Oscar Health指引45亿美元现金流逾九成营收依赖联邦医保补贴

浑水摸鱼清源

尽管Oscar凭借定制化险种与三年45亿美元现金流展现高成长潜力，但超90%营收依附政府补贴的脆弱架构与历史盈利巨震决定了投资者切忌重仓、仅宜待深度回调逢低介入。

AI-assisted summary of 【UNRIVALED INVESTING】再次买入？下一个医疗保健巨头 — original source. Check the original for full context.

Source published: 2026-10-10

Key ideas

Oscar Health 会员数量激增至近 300 万人，总保费预计冲向 200 亿美元，管理层指引 2026 年营业利润率有望达创纪录的 4%（约 6 亿至 8 亿美元）。 (3:33)
公司预计 2027 年 EPS 达 2.25 美元，2029 年 EPS 突破 4 美元；若以当前约 33 美元股价测算，对应 2029 年动态市盈率仅约 8 倍。 (10:00)
未来三年预计累计产生 40 亿至 45 亿美元内部现金流，占当前约 110 亿美元市值的近 40%，管理层计划用于有机增长、潜在并购、分红及回购对冲可转债稀释。 (20:00)
核心死穴在于 90% 以上保费收入直接依附于联邦 ACA 财政补贴，在 80% 保费用于赔付的薄利杠杆模式下，面临美债收益率攀升及补贴削减的潜在系统性风险。 (11:48)

Detailed notes

## Background 该视频由 Bilibili UP 主“浑水摸鱼清源”于 2026 年 10 月 10 日发布，主要分享了海外投资频道《UNRIVALED INVESTING》对美国个性化医疗保险新星 Oscar Health（OSCR）的全面剖析。视频简介回顾了主讲人在 2025 年股价低位建仓并在翻倍后获利清仓的交易经历，并结合公司近期投资者日公布的财务预期，探讨其颠覆传统雇主医保模式的潜力与对政府补贴高度依赖的潜在致命风险。

## TL;DR 视频深度评估了 Oscar Health 从传统雇主统购转向平价医疗法案（ACA）细分人群定制化保险的商业模式变革，目前其会员规模已逼近 300 万人、保费规模迈向近 200 亿美元。管理层预期 2026 年利润率迎来拐点，未来三年内有望累计产生 40 亿至 45 亿美元内部现金流，并在 2029 年将每股收益提升至 4 美元以上，对应极具吸引力的远期估值。然而，公司超 90% 的保费流水高度依附于联邦政府财政补贴，加之 80% 的高赔付率成本结构、2025 年因医疗利用率与 ACA 风险调整款项倒灌引发的严重业绩暴雷，以及可转债带来的稀释隐患，构成了显著的下行风险。主讲人建议投资者严控仓位、切忌重仓，保持耐心等待市场波动带来的非理性杀跌与左侧安全边际。

## Atmosphere & style 整体叙事风格冷静客观、务实且充满操盘纪律性，完全摒弃了单纯炒作概念的狂热。主讲人在梳理公司千亿潜在市场拓展与充沛现金流前景时逻辑严密，但在谈及 2025 年业绩断崖式下修与政府补贴依存度时语气果断而冷峻，展现出成熟投资者对下行风险的高度敬畏。整期内容在乐观的成长蓝图与严苛的风险警示之间形成了张弛有度的平衡，带给听众一种理性推演、伺机而动的专业投研质感。

## Bulletin - [03:33](https://www.bilibili.com/video/BV1RsHS6RERf?t=213s) Oscar Health 会员数量激增至近 300 万人，总保费预计冲向 200 亿美元，管理层指引 2026 年营业利润率有望达创纪录的 4%（约 6 亿至 8 亿美元）。 - [10:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=600s) 公司预计 2027 年 EPS 达 2.25 美元，2029 年 EPS 突破 4 美元；若以当前约 33 美元股价测算，对应 2029 年动态市盈率仅约 8 倍。 - [20:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=1200s) 未来三年预计累计产生 40 亿至 45 亿美元内部现金流，占当前约 110 亿美元市值的近 40%，管理层计划用于有机增长、潜在并购、分红及回购对冲可转债稀释。 - [11:48](https://www.bilibili.com/video/BV1RsHS6RERf?t=708s) 核心死穴在于 90% 以上保费收入直接依附于联邦 ACA 财政补贴，在 80% 保费用于赔付的薄利杠杆模式下，面临美债收益率攀升及补贴削减的潜在系统性风险。

## Key takeaways - [00:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=0s) 历史交易回顾：主讲人曾在 2025 年美股大跌期间于 13 至 14 美元低位建仓 Oscar Health，并在数月后股价翻倍（100% 收益）时全额清仓了结。 - [01:14](https://www.bilibili.com/video/BV1RsHS6RERf?t=74s) 商业模式颠覆：打破传统雇主一刀切统购医保模式，转向平价医疗法案（ACA）市场，针对西班牙语族裔、更年期女性及慢病群体提供精准定制化健康险。 - [03:33](https://www.bilibili.com/video/BV1RsHS6RERf?t=213s) 规模与成本杠杆：会员数增至近 300 万，总保费逼近 200 亿美元；约 80% 保费用于医疗赔付（MLR），而管理及销售费用率（SGA）随规模效应降至约 15%。 - [05:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=300s) 盈利拐点与 2027 年展望：2026 年营业利润率预计达 4%（6 亿至 8 亿美元营业利润），2027 年稀释每股收益预计达到 2.25 美元，对应远期市盈率约 18 倍。 - [07:03](https://www.bilibili.com/video/BV1RsHS6RERf?t=423s) TAM 空间升级：通过 ICHRA（雇主选择制）将目标市场由数百亿美元个人市场拓展至数千亿美元雇主市场，由雇主提供免税津贴供员工自选 Oscar 定制方案。 - [07:03](https://www.bilibili.com/video/BV1RsHS6RERf?t=423s) Lucy 一站式医疗平台：通过 Lucy 平台提供透明化医疗比价与预约，并打通临床数据，即使在非主导承保州也能赚取平台服务流量与交易价值。 - [10:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=600s) 2029 年远期估值吸引力：管理层目标 2029 年 EPS 超 4 美元，以当前约 33 美元股价计算对应动态 P/E 仅约 8 倍，估值具备极高折价空间。 - [11:48](https://www.bilibili.com/video/BV1RsHS6RERf?t=708s) 收入集中度致命风险：超 90% 保费收入由 CMS 政府补贴支付（自付仅占小头），政府对医保财政支出的任何收紧都可能对公司造成毁灭性打击。 - [11:48](https://www.bilibili.com/video/BV1RsHS6RERf?t=708s) 美债收益率上升压制财政：10 年期美债收益率突破 5% 加剧美国联邦财政失衡，随着利息支出恶化，高昂的 ACA 增强型税收补贴面临严格预算削减审查。 - [16:08](https://www.bilibili.com/video/BV1RsHS6RERf?t=968s) 2025 年指引断崖式暴雷：当年业绩从预期的盈利约 3 亿美元骤变为亏损近 3 亿美元，主要受 GLP-1 减肥药等利用率激增及 ACA 风险调整款项倒灌影响。 - [16:08](https://www.bilibili.com/video/BV1RsHS6RERf?t=968s) 可转债稀释与风控防守：2025 年暴雷后公司发行数亿美元可转换优先次级票据充实流动性防火墙，带来了潜在的股权稀释隐患。 - [20:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=1200s) 巨额内部现金流保障：未来三年预计创造 40 亿至 45 亿美元现金流，占当前市值近 40%，充沛资金为股份回购与对抗稀释提供了坚实后盾。 - [21:15](https://www.bilibili.com/video/BV1RsHS6RERf?t=1275s) 高净推荐值（NPS）驱动份额扩张：凭借满足特定人群需求的差异化服务，Oscar 获得行业领先的用户满意度与客户黏性，持续蚕食传统老牌巨头份额。 - [22:18](https://www.bilibili.com/video/BV1RsHS6RERf?t=1338s) 严格仓位管理与择机策略：鉴于政府依赖度达 90% 带来的本源爆雷风险，建议切忌盲目重仓，耐心等待市场波动回调带来的左侧安全边际建仓机会。

