Oscar: a member product that improves care quality and efficiency and stands out

You are a product manager at Oscar, the US health insurer. Leadership has set three goals at once: raise the clinical quality of the care members receive, run care and operations more efficiently, and give patients a quality of life that clearly stands apart from what other options offer. What product, or changes to existing products, would you propose to deliver all three, and how would you know it worked? ```hint Look for where the goals overlap Find a moment in a member's care where friction hurts health, adds cost and frustrates the member all at once. A fix there serves all three goals instead of trading one against another. ``` ### Clarifying Questions - Who counts as the patients here: Oscar members only, or also the clinicians and care teams who serve them? - How should operational excellence be judged: medical cost per member, speed of claims and approvals, or care-team productivity? - Is this a new standalone product, or a change to the existing member app and services? - Differentiated against which alternatives: other individual-market insurers, employer plans, or both? ### What a Strong Answer Covers - A working definition of each goal and of where they conflict, such as cost cuts that restrict care - A member journey analysis that finds moments where the three goals overlap, with a chosen segment - Prioritized solutions with clinical safety built in - Metrics for each goal plus guardrails against under-treatment - What makes the solution hard for other insurers to copy, and its main risks ### Follow-up Questions - Your routing flow lowers emergency visits, but some members sent to virtual care end up in the emergency room days later. What do you do? - How would you win over the in-network doctors whose cooperation the solution needs? - If the three goals conflict on a specific decision, which gives way first, and why?