How to Build an AI-Native Health Plan with Mario Schlosser

Tech Challenges

Mario Schlosser, co-founder of Oscar Health, shares insights into the complexities of building healthcare technology stacks. He explains that transitioning from old systems to new ones is a lengthy process, often taking years due to the intricacies of operating live systems and the need for comprehensive data integration 1. Mario emphasizes the importance of having visibility into all operations, which has significantly contributed to Oscar's success 1.

The survival rate of Oscar way outpaces something like 97% of the insurers that started in the ACA back then.

--- Mario Schlosser

He also discusses the initial strategy of outsourcing components like claims processing, which later evolved into a more integrated approach to enhance consumer experience 1.

   

Tech Transformation

Oscar Health, described as a digital-native health plan, aims to revolutionize healthcare through technology. Mario Schlosser highlights the shift towards a software-as-a-service model, making their platform available to others in the healthcare system 2. He outlines the initial challenges of building a health plan, which involved outsourcing many components and gradually bringing them in-house to improve efficiency and control 3.

We insourced claims in February 2017. And the reason why that is so interesting is because literally this week, we finally switched off that system.

--- Mario Schlosser

This transition reflects Oscar's commitment to leveraging technology for better healthcare delivery and operations.

   

Network Innovation

Oscar Health is reimagining doctor networks by focusing on efficiency and member satisfaction. Mario Schlosser discusses the potential of non-monolithic networks that go beyond mere cost efficiency, emphasizing the need for unique provider benefits like preferred scheduling slots 4. He also highlights the importance of value-based care, noting that about 45% of Oscar's members are in such contracts, which aim to reduce costs and improve care quality 5.

Members have an ability of spotting quacks, whatever, like bad doctors, just like people who really want to take their money, essentially.

--- Mario Schlosser

This approach aims to optimize healthcare delivery by aligning incentives and improving patient experiences.