## Detailed walkthrough ### [00:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=0s) Oscar Health Investor Day & Personal Trading Recap

Oscar Health (NYSE: OSCR) recently hosted its Investor Day, prompting a fresh review of management's projections, targets, and strategic vision. Oscar had previously presented an investment thesis tapping into an opportunity with "10x upside potential over time." That thesis led to personal share purchases during the market dips in 2025 at prices in the low teens, around $13 to $14 per share. That entire position was exited several months later earlier this year after the stock staged a sharp rally, locking in a gain of roughly 100%.

Despite having fully exited, Oscar continues to pass the core criteria of the Unrivaled Investing checklist, which screens for businesses showing obvious growth momentum, well-aligned management teams, and an authentic, "win-win consumer value proposition." This framework underpins a free multibagger training course focused on identifying stocks capable of quadrupling over a four-year horizon (4x in 4 years). Evaluating Oscar today requires recognizing that the broader healthcare and health insurance landscape has shifted dramatically from the legacy employer-sponsored model.

[01:14](https://www.bilibili.com/video/BV1RsHS6RERf?t=74s) Tailored Plans and the Affordable Care Act Paradigm Shift

The traditional American health insurance model has historically been defined by rigid employer group purchasing. A company would evaluate a handful of health plans, purchase a single standardized package, and mandate it across its entire workforce regardless of individual health profiles. Oscar identified a fundamental market inefficiency in this one-size-fits-all approach and pivoted toward individualization enabled by the Affordable Care Act (ACA) exchanges.

Rather than forcing diverse employee populations into generic coverage, Oscar designs hyper-targeted insurance products tailored to discrete demographics and health conditions. Examples of these custom programs include: - Dedicated Spanish-language plans specifically built for consumers who speak primarily Spanish at home, eliminating language and administrative friction. - Tailored coverage specifically designed for postmenopausal women. - Chronic condition management tracks engineered around conditions such as diabetes, asthma, and hypertension.

