OSCAR HEALTH $OSCR downgraded to 'Neutral' (from Outperform) at Baird, price-target slashed in half to $14 (from $28): "Given the recent pre-announced 2Q and 2025G revision (see here), we are increasingly cautious into 2026. While we like the management team, track record of execution, and long-term story, the difficulty is a broader end-market issue with the ACA Exchange Marketplace rather than a company-specific operating issue. Due to the zero-sum nature of ACA risk adjustment and ACA risk adjustment being based on current year diagnoses, there is significant complexity in projecting risk adjustment revenue. This year, the Exchange Marketplace is seeing material / unexpected risk pool deterioration (and likely will again next year into 2026). If we had to guess at the cause of the 2025 risk pool deterioration, possible drivers may include CY25 HIX program integrity measures or Medicaid redeterminations (though the lives that were redetermined are often the "healthier" MDCD lives, they might be sicker than the typical HIX life and therefore catalyze mix shift). Because none of our HIX-exposed MCOs have seen enrollment attrition or unexpectedly large risk adjustment receivables, we suspect private plans are benefiting from the zero-sum risk pools. This creates a significant lack of visibility for OSCR to project / accrue risk adjustment revenue because they can only see their own members, not what’s happening with other competing plans."
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