CVS Health vs Oscar Health: 2025 Financial Performance Analysis

In 2025, CVS Health and Oscar Health experienced contrasting financial outcomes under similar economic and regulatory conditions, influencing their operational strategies. Both firms are eager to enhance their financial performance by 2026.

CVS Health's Financial Overview

CVS Health reported an impressive revenue increase for the fourth quarter of 2025, reaching $105.7 billion, which marks an 8.2% rise from the previous year. The annual revenue achieved a record $402.1 billion, reflecting a 7.8% growth. Despite these figures, the company's earnings were challenged by financial setbacks, including a 45.3% decline in operating income due to a $5.7 billion goodwill impairment in its Health Care Delivery segment and approximately $1.2 billion in legacy litigation costs. This was partly offset by higher adjusted operating income and the absence of restructuring expenses recorded in 2024.

Earnings per share (EPS) presented mixed results; the GAAP diluted EPS for the fourth quarter increased to $2.30, assisted by a tax gain from a subsidiary's worthless stock deduction. Adjusted EPS decreased to $1.09 from $1.19 due to seasonal changes in Medicare Part D under the Inflation Reduction Act. The full-year GAAP diluted EPS fell to $1.39 from $3.66, while adjusted EPS improved to $6.75 from $5.42. Operating cash flow was recorded at $10.6 billion.

The Health Care Benefits segment's revenue rose to $143.4 billion, with adjusted operating income recovering to $2.94 billion from $307 million previously. The medical benefit ratio slightly improved to 91.2% from 92.5%. Despite revenue growth, the fourth quarter grappled with Part D cost changes and premium deficiency reserves.

The Health Services division saw a 9.7% revenue increase to $190.4 billion, although adjusted operating income fell by 1.3%, due to complications such as client pricing dynamics and medical loss expenditures in care delivery. Pharmacy & Consumer Wellness revenue grew by 11.9% to $139.4 billion, driven by prescription volume growth and favorable drug mix, including contributions from Rite Aid file acquisitions.

For 2026, CVS projects GAAP diluted EPS between $5.94 and $6.14, with adjusted EPS ranging from $7.00 to $7.20. The company revised its operating cash flow expectation to at least $9.0 billion, down from a previous forecast of $10.0 billion. President and CEO David Joyner emphasized CVS’s ongoing progress in transforming healthcare delivery, highlighting its integrated model as a strategic advantage.

Oscar Health's Financial Performance

Oscar Health's 2025 revenue increased to $11.7 billion from $9.2 billion the previous year, driven by expansion in individual and small-group markets. Membership grew to 2.04 million, despite the discontinuation of the Cigna+Oscar partnership at the end of 2024.

The company's medical loss ratio rose to 87.4% from 81.7% due to market morbidity, net risk-adjustment accruals, and usage rates that were not fully counteracted by risk adjustments. The SG&A ratio improved to 17.5% from 19.1% thanks to cost efficiencies and reduced exchange fees.

Oscar reported an operating loss of $396.4 million, reversing from a $57.3 million income in 2024. The net loss amounted to $443.2 million, equivalent to a negative $1.69 per diluted share, compared to the prior year's net income of $25.4 million, or $0.10 per share. Adjusted EBITDA swung to a loss of $279.8 million from a positive $199.2 million.

CEO Mark Bertolini described 2025 as a transformative year for the individual market, with plans for significant financial improvements in 2026 through new products, AI-driven initiatives, and enhanced member experiences. Oscar's 2026 forecasts anticipate revenue between $18.7 billion and $19.0 billion, a medical loss ratio of 82.4% to 83.4%, and operational earnings of $250 million to $450 million. The company secured a $475 million three-year revolving credit facility in early 2026 to support liquidity and growth ambitions.

The financial results from both companies illustrate the challenges and adaptations to rising medical expenses, fluctuating Medicare and ACA conditions, and increasing interest rates. CVS’s diversified structure absorbed these pressures more effectively, whereas Oscar faced notable volatility and is concentrating on strategic adjustments for future stability.