By establishing specialized underwriting, clinical pathways, and care navigation for these specific subsets, Oscar delivers higher customer satisfaction. This focus is reflected in industry-leading Net Promoter Scores (NPS), with members consistently endorsing their Oscar plans over legacy alternatives.

```mermaid flowchart TD accTitle: Oscar Health Targeted Plan Strategy accDescr: Visualizing the shift from traditional employer coverage to Oscar Health targeted plans.

subgraph Legacy["Traditional Employer Model"] EMP["Employer Selects Single Carrier"] --> ALL["Generic Plan For All Employees"] end

subgraph Oscar["Oscar Health Segmented Strategy"] ACA["Affordable Care Act Exchanges / Choice"] ACA --> SP["Spanish Speakers Program"] ACA --> PM["Postmenopausal Women Plan"] ACA --> CHR["Chronic Care: Diabetes / Asthma / Hypertension"] end

Legacy -.->|"Disrupted by"| Oscar ```

[03:33](https://www.bilibili.com/video/BV1RsHS6RERf?t=213s) Revenue Explosion and Cost Structure Dynamics

Oscar's specialized proposition has fueled substantial top-line and enrollment expansion across the ACA individual marketplaces. The company's total member base has expanded rapidly from roughly 1 million members to nearly 3 million members. Concurrently, top-line premiums and revenue have surged from just a few billion dollars historically to nearly $20 billion expected this year, demonstrating clear market share gains against legacy carriers.

However, health insurance is an intrinsically narrow-margin industry governed by strict cost structures: - **Medical Loss Ratio (MLR):** Approximately 80% of the incoming ~$20 billion in premium revenue goes directly out the door to cover medical claims and healthcare provider costs. - **Operating Overhead (SG&A):** Sales, general, and administrative expenses historically oscillated between 20% and 30% of revenue, but operational scaling has steadily compressed SG&A down toward roughly 15%.

This cost profile leaves thin baseline operating margins. Although multi-year trends had shown structural cost improvements, 2025 served as a significant negative outlier with unexpected spikes in medical utilization and volatile risk adjustments, highlighting how vulnerable narrow-margin insurers remain to sudden shifts in member sickness, claims velocity, and government policy.

[05:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=300s) Margin Inflection, 2026–2027 Outlook, and Valuation

At its Investor Day, management reiterated an annual revenue outlook around $19 billion to $20 billion while forecasting a material rebound in operational efficiency. With medical claims costs trending favorably, the company is guiding toward a reduced Medical Loss Ratio alongside stable SG&A, driving an inflection in bottom-line profitability.

For 2026, Oscar projects the strongest operating margins in its corporate history at approximately 4%, translating to roughly $600 million to $800 million in operating profit. Looking out to 2027, management forecasts: - Diluted earnings per share (EPS) of approximately $2.25. - Sustained hyper-growth in direct written premiums and continued market share conquest across core ACA regions. - An attractive valuation profile, with the stock trading at an implied forward price-to-earnings multiple in the mid-teens (around 18x forward earnings), which is "certainly not expensive relative to the growth."

[07:03](https://www.bilibili.com/video/BV1RsHS6RERf?t=423s) TAM Expansion: From Individual ACA to ICHRA and the Lucy Marketplace

Management emphasized that the core individual ACA exchange is merely the entry point. The broader growth strategy centers on transitioning from an addressable market worth tens of billions into an employer-backed market worth hundreds of billions of dollars.

Historically known as ICHRA (Individual Coverage Health Reimbursement Arrangement) and now increasingly marketed as "Choice," this mechanism allows both small businesses and large enterprises to abandon traditional group health plans. Instead, the employer allocates a defined pre-tax dollar stipend directly to each employee, stating, "we previously set aside this much for your health costs... that actually goes straight to you and you decide which plan fits your needs." Because "different strokes for different folks," individual employees can allocate their employer allowance to select an Oscar niche plan that matches their distinct medical needs.

Beyond underwriting risk, Oscar is expanding into healthcare consumerism through the acquisition and rebranding of its marketplace platform, **Lucy**: - **Price Transparency & Direct Booking:** Lucy functions as an open healthcare marketplace allowing patients to shop for clinical services (such as diagnostic blood draws, lab work, and imaging) by comparing verified customer reviews and transparent out-of-pocket prices across competing facilities. - **System Integration:** All diagnostic and clinical data flows directly back into Oscar's integrated care management system. - **A Platform Play:** If Oscar is not the dominant insurance underwriter in a specific state, it still aims to capture transaction volume by owning the digital marketplace platform connecting patients, insurers, and medical providers.

[10:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=600s) 长期每股收益指引与估值吸引力

管理层设定了一个极具野心的长期目标：在持续超高速增长和利润率扩张的推动下，到 2029 年公司的每股收益（EPS）预计将突破 4 美元以上。若以当前约 33 美元的股价计算，这意味着该股对应 2029 年预期收益的远期市盈率仅为 8 倍左右，处于相当公允甚至极为便宜的估值区间。面对如此高确定性的增长轨迹，Oscar Health 究竟是否正处于被市场低估的打折促销状态？主讲人特别提示，本分析仅用于投教分享，不构成直接的投资建议。

在分享社区反馈时，主讲人读到了几位长期会员的致信。会员 Barry S. 表示，加入会员数年来，主讲人的投资历程与投教工具对自己的投资起到了极大的帮助；另一位会员 Isbell 则幽默地写道：“自从关注了你，我对自己的投资感觉好多了，哪怕跟你去世界尽头或者去火星我也跟定你了。”主讲人调侃称“希望我们暂时不需要真的跑去火星”，并邀请感兴趣的观众加入其 Unrivaled Investing 社区，获取实盘组合更新、每月金股视频、每周深度研究报告以及独家 Discord 讨论群组。

- **2029 年 EPS 目标**：4 美元以上 - **当前股价**：约 33 美元 - **2029 年动态估值**：约 8 倍市盈率（P/E）

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[11:48](https://www.bilibili.com/video/BV1RsHS6RERf?t=708s) 致命死穴：90%营收依赖政府补贴与美债利率风险

尽管长期估值极具吸引力，但专有 AI 分析工具“Flash”却给出了谨慎预警：该标的的风险回报比并不理想，存在超过 50% 的潜在下行风险。这种担忧并非空穴来风，其根本原因在于 Oscar Health 特殊的商业变现架构。当消费者在平价医疗法案（ACA，即奥巴马医保）平台上挑选金牌、银牌或铜牌保险计划时，假设一份全额保费为每月 600 美元，投保人根据自身收入、年龄及居住地等因素测算后，自掏腰包的往往只有 50 美元左右；而剩余高达 550 美元的巨额差额，全部来自美国联邦医疗保险和医疗补助服务中心（CMS）的政府财政补贴。

这种高度集中的收入来源构成了公司的核心脆弱性——Oscar 超过 90% 的保费流水直接依附于政府补贴政策。更为紧绷的是其成本结构：每收取 1 美元的保费，就有大约 80 美分直接用于支付医疗理赔（医疗损失率 MLR）。在这类薄利且波动极高的商业模式下，一旦美国政府因财政压力取消或收紧增强型税收补贴（Enhanced Subsidies），将直接重创公司的现金流与盈利底线。

随着近期 10 年期美债收益率一路从 4% 攀升至 5% 以上，美国联邦政府财政支出失控的隐患正在加速暴露。国债市场面临严重的供需失衡，而政客们的惯性思维往往是继续借新还旧、推迟危机，这可能推动美债收益率进一步迈向 6%、6.5% 甚至 7%。长远来看，当国债市场反噬联邦预算时，高昂的医保财政补贴势必面临被削减的严峻审查。虽然 Oscar 管理层据理力争，认为 ACA 市场的充分竞争使得医保通胀率远低于其他传统险种，能为政府节省开支并推动雇主赋予员工更多选择权，但“90% 收入靠政府、80% 成本归理赔”的高杠杆现状，仍让投资者如坐针毡。

```mermaid flowchart LR accTitle: ACA 模式下的保费收入构成与医疗赔付流向 accDescr: 展示消费者自付与政府补贴构成的总保费，以及保费流向医疗赔付的成本结构。 subgraph Revenue["月度保费结构 (假设 $600/月)"] A["个人自付 约 $50 (~8%)"] B["CMS 政府补贴 (ACA) 约 $550 (~92%)"] end subgraph Premium["总保费池 (100%)"] C["Oscar Health 保费收入 $600"] end subgraph Outflow["赔付支出与利润空间"] D["医疗损失支出 (MLR) 约 80% (医疗理赔)"] E["留存毛利与营运费用 约 20%"] end A --> C B --> C C --> D C --> E ```

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[16:08](https://www.bilibili.com/video/BV1RsHS6RERf?t=968s) 2025年业绩爆雷、风险调整陷阱与可转债稀释

除了对宏观政策的极度敏感，Oscar 极易波动的历史业绩也是一大隐患。在 2025 年，公司经历了一次灾难性的指引滑铁卢：管理层最初向市场给出了约 3 亿美元的年度盈利预期，但仅在数月之后便不得不大幅砍掉指引，最终演变成近 3 亿美元的巨额亏损。这种前后高达 6 亿美元的断崖式落差严重损害了管理层的公信力——即使首席执行官 Mark Bertolini 此前因成功掌舵并高价出售安泰保险（Aetna）而在业内享有极高声誉，也难以平息市场的恐慌。

