (complaints and annoyances) from our members into five categories*: Enrollment, Care, Benefits, Network, and Cost. In the next few posts, we’ll dig deeper into each. Each will also tell us something about the gaps in the existing healthcare system, and what we are doing to address them.

What’s next?

This analysis will serve as a benchmark for our success addressing our member’s biggest concerns over time. This will also create opportunities to collaborate with stakeholders across the industry, and - we hope - inspire others to take an honest look at where they can help reduce consumer pain points.

In the years to come, we will keep publishing these metrics, so everyone can keep closer track of how we’re doing, and if we’re living up to our mission to make healthcare easy.

*These categories are for Oscar’s internal use only.