Teladoc Health

Teladoc Health, Inc. is a multinational telemedicine and virtual healthcare company headquartered in the United States.[7] Primary services include telehealth,[8] medical opinions,[9] AI and analytics, telehealth devices and licensable platform services.[2] In particular, Teladoc Health uses telephone and videoconferencing software as well as mobile apps to provide on-demand remote medical care.[8]

Teladoc Health, Inc.
Formerly
  • Teladoc Medical Services
  • Teladoc, Inc.
TypePublic
IndustryMedical care
Founded2002 (2002) in Dallas, Texas, U.S.
Founders
  • Byron Brooks
  • Michael Gorton
Headquarters
Purchase, New York, U.S.
Areas served
130+ countries[1]
Key people
Jason Gorevic (CEO)
Mala Murthy (CFO)
BrandsTeladoc, Advance Medical, Best Doctors, Livongo, BetterHelp, InTouch Health, HealthiestYou,[2] MédecinDirect[3]
ServicesTelemedicine, analytics
RevenueIncrease US$2.4 billion (2022)[4][5]
Increase US$−265.3 million (2021)[5]
Increase US$−428.8 million (2021)[5]
Total assetsDecrease US$17.73 billion (2021)[5]
Total equityIncrease US$16.05 billion (2021)[5]
Number of employees
5,000 (2023)[6]
Websiteteladochealth.com

Billed as the first and largest telemedicine company in the United States, Teladoc Health was launched in 2002[10] and has acquired companies such as BetterHelp in 2015,[11] Best Doctors in 2017,[12] and Advance Medical in 2018.[13] It trades on the NYSE[14] and is active in 130 countries.[1][15] As of 2023 Teladoc was serving "80 million people across its virtual care products"[4] with 56 million paid members in the United States.[6]

History

2002–2015

Teladoc was founded in 2002 in Dallas, Texas by G. Byron Brooks EE MD and Michael Gorton. Billing itself as the oldest telemedicine company in United States,[10] Teladoc's initial business model allowed patients to remotely consult with state-licensed doctors at any time.[16] Companies paid a monthly fee for their employees to access the service, while patients paid a flat fee for each consultation, originally about $35 to $40.[10] With Gorton as both chairman and CEO,[17] Teladoc launched nationally in 2005[10] at the Consumer Directed Health Care Conference in Chicago, Illinois.[17] Teladoc had around 1 million members by the end of 2007, with large employers such as AT&T[10] providing the service to employees as a health benefit.[18] Jason Gorevic was named Teladoc's chief executive in 2009.[18] In 2011, Aetna began offering Teladoc for its fully insured members in Florida and Texas, later offering Teladoc in all 50 states.[10]

Teladoc acquired Consult A Doctor for $16.6 million cash in 2013,[11] allowing smaller companies to access Teladoc's services.[19] The Affordable Care Act led to a large number of insurance companies signing with Teladoc, resulting in a growth surge around 2014. By that time, insurance companies such as Blue Shield of California and Oscar had signed with Teladoc, as well as other companies such as Home Depot, T-Mobile, CalPERS,[8] and Rent-A-Center.[20] Teladoc acquired AmeriDoc for $17.2 million in May 2014.[11] The acquisitions of Consult A Doctor and AmeriDoc, both Teladoc's main competitors, resulted in Teladoc becoming the largest telemedicine provider in the United States.[8] After initial fundraising rounds in 2009,[21] 2011,[22][23] and 2013,[19] Teladoc raised $50 million in 2014,[24] bringing total funding to $100 million.[8] Teladoc's sales doubled in both 2013 and 2014.[20]

2015–2016
Teladoc executives ring the NYSE bell

Teladoc went public[25][26] on July 1, 2015[27] as the only telemedicine company on the New York Stock Exchange.[10] Teladoc's initial public offering listed at $19 per share, giving the company a market capitalization of $758 million and an enterprise value of $620 million.[27] The initial response to the IPO was positive, as shares surged 50 percent on the opening day.[28][29] Three months after the IPO, health insurer Highmark, which represented 1.5% of Teladoc's 2015 revenue, ceased to renew a contract. Teladoc shares fell significantly as a result, before rising to earlier levels.[10] In 2015 Teladoc acquired the behavioral health services provider Compile Inc.,[30] BetterHelp for $3.5 million,[11] and the competitor Stat Health Services (StatDoc) for $30 million.[30] The following year Teladoc began aggressively expanding, acquiring other companies and launching health segments for dermatology, behavioral health, and sexual health. That year the company won a patent infringement lawsuit filed against competitor American Well.[10] In July 2016, Teladoc acquired HealthiestYou[11] for $45 million.[31] Teladoc had 15 million members by November 2016[10] and a market share of 75% in the United States.[16] It also operated its full service suite in 48 states, excluding Arkansas and Texas. In December 2016, the American Hospital Association exclusively endorsed Teladoc's telehealth technology platform.[10] Teladoc logged 952,000 patient visits that year.[32]