造成这次业绩暴雷的核心原因包括全行业性的医疗利用率激增（部分原因归咎于诺和诺德等 GLP-1 减肥药的广泛普及应用），以及 ACA 机制特有的“风险调整支付金”（Risk Adjustment Payments）倒挂。在 ACA 框架下，保费池会根据不同保险公司参保人群的患病程度（健康敏锐度 Acuity）重新分配资金：如果一家险企测算自身会员病患程度较高，但实际汇总比对后发现其群体健康状况反而优于行业平均水平，该险企就必须将收取的巨额保费反向退还或补缴给资金池。这种宛如“反转卡（Uno Reverse Card）”的政府再平衡机制，给 Oscar 的账面利润带来了极大的不确定性，也是纯消费端业务所不具备的制度性风险。

```mermaid flowchart TD accTitle: ACA 风险调整支付金运作机制与业绩反转 accDescr: 解释 Oscar Health 因健康度重新核算导致保费回吐并引发 2025 年巨亏的流程。 subgraph AcuityAssessment["风险评估与初始预期"] F["评估参保人群健康敏锐度 (预期病患程度较重)"] G["给出乐观业绩指引 (预计实现约 3 亿美元利润)"] F --> G end subgraph ExternalFactors["外部冲击"] H["医疗利用率激增 (如 GLP-1 药物普及)"] I["ACA 行业全盘风险再比对 (自身群体实际健康度优于大盘)"] end subgraph Result["业绩爆雷与机制惩罚"] J["触发风险调整扣款 (保费倒灌回吐给其他险企)"] K["指引断崖式暴跌 (演变为近 3 亿美元亏损)"] end G --> H H --> I I --> J J --> K ```

业绩暴跌之后，管理层宣布发行数亿美元的可转换优先次级票据（Convertible Senior Subordinated Notes），这成为了促使主讲人果断获利清仓的关键诱因。虽然管理层对外将此举美化为储备“增长资本”，但主讲人敏锐地意识到，其背后真实动因是在增强型补贴退坡、医疗索赔趋势恶化的背景下，管理层急于通过具有潜在稀释性的股债混合工具建立流动性防火墙，防止公司在遭遇类似 2025 年那样的突发系统性冲击时彻底崩盘。这种转股可能带来的股权稀释以及管理层防御性的心态，促使主讲人在翻倍收益后选择落袋为安。

- **2025 年指引落差**：从预计盈利约 3 亿美元骤变为亏损近 3 亿美元（振幅高达 6 亿美元） - **医疗端扰动**：医疗利用率激增（包括 GLP-1 药物滥用）与 ACA 风险调整款项倒灌 - **资本运作隐患**：发行数亿美元可转换优先次级票据，带来潜在的股权稀释风险并暴露出管理层的风控防守姿态

[20:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=1200s) Massive Internal Capital Generation and Capital Allocation Plans

Management has expressed immense confidence in steering Oscar Health back toward significant profitability, projecting an impressive $4.0 billion to $4.5 billion in cumulative internal capital generation over the next three years. When evaluated against Oscar's current share price of approximately $33 per share—which translates to an enterprise market capitalization of roughly $11 billion—that projected capital generation represents nearly 40% of the entire company's market value generated purely in cash over a 36-month window. This sheer magnitude makes the underlying valuation dynamic "quite compelling" when looking forward.

Oscar's leadership outlined several key priorities for deploying this incoming wave of cash flow. Beyond returning capital to shareholders, management plans to fund organic business expansion, explore potential strategic M&A, and consider initiating dividend payments. Crucially, that capital can also be deployed to manage share dilution through opportunistic share repurchases, offsetting the overhang from previous convertible bond issuances. For an investor, having a company priced at an $11 billion valuation capable of generating billions in cash flow makes the risk-to-reward calculus exceptionally intriguing.

- **Cumulative Cash Generation Projection:** $4.0 billion to $4.5 billion over the next three years. - **Current Valuation Metrics:** ~$33.00 per share, yielding an approximate $11.0 billion market cap. - **Cash Flow Yield:** Projected internal capital generation equates to roughly 40% of current market capitalization. - **Capital Allocation Priorities:** Organic expansion funding, potential M&A, potential shareholder dividends, and share buybacks to combat dilution.

[21:15](https://www.bilibili.com/video/BV1RsHS6RERf?t=1275s) Customer Love, NPS, and the Tailored Care Strategy

A core pillar supporting the bull case is Oscar's sky-high Net Promoter Score (NPS) and outstanding customer loyalty. A foundational tenet of the *Unrivaled Investing* philosophy is that when customers genuinely love a product or service, "eventually the stock and Wall Street will eventually love it as well." That dynamic played out over the preceding year as sentiment pivoted and Oscar's stock experienced a massive rally.

Central to that customer resonance is Oscar's tailored plan architecture. Rather than treating healthcare coverage as an undifferentiated, monolithic block, Oscar creates customized plans designed to exceed expectations for precise demographic and clinical segments—such as dedicated coverage built from the ground up for individuals managing diabetes. By meeting patients where their actual needs lie, the company continues to pull market share away from legacy health insurance incumbents.

```mermaid flowchart TD accTitle: Oscar Health Value Creation Flow accDescr: Flowchart illustrating how tailored plan design drives customer satisfaction, revenue growth, and capital allocation.

subgraph ProductStrategy["Product Strategy"] A["Tailored Segment Plans (e.g., Diabetes, Specialized Demographics)"] B["High Net Promoter Score (NPS) & Customer Satisfaction"] end

subgraph MarketImpact["Market & Financial Impact"] C["Market Share Capture from Incumbents"] D["$4.0B–$4.5B Cumulative Capital Generation"] end

subgraph Deployment["Capital Deployment"] E["Organic Growth & M&A"] F["Dilution Management & Buybacks"] end

A --> B B --> C C --> D D --> E D --> F ```

[22:18](https://www.bilibili.com/video/BV1RsHS6RERf?t=1338s) Government Dependence, Position Sizing, and Long-Term Investment Thesis

Despite the strong consumer adoption and robust cash generation forecasts, there remains an unavoidable, existential headwind: customer concentration risk. Roughly 90% of Oscar's top-line revenue flows directly through federal Affordable Care Act (ACA) government subsidies. Because a single legislative stroke or policy shift could jeopardize this income stream, Oscar carries genuine "blow-up risk." Consequently, the stock cannot justify an outsized portfolio allocation, such as an immediate 10% position, unless the business undertakes a radical structural transformation that drastically reduces its sovereign customer concentration.

Instead, the actionable strategy is to maintain discipline and wait for pullbacks: - **Buy on Weakness:** Take advantage of broader market volatility to establish or rebuild an initial position at a wide margin of safety. - **Strict Risk Allocation:** Start with a modest, controlled position size and allow portfolio exposure to grow organically as the company executes. - **Alignment with Systematic Healthcare Reform:** Oscar is structurally positioned as an engine for healthcare reform by taking unnecessary costs out of the system in a competitive, win-win-win model where "the government spends less, customers get better care, and there's more solutions available."

Oscar firmly meets the criteria outlined on the *Unrivaled Investing Checklist*—demonstrating superior consumer love, visible market share capture, and a realistic path toward billions in cash flow, tempered only by prudent position sizing against regulatory dependence.

## Notable quotes > [00:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=0s) 10x upside potential over time

> [00:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=0s) win-win consumer value proposition

> [05:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=300s) certainly not expensive relative to the growth

> [07:03](https://www.bilibili.com/video/BV1RsHS6RERf?t=423s) we previously set aside this much for your health costs... that actually goes straight to you and you decide which plan fits your needs.

