It depends. Disclosure up-front: I work for Clover Health, which is a company people probably would put in the same bucket as Oscar. The biggest difference is

It depends. Disclosure up-front: I work for Clover Health, which is a company people probably would put in the same bucket as Oscar. The biggest difference is we operate solely in the Medicare market (people who are eligible for Medicare can enroll in the traditional single-payer system, or a plan from a private insurer under contract to Medicare; in the latter case, Medicare pays a monthly premium to the insurer). So we're an insurance company. Ho-hum. No big deal. Except... it turns out that if you want to get people healthy and keep them healthy, being a provider of health care (i.e., nurse, doctor, clinic, etc.) may be the wrong business to get into. A provider sees only the particular slice of your health that they happen to deal with, which may not be much at all. The only entity in the whole system who sees everything is the entity that pays the bills, and that's the insurer. And that opens up all kinds of opportunities, if you can break into the business. Medicare is interestingly set up to encourage this, since Medicare Advantage plans (that's what we are) get paid partly based on their rating on a five-star scale. The input to that scale is a set of about four dozen factors, many of which measure actions likely to improve or maintain health. For example: someone who's on a lot of different prescriptions for various conditions faces risks as a result. Not just from uncaught interactions, but from things like the complexity of when and how often they need to take different medications. One of the ratings takes into account how many of those people have had a sit-down chat with someone who will help them go over and understand all of it and come up with a plan to stick to the required regimen. Which sounds like something so simple that it's almost silly, but non-adherence to prescribed medications is a huge problem that affects the health of a lot of people. And beyond the factors that go into our star rating, there's a lot more low-hanging fruit to go after, and a lot of little and inexpensive things that you can do to help people get healthier and stay that way Which is a major break from a lot of plans, especially in the Medicare space, because generally people treat the business of insurance as solved: you just hire some actuaries, work out from a given population what you expect the cost to be of covering them, and make sure you charge more than that. Very few companies are trying to get there from the other direction (figure out what the cost would be, then figure out what little things nobody has bothered to do that might have a big impact on that cost).