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Oscar(OSCR) - 2025 Q2 - Earnings Call Transcript
2025-08-06 13:02
Financial Data and Key Metrics Changes - Total revenue for Q2 2025 was reported at $2,900,000,000, representing a 29% increase year over year [7][18] - The medical loss ratio (MLR) increased by 12 points year over year to 91.1%, primarily due to an overall increase in average market morbidity [7][19] - The SG&A ratio improved by 90 basis points year over year to 18.7% [8][21] - The loss from operations was $230,000,000, a decrease of $298,000,000 year over year, while the adjusted EBITDA loss was $199,000,000 [8][22] - The company reaffirmed its 2025 guidance, projecting total revenue between $12,000,000,000 and $12,200,000,000 [8][24] Business Line Data and Key Metrics Changes - Membership grew to over 2,000,000, an increase of 28% year over year, driven by solid retention and above-market growth during open enrollment [19] - The second quarter MLR was impacted by a $316,000,000 increase in risk adjustment payable for 2025 due to higher ACA marketplace morbidity [19] Market Data and Key Metrics Changes - The latest risk adjustment data indicates a meaningful market-wide increase in morbidity in 2025, affecting all carriers with increases in mid to high single digits [9] - The company anticipates double-digit rate increases in the market for 2026 to address current morbidity pressures [10] Company Strategy and Development Direction - The company is focused on the individual market, believing it will stabilize in 2026 and is taking actions to mitigate current industry headwinds [8][12] - Oscar Health is acquiring early-stage assets to build a consumer marketplace, including a brokerage and a direct enrollment technology platform [13][14] - The company is launching a new ICRA product in partnership with Hy Vee Inc., targeting employers and employees in Des Moines, Iowa [15] Management's Comments on Operating Environment and Future Outlook - Management believes the individual market has significant long-term growth potential and is taking corrective actions to return to profitability in 2026 [16][27] - The company is confident in its capital position and expects to absorb the majority of forecasted losses through its excess capital [32][90] Other Important Information - The company is reducing its workforce in the second half of 2025, expecting to save approximately $60,000,000 in administrative costs for 2026 [12][27] - The company has a strong capital position with approximately $5,400,000,000 in cash and investments [22][90] Q&A Session Summary Question: Guidance on 2025 free cash flow and risk adjustment payable - Management confirmed a strong capital position and indicated that the majority of expected losses would be absorbed by excess capital [31] Question: Long-term targets for 2027 - Management reaffirmed the 5% margin target and stated that no changes to long-term forecasts are being made at this time [34] Question: Multiyear earnings levers - Management indicated that there are still opportunities to improve medical costs and administrative efficiencies [41] Question: Potential risk pool deterioration - Management expressed confidence that the risk pool would not deteriorate further and that they have factored risks into their pricing for 2026 [48] Question: Market stabilization assumptions for 2026 - Management stated that conservative assumptions have been built into the 2026 guidance, considering market morbidity shifts and program integrity impacts [52] Question: Membership shifts and retention - Management noted that improved membership retention and lower lapse rates contributed to membership growth, with no adverse selection observed [105]
Bear of the Day: Centene (CNC)
ZACKSยท 2025-07-24 11:21
Core Insights - Centene Corporation (CNC) unexpectedly withdrew its earnings guidance for 2025 due to changes in the health insurance marketplace dynamics, which are anticipated to have a more significant impact on earnings than previously forecasted [1][7] Financial Impact - The company is expecting a shortfall of approximately $1.8 billion in net risk adjustment revenues, which translates to an estimated $2.75 reduction in adjusted diluted EPS for 2025 [3][7] - Wall Street analysts have significantly reduced their EPS projections for 2025, cutting the Zacks profit consensus from $7.29 to $3.55, reflecting a more cautious outlook [3][7] Market Conditions - The decision to withdraw guidance was influenced by industry risk adjustment data from Wakely, which indicated higher-than-expected overall market morbidity and a slower growth rate in the marketplace [2] - Despite challenges, the final 2024 risk-adjusted results from the Centers for Medicare and Medicaid Services met the company's expectations, and segments like Medicare Advantage are performing better than anticipated [4] Strategic Adjustments - Centene is proactively adjusting its rates to account for a higher morbidity baseline, which is seen as essential for mitigating potential losses [5] - The company plans to implement these pricing changes in states where it has significant marketplace operations, indicating a more defensive pricing strategy moving forward [5] Analyst Reactions - Wells Fargo downgraded CNC shares to Equal-Weight and reduced their price target from $72 to $30, reflecting the need for a closer examination of the second-quarter earnings and data analysis [6]