> [07:03](https://www.bilibili.com/video/BV1RsHS6RERf?t=423s) different strokes for different folks

> [10:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=600s) 自从关注了你，我对自己的投资感觉好多了，哪怕跟你去世界尽头或者去火星我也跟定你了。 — Isbell

> [10:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=600s) 希望我们暂时不需要真的跑去火星

> [20:00](https://www.bilibili.com/video/BV1RsHS6RERf?t=1200s) quite compelling

> [21:15](https://www.bilibili.com/video/BV1RsHS6RERf?t=1275s) eventually the stock and Wall Street will eventually love it as well.

> [22:18](https://www.bilibili.com/video/BV1RsHS6RERf?t=1338s) blow-up risk

> [22:18](https://www.bilibili.com/video/BV1RsHS6RERf?t=1338s) the government spends less, customers get better care, and there's more solutions available.

## Mentioned Oscar Health, Unrivaled Investing, Affordable Care Act (ACA), Lucy, ICHRA, Mark Bertolini, Aetna, Novo Nordisk, GLP-1, CMS (Centers for Medicare & Medicaid Services), Flash, Barry S., Isbell, Discord

## Video description 【UNRIVALED INVESTING】再次买入？下一个医疗保健巨头 Oscar Health (OSCR) CHEAP & GROWING？

今天我们来深度剖析美国个性化医疗保险新星 Oscar Health（股票代码：OSCR）。该公司近期举办了投资者日，管理层释放出强烈的成长预期。回顾我自己过去的交易记录，我在2025年美股大跌期间于13.40美元左右的低位建仓，并在随后几个月股价翻倍至100%收益时全部清仓。目前该公司的股价大约在33美元左右。Oscar 的核心逻辑在于打破传统雇主统一购买医保的僵局，转而通过平价医疗法案（ACA，即奥巴马医保）市场，针对不同细分人群（如西班牙语族裔、更年期女性、糖尿病等慢性病群体）推出高度定制化的专属健康险计划，并致力于打造一站式医疗服务市场平台（Lucy）。

从核心业务及财务数据来看，公司会员数量从早期的100万人飙升至近300万人，今年总保费收入预计将从过去的数十亿美元跃升至近200亿美元。在成本结构方面，大约80%的保费收入用于支付医疗理赔成本（医疗损失率 MLR），而销售及行政开支（SGA）随着规模效应逐渐下降至15%左右。管理层预计2026年将迎来公司历史上最优异的利润率，利润率有望达到4%左右，预计实现6亿至8亿美元的营业利润。到2027年，每股收益（EPS）预计将达到2.25美元，对应十多倍的前瞻市盈率；而在2029年，管理层长远规划每股收益将超过4美元，若按当前33美元股价计算，对应2029年动态市盈率仅为8倍左右。

然而，投资者必须高度警惕其潜在的重大风险。首先是极高的客户与政策集中度风险：Oscar有高达90%以上的保费收入依赖于美国政府平价医疗法案（ACA）的财政补贴。如果未来政府削减补贴或收紧医保政策，公司将遭受毁灭性打击。其次是历史业绩波动剧烈，2025年曾出现过从预期的3亿美元盈利突然变为近3亿美元亏损的巨大滑坡，主要由于医疗利用率超预期及ACA风险调整支付金的不确定性。最后，公司此前曾发行过数亿美元的可转换债券，存在一定的股权稀释隐患。不过考虑到其未来三年预计产生40亿至45亿美元的累计内部现金流，其成长爆发力与低估值吸引力依然并存。

可执行操作指引：密切追踪美国平价医疗法案（ACA）政府补贴政策的后续演变及10年期美债收益率对财政支出的压制影响。设定合理的仓位管理，由于政府依赖度高达90%，建议控制整体持仓比例，切忌盲目重仓。保持耐心等待市场波动带来的回调机会，若未来股价出现非理性杀跌，可结合估值安全边际择机分批左侧建仓。

简洁时间轴 [00:00] Oscar Health近期投资者日核心看点与个人历史交易回顾 [01:14] 业务模式变革：从传统雇主统购转向ACA细分人群定制化保险 [03:33] 核心财务数据：保费冲向200亿美元与利润率改善预期 [07:03] 长期增长驱动：从百亿美联储市场到数百亿雇主选择制改革 [11:48] 致命风险揭秘：90%营收依赖政府补贴与2025年业绩暴雷教训 [19:11] 现金流创造能力、可转债稀释隐患与当前估值性价比评估

[Source](https://www.bilibili.com/video/BV1RsHS6RERf)

中文简报

Oscar Health指引45亿美元现金流逾九成营收依赖联邦医保补贴尽管Oscar凭借定制化险种与三年45亿美元现金流展现高成长潜力，但超90%营收依附政府补贴的脆弱架构与历史盈利巨震决定了投资者切忌重仓、仅宜待深度回调逢低介入。视频深度评估了 Oscar Health 从传统雇主统购转向平价医疗法案（ACA）细分人群定制化保险的商业模式变革，目前其会员规模已逼近 300 万人、保费规模迈向近 200 亿美元。管理层预期 2026 年利润率迎来拐点，未来三年内有望累计产生 40 亿至 45 亿美元内部现金流，并在 2029 年将每股收益提升至 4 美元以上，对应极具吸引力的远期估值。然而，公司超 90% 的保费流水高度依附于联邦政府财政补贴，加之 80% 的高赔付率成本结构、2025 年因医疗利用率与 ACA 风险调整款项倒灌引发的严重业绩暴雷，以及可转债带来的稀释隐患，构成了显著的下行风险。主讲人建议投资者严控仓位、切忌重仓，保持耐心等待市场波动带来的非理性杀跌与左侧安全边际。 Oscar Health 会员数量激增至近 300 万人，总保费预计冲向 200 亿美元，管理层指引 2026 年营业利润率有望达创纪录的 4%（约 6 亿至 8 亿美元）。 (3:33) 公司预计 2027 年 EPS 达 2.25 美元，2029 年 EPS 突破 4 美元；若以当前约 33 美元股价测算，对应 2029 年动态市盈率仅约 8 倍。 (10:00) 未来三年预计累计产生 40 亿至 45 亿美元内部现金流，占当前约 110 亿美元市值的近 40%，管理层计划用于有机增长、潜在并购、分红及回购对冲可转债稀释。 (20:00) 核心死穴在于 90% 以上保费收入直接依附于联邦 ACA 财政补贴，在 80% 保费用于赔付的薄利杠杆模式下，面临美债收益率攀升及补贴削减的潜在系统性风险。 (11:48)

