Louis DeStefano, Senior Vice President of Growth at Oscar Health

Summary

Becker’s Healthcare Podcast: Episode Featuring Louis DeStefano, Senior Vice President of Growth at Oscar Health

Release Date: June 23, 2025

In this insightful episode of the Becker’s Healthcare Podcast, host Haley Rutger engages in a comprehensive discussion with Louis DeStefano, Senior Vice President of Growth at Oscar Health. Recorded live at Becker's third annual Spring Payer Issues Roundtable, the conversation delves deep into Oscar Health's strategies for balancing affordability and quality in healthcare, enhancing member satisfaction, and exploring future opportunities for payers to transform care delivery.

Louis DeStefano’s Background

Louis DeStefano begins by sharing his extensive experience in the healthcare industry. “I've been in healthcare almost 20 years at UnitedHealthcare prior to Oscar,” he states (00:48), highlighting his long-term commitment and deep understanding of the sector. At Oscar Health for nearly a decade, Louis oversees sales, marketing, distribution, and product strategy, focusing on member and consumer needs. Additionally, he contributes to the health tech ecosystem by consulting for digital startups and supporting Oscar alumni who have ventured into their own organizations.

Balancing Affordability and Quality

The conversation shifts to a critical issue in healthcare: balancing cost and quality. Louis emphasizes Oscar Health’s focus on the individual market as a strategic approach to achieve this balance. “Oscar is wholly focused on the individual market which drives affordability, quality, and choice,” he explains (01:27). By catering to nearly 2 million members, Oscar distinguishes itself from the traditional employer-based insurance models, offering highly competitive individual plans regulated by the Affordable Care Act (ACA). These plans provide essential health benefits, maximum out-of-pocket limits, and protections for pre-existing conditions, ensuring both affordability and comprehensive coverage.

Louis also highlights the advantage of choice in the individual market: “Individual plans offer access, you know, within a specific zip code. You could have over 100 plans offered from your ICHRA employer as opposed to maybe one, two or three plans that your employer typically gives you during your open enrollment period” (01:27). This extensive selection allows members to tailor their coverage to their specific needs, addressing gaps in cost and quality that employer plans might overlook.

Member Satisfaction and Engagement Strategies

Focusing on member satisfaction, Louis underscores the importance of a member-first approach powered by technology. “Oscar's really a favorite in the individual market because of our technology. We're a member first company. That's how we were founded,” he shares (02:46). Oscar leverages real-time personal communications and digital tools to engage members actively and enhance their clinical outcomes. By reducing administrative burdens, Oscar simplifies the healthcare experience, making it more accessible and user-friendly.

Personalized plan designs are a cornerstone of Oscar’s strategy. Louis mentions, “We bundle a lot of multi-point solutions to lower cost and clinical outcomes, specifically our multi-condition plans, which are meant for members with diabetes, COPD and it helps them manage these conditions at a much lower cost” (02:46). These tailored plans allow Oscar to address specific health needs more effectively, fostering better health management and cost savings for members.

Measuring Member Satisfaction with NPS

Net Promoter Score (NPS) serves as a pivotal metric for Oscar Health in gauging member satisfaction and loyalty. “We’re relentlessly focused on the member experience, and that translates directly to our NPS score of 66 as of Q1, which is truly industry leading,” Louis reveals (03:59). This impressive score reflects Oscar’s dedication to delivering exceptional member experiences.

Louis provides examples of Oscar’s unique plan designs that contribute to high satisfaction rates. “We have plans around that are called OLA Oscar, obviously based for bilingual Americans. Breathe Easy for COPD, a diabetes plan. And a lot of these multi-condition plans have the highest member satisfaction and retention rate in our book of business” (03:59). Notably, the Diabetes Care plan boasts an 81% member satisfaction rate, while OLA Oscar achieves an outstanding 87% NPS. These figures underscore the effectiveness of Oscar’s targeted approach in meeting diverse member needs.

Future Opportunities for Payers

Looking ahead, Louis identifies Individual Coverage Health Reimbursement Arrangements (ICHRA) as a significant opportunity for transforming the insurance market. “ICHRA is really the ability to transform the insurance market to meet the needs of all Americans,” he asserts (05:07). ICHRA represents a fundamental shift in how healthcare is purchased, benefiting both employees and employers. Employees gain the flexibility to choose plans that best fit their individual needs, while employers benefit from predictable healthcare costs and the ability to offer a variety of plan options.

Louis emphasizes the dual advantages of ICHRA: “The employees win because it's tax-free contributions. They get to pick their own plan… Employers win as well because it's really predictable health care costs” (05:07). By adopting ICHRA, payers can better cater to the evolving demands of the workforce and create a more adaptable and efficient healthcare system.

Conclusion

Throughout the episode, Louis DeStefano articulates Oscar Health’s innovative approaches to managing healthcare costs, enhancing member satisfaction, and leveraging technology to provide personalized care solutions. His insights into the individual market and the potential of ICHRA highlight the transformative opportunities for payers in the healthcare landscape. Listeners gain a comprehensive understanding of how Oscar Health is leading the charge in creating affordable, high-quality, and member-centric healthcare solutions.

