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2025 Membersâ Needs and Preferences Report External
Oscar Health·AZ, FL, GA, IA, IL, KS, MI, MO, NC, NE, NJ, NY, OH, OK, PA, TN, TX, VA·Provider Resources
We identified it
May 16, 2026
Summary
This is a provider resource report documenting Oscar Health's 2025 assessment of member cultural needs and preferences across racial, ethnic, linguistic, and gender categories. The report updates measurement metrics from a 500 providers per 1,000 members ratio to a new 1:2000 PCP-to-member ratio standard. However, this is a retrospective annual report (completed 1/20/2026) documenting 2025 data—not a policy change requiring immediate billing workflow modifications.
Action Required
No immediate action required for billing team. This is an informational report on network adequacy and cultural competency metrics used by Oscar Health for internal planning purposes. Billing teams should be aware that Oscar has updated its PCP-to-member ratio targets (1:2000) for evaluating network diversity, but this does not directly impact claims processing, coding, or reimbursement workflows. Monitor future policy updates if Oscar implements network changes based on these findings.