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主讲人回顾了其在 Oscar Health（NYSE: OSCR）股价翻倍后获利清仓的交易，并指出该公司凭借细分定制医保策略展现出强大的市场份额扩张与现金流潜力；但鉴于其 90% 的营收高度依赖政府补贴，且面临政策变动与业绩剧烈波动的风险，投资该标的必须审慎评估风险回报比。细分定制模式与潜在市场扩张 (1:14) 传统美国雇主医保模式通常采购单一标准化保单，忽视了员工个体的健康差异。Oscar 抓住平价医疗法案（ACA）交易平台的机遇，推出针对特定人群（如西语族群、绝经后女性以及糖尿病、哮喘和高血压等慢性病患者）的定制化保险方案，借此获得行业领先的净推荐值（NPS），参保人数从约 100 万激增至近 300 万，年营收规模预期接近 200 亿美元。在巩固个人 ACA 市场的同时，公司正依托 ICHRA（现推广为“Choice”机制）将业务由百亿美元级别的个人市场向数千亿美元的企业雇主市场渗透，允许雇主提供税前补贴由员工自选合适方案。此外，Oscar 通过收购并重塑 Lucy 平台打造医疗消费闭环，提供透明比价与直接预约服务，试图在未成为主导承保方的地区通过数字平台撮合交易，赚取平台化收益。利润率拐点与长期现金流目标 (5:00) 管理层在投资者日重申了 190 亿至 200 亿美元的年营收预期，并预测营运效率将出现实质性反转。随着管理费用率（SG&A）受规模效应压缩至约 15%，公司指引 2026 年营业利润率达到创纪录的约 4%，实现 6 亿至 8 亿美元营业利润；2027 年摊薄每股收益（EPS）预计达 2.25 美元，对应约 18 倍的远期市盈率。从更长周期来看，管理层设定了 2029 年 EPS 突破 4 美元的目标，以当前约 33 美元股价计算，对应远期市盈率约 8 倍。同时，管理层预计未来三年累计将产生 40 亿至 45 亿美元的内部现金，相当于公司目前约 110 亿美元市值的近 40%，并计划将资金用于内生业务扩张、战略并购、分红以及通过股票回购管理稀释。高补贴依赖与美债利率上行风险 (11:48) 专有分析工具“Flash”提示 Oscar 存在超过 50% 的潜在下行风险。其商业模式的致命死穴在于极端依赖政府补贴：在典型的 ACA 月保费结构中（假设为 600 美元），投保人个人自付通常仅约 50 美元，其余约 550 美元均由联邦医疗保险和医疗补助服务中心（CMS）通过财政补贴承担，导致公司超过 90% 的保费流水直接依附于政府政策。更严峻的是，健康险本身属于薄利行业，Oscar 收取的保费中有约 80% 需直接用于医疗理赔（医疗损失率 MLR）。在 10 年期美债收益率走高、美国联邦赤字承压的背景下，若政府财政压力迫使其削减或取消增强型税收补贴，这种“90% 靠政府、80% 归赔付”的脆弱杠杆架构将直接重创公司的现金流底线。 2025年业绩爆雷与可转债稀释隐忧 (16:08) Oscar 的历史经营极具波动性。在 2025 年，公司经历了一次严重的指引滑铁卢，年度业绩预期从原先约 3 亿美元的利润急转为近 3 亿美元的巨额亏损，前后达 6 亿美元的落差削弱了管理层的市场信誉。业绩暴跌的主因在于全行业医疗利用率激增（包括 GLP-1 减肥药的普及应用），以及 ACA 特有的“风险调整支付金”倒挂——当系统核算发现自身参保人群实际健康状况优于全行业平均水平时，险企须将已收取的保费反向退还至资金池。在业绩暴雷后，管理层发行了数亿美元的可转换优先次级票据。主讲人指出，尽管官方声称此举是为了储备增长资本，但实质是面对索赔恶化建立流动性防御防火墙，其带来的潜在股权稀释和防守姿态成为了主讲人此前获利清仓的关键催化剂。主讲人总结认为，Oscar 凭借差异化产品和高客户满意度顺应了医保降本改革的方向，且具备产生数十亿美元现金流的潜力；但鉴于其超 90% 收入受制于政府政策的系统性风险，该标的并不适合大比例重仓（如 10% 仓位），更为可行的策略是严守仓位纪律，等待市场剧烈回调释放安全边际后再行布局。

Source quotes

[0:00] 10x upside potential over time [0:00] win-win consumer value proposition [5:00] certainly not expensive relative to the growth [7:03] we previously set aside this much for your health costs... that actually goes straight to you and you decide which plan fits your needs. [7:03] different strokes for different folks [10:00] Isbell: 自从关注了你，我对自己的投资感觉好多了，哪怕跟你去世界尽头或者去火星我也跟定你了。 [10:00] 希望我们暂时不需要真的跑去火星 [20:00] quite compelling [21:15] eventually the stock and Wall Street will eventually love it as well. [22:18] blow-up risk [22:18] the government spends less, customers get better care, and there's more solutions available.

