Insider Q&A: Oscar CEO on insurers and patient health

If you're unhappy with how health care works, you could just start an insurance company.

That's essentially what Mario Schlosser did in 2012 after he grew frustrated navigating the system when his wife delivered their first child.

Six years after Schlosser, a data scientist, co-founded Oscar Health, his New York-based insurer covers about 250,000 people, many in big markets like New York and California.

Oscar has grown by emphasizing online tools and apps and taking some unique approaches to coverage. It assigns each customer to a six person "concierge team" that aims to quickly answer questions or find available doctors, among other tasks.

The 40-year-old Schlosser, Oscar's CEO, spoke recently with The Associated Press. The conversation has been edited for clarity and length.

Q: What was the biggest need you saw in a market already packed with insurers?

A: Nobody is really accountable for truly helping navigate health care and make it less complex and less costly. And I thought that the insurance company should play a major role in that because ultimately the insurance company is responsible for your end-to-end care.

Q: How does that team improve health?

A: Connecting the dots better, making sure you stay up to date with how you best manage your health. They can see if you are filling (a prescription), and they will reach out to you if you are not. They will try to make sure you can get access to the drugs that you need. If we are helpful in the background ... we think it's going to help your long-term health.

Q: Oscar's coverage uses narrow networks of doctors and other providers in part to keep costs down. What would you tell a customer who gets cancer and finds that the most experienced doctor for her condition isn't in your network?

A: We have a number of concierge teams that are dealing only with members who have the most complex conditions. Those teams are directly assigned to making sure that you've got what you need. That can include pulling in providers who we did not work with in the past.

Q: Enrollment for the Affordable Care Act's insurance exchanges starts Nov. 1. What have you learned about making that business viable?

A: Every provider in the market, every insurance company basically faces members voting with their feet as to whether they like the service at the price. That creates very powerful pressures on all of health care to be more innovative, be more nimble, more member-focused.

Q: Oscar raised $165 million earlier this year from private investors, and you are growing. Is a public offering of your stock on the horizon?

A: Nothing planned right now.