Notable Quotes:

• “Oscar is wholly focused on the individual market which drives affordability, quality, and choice.” (01:27)
• “We’re relentlessly focused on the member experience, and that translates directly to our NPS score of 66 as of Q1, which is truly industry leading.” (03:59)
• “ICHRA is really the ability to transform the insurance market to meet the needs of all Americans.” (05:07)

Transcript

[A]

Evernorth brings the power of wonder and relentless innovation to create world class pharmacy care and benefits solutions. Barriers to care can lead to gaps in care which can drive up the total cost of care. Our capabilities work seamlessly together to create innovative pharmacy care and benefit solutions for today and tomorrow. Our connected health services make the treatment, prediction and prevention of health care's most complex conditions easier and more accessible as we drive organizations and people forward.

[B]

This is Haley Rutger with the Beckers Payer Podcast and we are recording live at the Becker's third annual Spring Payer Issues Roundtable. I am thrilled today to be joined by Louis DiStefano, Senior Vice President of Growth at Oscar Health. Louis, thank you so much for being here with me today.

[C]

It's great to be here. Good morning.

[B]

All right, can you go ahead and get started by telling us a little bit about yourself and your background?

[C]

Sure. So my name is Louis DiStefano. As you mentioned, I work for Oscar Health, been at the organization for just under a decade. I've been in healthcare almost 20 years at UnitedHealthcare prior to Oscar and I lead at Oscar sales, marketing, distribution, a lot of our product strategy for members and consumers and I do quite a bit of consulting for a lot of health tech, digital startups, kind of a lot of the Oscar alumni network that has moved on to start their own organizations.

[B]

Well, thank you so much for that introduction. Now to get started, I want to start our conversation off by talking about balancing affordability and quality. So how is your organization innovating to manage the cost of care while maintaining or improving member outcomes?

[C]

So Ask Oscar is wholly focused on the individual market which drives affordability, quality and choice. You know, we've been in the individual market for well over a decade where we have the luxury of serving just under 2 million members. So individual plans is really what we do. And the traditional one size employer insurance model really no longer needs a financial outlook of what employers need in this is in this country. You know, if you look at it on cost, individual plans are extremely competitive across the country. It's the single largest risk pool with over 24 million Americans insured on quality. Individual plans are subject to all the ACA regulations of essential health plans, maximum out of pockets and really a lot of protections for Americans like pre existing conditions. So it's very strong fully insured options. And then lastly on choice, individual plans offer access, you know, within a specific zip code. You could have over 100 plans offered from your ICHRA employer as opposed to maybe one, two or three Plans that your employer typically gives you during your open enrollment period. So I think this market may address a lot of the shortcomings on cost and quality that employers are not offering today.

[B]

Thank you so much for laying that out for us. Now I kind of want to pivot the conversation a little bit to member satisfaction. So what experience or engagement strategies have proven effective for your organization and how are you measuring success?

[C]

Yep. So members are the heartbeat of our organization. Oscar's really a favorite in the individual market because of our technology. We're a member first company. That's how we were founded. And we use our techno technological experience to really fuel member engagement and innovative plan designs. So through our technology, we deliver real time personal member communications. We connect with members and their clinical outcomes through personal digital tools. And we take a lot away, a lot of the administrative burden that members face with the provider industry. So that's, that's also a key piece of it. Then we have personalized plans. We bundle a lot of multi point solutions to lower cost and clinical outcomes, specifically our multi condition plans, which are meant for members with diabetes copd and it helps them manage these conditions at a much lower cost. And we really have been innovative there. And I think that's one of the things that Oscar does differently is we have the ability to look at individual members, not just overall in a group chassis.

[B]

Yeah, I'd like to go a little bit deeper into measuring that member satisfaction. Net promoter score is a powerful indicator of member loyalty and satisfaction. So how are you using NPS to drive meaningful improvements across your health plan?

[C]

Yeah, so we, so we're relentlessly focused on the member. Kind of every meeting we got into is, okay, how does this impact the member experience? And that translates directly to our NPS score of 66 as of Q1, which is, which is truly industry leading. You know, some of the examples we have of unique plan designs, we have plans around that are called OLA Oscar, obviously based for bilingual Americans. Breathe easy for copd, a diabetes plan. And a lot of these multi competition plans have the highest member satisfaction and retention rate in our book of business. And it's becoming a credible portion of our business as well. For example, diabetes care has an 81% member satisfaction. Hola. Oscar has actually an 87% NPS because we're actually treating the members on the specific plans that they want as opposed to giving three plans to an entire organization. So we've done really well on the unique setting of plan designs for individuals and I think that's what sets us apart.

[B]

And before we end here, I just want to know, looking ahead, what do you see as the biggest opportunity for payers to lead the charge in transforming care delivery and driving better outcomes for all stakeholders? How can leaders take a step in this direction now?

[C]

Yeah, I would focus in subpanel that I'm going to be on later today. It's individual coverage, health reimbursement arrangements, ichra. It's really the ability to transform the insurance market to meet the needs of all Americans. It's a fundamental shift of how we purchase health care. The employees win because it's tax free contributions. They get to pick their own plan. They have the choice a lot of the options that I spoke to. They can also actually choose their own formulary between the multiple carriers that are out there. Employers win as well because it's really predictable health care costs. I haven't met a CFO that doesn't really want to understand what their budget is going to be in the in the future years as opposed to waiting for their renewal from their self funded carrier, their fully insured carrier, just 90 days before the renewal. So the individual market serves 24 million Americans with high quality, quality plans and many different needs and variations, as we've discussed. And I think the ICHRA opportunity is a way for the employer market to actually take advantage of all those great opportunities.

[A]

Absolutely.

[B]

Well, thank you so much for joining me today. Again, this is Haley Recker with the Becker's Payer podcast, recording live at the Becker's third annual Spring Pair Issues Roundtable. Louis, thank you so much.