Original transcript

[0:00] Oscar Health or OSCR stock recently had their investor day. And so I wanted to walk through what management is saying, what they expect, because I previously did a video on Oscar talking about how I had bought shares and also had talked about how they were tapping into an opportunity that created 10x upside potential over time. So significant upside potential. 2025 buying in the low teens around 13, $14 per share. And subsequently in the last few months, Earlier this year, I'd actually completely exited the position for roughly 100% gain as the stock had rallied. Now, I look at Oscar, and it largely passes my unrivaled investing checklist, you know, where I'm looking for companies with... Obvious growth, aligned management, a win-win consumer value proposition. I talk more about the importance of this checklist in my free course on how to find potential multibaggers or the types of stocks that could potentially forex in four years. You can check that out at Unrivaled Investing. Once again, that's a completely free course if you want to learn more about that checklist. But when I look about Oscar today and I look at where they've been and where they're going, it's important to understand the landscape has changed quite a bit. employers buying insurance for their employees. And it would be, here's the package that we got, and it's for all of our employees. Oscar is recognizing, you know what, what if we can have a bunch of different packages that might fit different parts of the population? And we'll talk about the importance of this in terms of creating value and unlocking costs in a way that a lot of these competitors can't match. And so that meets the era of the Affordable Care Act, these custom plans. plans, but we also want to become the number one health insurance marketplace. So if there's a state or region where we're not the number one or not most competitive, we want the other platforms, the other, you know, insurance solutions to win, but we want to own that marketplace for potential services as well. So that's the future that they're aspiring to be. And what I just talked about is having these tailored programs. Maybe it's a offering that has to deal with Spanish speakers, something that says, hey, we custom built this. So that way folks that. Maybe they only speak Spanish at home. This product is going to resonate more. Or maybe we're targeting about postmenopausal women, or maybe we're looking at customers with potential chronic conditions, asthma, diabetes, hypertension, looking at this and saying, what if we create custom plans to deal with these subsets of the population? we become a specialist in these subsets. And that's what the data has shown with... The industry-leading net performer scores where customers say, hey, we love this. We love our Oscar plans, and that's what they've shown. And you can also see it in the numbers where the number of members on their platform in terms of their health insurance plans keep growing. where they've gone from 1 million to nearly 3 million, and they're clearly taking market share, and they're clearly growing revenue. from billions of dollars to nearly $20 billion in revenue this year. So these are the signs that their value proposition is winning. And you could see it not only in their growth, and this is such an important data point that says, this strategy of focusing on plans that are targeting the subset versus an employer that says, here's our insurance for everybody, we're going to create these niches that are more valuable for the end consumer. and you see it with the results. where they've been able to scale significantly in the Affordable Care Act markets, which is where they're focused on, you could see that the cost structure is getting... more under control over time. It has been bouncing around a bit. 2025 was a bit of an outlier in terms of several years of improvement. Then 2025, you know, had this huge negative movement. And these figures do help you understand what's going on, which is roughly $20 billion in premiums coming in. And then of that $20 billion, there's, around 80% of that is going back out for medical care. [5:00] claims. for medical costs. And then the remainder... around 15%, historically bouncing around between 20 and 30, but... coming down as they scale around 15% is their operating expenses, the sales, general, and admin expenses. So that leaves a very narrow margin business. But as they get scale, as their sales continue to grow at an exponential rate, there's the potential for their margins to improve significantly. And that's why they're looking at 2026 and saying, yeah, this is going to be the best margins we've ever had. where we're now going to be looking at around 4% margin. So very narrow margin business dependent on, you know, how, How much the customers are going to be using their medical plans, how sick the customer base is, changes in government policy. There's a lot of moving parts, and that's part of the reason why in 2025 you saw that huge uptick in costs. So we'll talk more about that in just a second. So looking at it now, this is from their investor day. Their prior outlook was around $19 billion. They're still keeping that outlook. However, they're saying the costs have improved. Thank you. So they're lowering that medical loss ratio a bit. So the lower this is, the more profitable they are. underlying operating expenses are roughly the same. So because their medical loss ratio is more favorable, their underlying profitability is surging a bit higher. So that's what you're seeing here. So around 600 to 800 million in operating profit. And they're expecting in 2027 to deliver around $2.25 in earnings, continuing their hyper growth in terms of premiums that means continued market share continued expansion continued margin improvement and that suggests they're trading once again around 18's forward earnings multiple certainly not expensive relative to the growth and this is what gets a lot of investors excited and management would say well wait a second We're just getting started here, folks, because when you look at the Affordable Care Act marketplace, you know, with the tens of millions of. customers on the platform, we think we're going to be able to keep winning users over time. Maybe it's part-time workers that want insurance. Maybe it's gig workers that go onto the Affordable Care Act platforms. Maybe it's employers. And, you know, small, small companies and larger companies that are going to increasingly switch to a choice based system. It was previously called ICRA. Now it's going by choice. Or maybe the whole strategy goes from the employer picks to the employer gives you a stipend or a dollar figure saying, hey, we previously set aside this much for your health costs. Set aside a similar figure, but that actually goes straight to you and you decide which plan fits your needs. Because different strokes for different folks. You know, some folks, the postmenopausal woman, she might want a different plan versus the Spanish speaker versus, you know, the guy with diabetes. Yeah. This is where these different niches, this is exactly where Oscars. playing and saying we can create value here. And by the way, this is a tremendous market for us. Tremendous potential. And... The potential goes from, let's say tens of billions of dollars in terms of revenue in the ACA market, to hundreds of billions of dollars as they start working with employers that then provide that funding saying, Hey, we, we will provide the funding. So that way, cause their employees have the choice. So that's hundreds of billions of dollars. And then what if we own a platform and they, and Oscar has acquired a platform, which they've subsequently rebranded as Lucy, where, what if you could shop for various different services? Maybe you need to have your for anything else, you could say, oh, I could have my blood drawn here, here, and here, It's all going to feed straight back to this system. And these are the different costs for where I can get My labs, my blood. All of a sudden, it turns the capitalistic system in the way you'd want, which is customer reviews and pricing. That is completely obscure now. So this is the consumer-oriented shopping revolution that Oscar's trying to create and push, both through their own marketing. insurance plans as well as the marketplace. that they're looking to push. So those are the two hyper growth drivers for the business in the years ahead. If you look at just the Affordable Care Act market, that is much smaller versus the opportunities that they're looking to take. [10:00] into overtime. Thank you. Still? Management thinks they can get to $4 plus in earnings per share by 2029, driven by continued hyper growth, continued margin improvement, and that would suggest the stock is trading at a very... arguably fair or even cheap valuation of around eight times their 2029 earnings based on the current share price of around $33 per share. So is Oscar Health on sale, given that you have this very strong growth? As always, none of this is financial advice. This is for educational purposes only. Also a quick plug. Barry S. wrote, I have been a member for several years and have found your journey and educational tools extremely valuable for my own journey. This follows Isbell, who wrote, I just wanted to say that I feel much better regarding my investments since I found you. I'll follow you to the end of the Earth or Mars. Well, hopefully we don't have to go to Mars. I mean, I guess it could be fun at some point. But if you are interested in following along with my own investing journey for real money portfolio updates, come check out Unrivaled Investing. monthly videos as well, where I share my top ideas and weekly research talking about compelling ideas. Once again, that's Unrivaled Investing. We also have an exclusive Discord community as well available for Unrivaled Investing members. And so when we look at Flash, my AI tool to help me analyze stocks, it's said, you know what? I don't like the risk reward here. Or, you know what? There's a lot of downside risk, maybe over 50% downside risk. But there is a lot of downside risk. And truthfully, I respect that concern, because when you look at Oscar, I think it is important to understand this about their business model, which is that when a customer is shopping for various different plans, gold, silver, bronze, ultimately what they sign up for based on Oscar's current business. Let's say they sign up for a plan that all in costs $600 per month. Currently. they're paying around $50 per month based on, let's say, their income, you know, versus their age, where they live, all that sort of stuff. Those factors go into it. They're only paying, let's say, $50 out of the $600 premium, and roughly $550 is coming from CMS, or the Centers for Medicare and Medicaid Services, which oversees the Affordable Care Act. So the Affordable Care Act platform, previously known as Obamacare, they... those platforms, that That system, that's where Oscar's getting 90% of their premiums from. the ACA market. So it's important to recognize it's the subsidies from the government that is the vast majority of Oscars business. So if something goes on with the government where the government says, hmm, enhanced subsidies gone, that's going to hit their impact. And that that did impact their business. So it's important for you to recognize when 90 percent of your business. comes from the government in terms of their subsidies, you're very, very sensitive to what happens with the government, how they think about it, especially when 80 cents of every dollar that you're collecting ultimately goes to medical claims. So 90 cents of every dollar is currently the premiums from the government. 