What They’re Watching: Michael Lujan, Oscar Health

Michael Lujan is the Market Director at Oscar Health. He joins us in this edition of “What They’re Watching” to discuss consumer experience and telemedicine.

“This might sound trite but we’re a differentiated consumer experience, meaning we put the consumer experience first. By that we mean we give a dedicated team of six health care guides, including one nurse for every one of our members.  So that means, you know, the health care systems pretty complex hard to navigate by yourself. So rather than like the typical healthcare journey where the insurance company gets involved after everything’s done, we get involved upfront.  We make sure that they get access to care in the right place. And for many of them they get access to free and unlimited telemedicine instead of going to the emergency room or urgent care and stuff like that.

We have a pretty high rate, I think it’s about 64% of our members will actually sign up after they enroll with us. They will actually sign up for an account and engage with their concierge team. So the health care guide can answer simple questions like, “Can you explain my coverage to me again?” Or “Tell me if this is covered,” or “I got something going on with my knee. Can you help me find a doctor even book the appointment?”

That, as simple as that may seem, that’s a big barrier to people getting health care. They don’t even know where to start and end up in the emergency room. The take-up rate on free and unlimited Telemedicine, I think we’re about 18 percent.  It varies from market to market but compared 2 to 3 percent of members with other traditional insurance companies, that’s huge. And if you think about how many people are on high deductibles, the highest deductibles they’ve been on. It’s a pretty serious barrier to care. “I cannot go to a doctor because I can’t afford my copay, my deductible, or I don’t know where to go.” And that telemed in many cases solves for that. That’s really exciting!”