80 cents is medical claims, which is going to fluctuate. This is a very volatile type of business model. the win-win relationship, then you're going to say, this is great. But if you're concerned about the government, then it creates more uncertainty. And I would say, looking at what's been going on with interest rates, I think this is a very real risk for investors to monitor. Because if you look at, for example, what's gone on with the 10-year treasury yield, it's gone from 4% to 5% plus. situation that the US spending is out of control. And that means eventually the market's going to push enough. That the U.S. government is going to say, OK, well, do we issue more debt? OK, let's issue more debt. Let's see how that feels. And then all of a sudden it's like, oh, the 10-year is now at 6%. Okay, tenure at 6%. What do we do now? Do we issue more debt or do we try to cut spending? Knowing our politicians will be like, well, I feel like we should issue more debt. And then it'll be like, okay, treasury market at 6.5%, 7%. That's the nature of politicians and people kick the can down the road. And I think the market's starting to wake up to the fact that there's a supply demand in. [15:00] balance. That's the challenge. And at some point, unclear when exactly, there will be pushback. And then when your business is 90% the subsidies from the government, you're going to get a little hot around the collar because you're going to say, well, wait a second, could this come under pressure. Now, the flip side is that Oscar management would say, if you look at the Affordable Care Act, inflation over time relative to how every inflation in the rest of various different insurance verticals have played out, the inflation rate in the ACA market is much lower because it's much more competitive. So they would say, this is the net win that you want for the government. So you want more choice. And so I understand and I agree. So if anything, you might say this could accelerate that pivot to where the government encourages and employers encourage more choice, which accelerates the business. But for now, 90% plus of their premiums are coming through the government through CMS. So that is super super important for investors to understand And it also as I alluded to earlier 80 plus of their premiums you know going out in medical costs their medical loss ratio And that can fluctuate around a lot. 2025, frankly, was disappointing. And this is what created the opportunity for me personally to call out to members that, you know, are buying shares is this disappointment that they face where they had guidance. And then a few months later, they had to slash it. They were saying, look, we think we're going to do roughly $300 million in profit. A few months later, they're like, whoopsie doopsie, closer to a $300 million loss. That was a huge swing. And frankly, I didn't like to see it. It hurt management's credibility, despite the fact that management had a lot of goodwill from the fact that they had a track record of creating tremendous shareholder value, particularly Mark Bertolini and his previous sale of Aetna. But there were some real challenges that they faced as a sector, one of which was elevated healthcare utilization. Some might point to the GLP adoption. Other aspects were higher ACA risk adjustment payments. Now, this is partly due to looking at how the risk is pooled across ACA, where you say okay you get this much premiums relative to the acuity or how sick the patient base is And if you say well our patient base is this sick but it turns out that they are not actually as sick as someone else you all of a sudden have to swap or reverse course in terms of your premiums, in terms of how much you're able to collect, especially when you're dealing with the government. This is part of the reason why I would prefer a business model that was 90% consumer oriented. You wouldn't have as much of this fluctuation. whereas when you're collecting so much from the government you're gonna have this these sorts of well how sick is the general population and if you're not if you think you're you know measuring up way higher and then actually you're not as sick as the general population that resulted in part of this you know uno reverse card and generating the sizable loss so this is important to understand what happened last year. There's a lot of moving pieces when you look at Oscar. And the final, you know, kick in the pants that I didn't like, and I think, frankly, is part of the reason why I sold shares. Now, there was a bit of a delayed reaction was when management, you know, announced, yeah, we're going to be issuing hundreds of millions of dollars in convertible senior subordinated notes. And I think this was a reflection that A the enhanced subsidies were pulled back from the ACA market and that directly impacts Oscar And then they did talk about worse medical conditions, worse medical trends resulting in higher losses. And then to have to issue this hundreds of millions in debt, I personally viewed it as management raising capital, dilutive capital for shareholders because it can convert into stock. So dilution, which I don't like when you have to issue stock, which this converts into. management doing that to effectively pull the risk off the table of, hey, this company could implode if we have another repeat of 2025, where things just completely go askew, where maybe government pulls back on some sort of subsidies, or they say, hey, we need to talk about ACA and how we can cut spending even more, and then medical loss goes the wrong way. So I think it is important to recognize it wasn't that long ago that management was saying, it would be a good idea for us to raise capital. Now, they would frame it as, look, this is growth capital. That's why we did it. I viewed it as, hmm, I'm not... [20:00] THRILLED. by this dynamic. Subsequently, management saying we're back on track to significant profitability and we're expecting four to four and a half billion dollars in cumulative internal capital generation versus, you know, at thirty three dollars per share, that's around eleven billion dollar market cap. So that's roughly 40 percent of their market cap available in cash that's going to be generated over the next three years. So I I do find that actually to be quite compelling. that cash flow to shareholders. They're going to be, you know, doing the things that they call out here, the fund organic growth to, you know, possibly possible dividends, possible M&A, managing the share dilution. So maybe some buyback. So I look at this and I'm, I'm, very cognizant that the business... in theory, should generate a lot of cash flow in the years ahead. And that's something to watch for. because that would make the valuation quite compelling when you're generating billions of dollars in cash flow relative to the market cap. Hmm. Intriguing. So I look at Oscar and as I talked about earlier, Sky high consumer promotion score, net promoter score, where customers love it. And generally, my philosophy is that when customers love it, eventually the stock and Wall Street will eventually love it as well. And I think we've seen that shift significantly this past year where the stock has rallied significantly. However, I'm very cognizant of the risks the business faces, and there are a lot of risks. And so overall, I'm a believer in what they're doing. I really like their strategy of these different plans that are tailor-made products to exceed expectations for different customer base. You know, for someone with diabetes saying we have these plans designed for you. And so I really like that. I don't like the... Customer concentration risk, which is effectively 90% of your revenue via the government subsidies. So, I don't think I will ever make Oscar an outsized position unless customer concentration goes down significantly in the future, which means a revolution transformation in the business. But I would like to buy again on weakness if it happens in the months ahead, just because I do believe that Oscar is. is one of the players that is pro a revolution in healthcare, which I think needs to happen, and is pro pulling costs out of the healthcare system in a competitive and productive way that creates this win-win-win, which means the government spends less, customers get better care, and there's more solutions available. There's more offerings available. So I do think Oscar is well-positioned for this future, and that's part of the reason why I would like to align myself with them yet again. And I will call that out to my members at Unrivaled Investing. You know, if I do pull the trigger in the future, you know, if, if I'm able to get that, that weakness, who knows, markets tend to be volatile. Uh, but I, I'm also very cognizant that that blow up risk of the, depending on the government is part of the reason why I don't think I'll make it, let's say a 10% position, you know, out of the box, it's going to start smaller and, you know, or, you know, be a smaller allocation and let's watch it grow because clearly what they're doing is resonating with customers and they're taking market share. And that is what I like to see. Those are some key aspects that I'm looking for in the Unrivaled Investing Checklist. If this video has been helpful for you, please make a point of hitting that thumbs up, hit that subscribe button. Thanks so much for watching Unrivaled Investing.

Oscar Health指引45亿美元现金流 逾九成营收依赖联邦医保补贴