2017–2020

In its largest acquisition at the time,[12] in 2017 Teladoc spent $440 million purchasing Best Doctors, a consultation firm[33] and provider of medical second opinions and medical award listings.[12] In 2019, ProPublica criticized companies such as Best Doctors for selling physician awards[34] as pay-to-play.[12] Teladoc had 7,500 clients in 2017, of which 220 were Fortune 1000 companies.[35] Sales that year were $233 million, 89% higher than the year prior.[16] Teladoc Health brands by 2018 included Teladoc, Advance Medical, Best Doctors, BetterHelp and HealthiestYou.[2] On August 10, 2018, Teladoc, Inc. changed its name to Teladoc Health, Inc. while continuing to trade on the NYSE.[2] Teladoc Health began partnering with CVS in August 2018 on remote consults at MinuteClinics.[36] Teladoc Health acquired Advance Medical, a telemedicine company employing doctors in Latin America, Europe, and Asia, for $352 million in 2018.[13] In December 2018, Teladoc Health's chief financial officer and chief operating officer Mark Hirschhorn resigned after a report that he engaged in a sexual relationship and insider trading with an employee.[37][38] According to Yahoo Finance, stock value fell roughly 20% in the days following,[39] while an investor class action lawsuit alleged that Teladoc Health had violated securities laws by failing to disclose Hirschhorn's behavior. Teladoc Health denied making false statements or any legal violations.[40] Active in 130 countries by 2019,[1] that year Teladoc acquired the French health company MédecinDirect[3] and launched in Canada with the Teladoc Telemedicine Service.[41] Joining from American Express, Mala Murthy was appointed CFO in June 2019. Also that year, David Sides was appointed Chief operating officer,[42] then leaving in 2021.[43]

In March 2020, Teladoc was providing "near real-time" surveillance data on the spread of coronavirus to the CDC.[44] In July 2020,[45][46] Teladoc acquired InTouch Health.[47] In October 2020,[48] Teladoc acquired the chronic care company Livongo Health[49] for $13.9bn[50] in a deal described by the press as the third-largest for a US company that year. The combined companies had an estimated enterprise value of $37 billion.[51] Teladoc then brought in Florida Blue as the first insurer to use Livongo's digital diabetes program. Teladoc sued Amwell in October 2020 for alleged copyright infringement on nine patents,[52] settling the case in July 2022.[53]

2021-2023

In early 2021, paid membership in the US was at 52 million.[54] In January 2021, Teladoc began offering a diabetes management service through Dexcom.[55] Later that year, Teladoc Health launched myStrength Complete, a "unified mental health care platform for its B2B customers."[56] In June 2021, Teladoc sued the company Avail for allegedly infringing on three patents related to telemedicine consoles.[57] On the 14th of July 2021, Teladoc announced it was collaborating with Microsoft to combine its delivery platform for hospitals and health systems with Microsoft Teams.[58] Teladoc introduced its primary care service Primary360 on a national scale in October 2021. The program gave members access to both a primary physician and care team, with a system in place for followup reminders about appointments and personal maintenance.[59] In February 2022, Teladoc Health launched Chronic Care Complete, a program to help patients manage multiple chronic conditions.[60]

Teladoc had a valuation of roughly $11.3 billion by February 2022. That month, Teladoc warned investors there might be a goodwill write-down that year related to the Livongo acquisition. although Teladoc CEO Gorevic announced that the company's plan to create $500 million in revenue from the purchase by 2025 was still solvent.[50] In February 2022,  Teladoc announced that Amazon users would be able to access Teladoc through Alexa[61] and related voice-activated devices such as the Echo, Echo Dot, and Echo Show.[62] The collaboration led to debate among experts about the potential impact on the health industry,[63] with antitrust advocates raising concerns the partnership could result in Amazon dominating the telehealth market.[64] In response to privacy concerns, Amazon noted it couldn't access or store any conversations that took place with Teladoc, only logging that a call took place,[61] while Teladoc also responded that all interactions through Amazon would remain protected under HIPAA. In April 2022, Northwell Health began using the Teladoc platform with its clinicians, starting with 20 hospitals in the system.[65] After Teladoc's stock value fluctuated significantly during the coronavirus pandemic,[54] the company in June 2022 was sued by investors alleging it had misrepresented its financial prospects,[66] particularly in regard to its BetterHelp mental health subsidiary and chronic care business.[67] Characterizing the lawsuit as "frivolous,"[66] in July 2022, Teladoc reported revenue growth "that beat Wall Street analysts' projections", with significant growth in BetterHelp.[68] In August 2022, Teladoc became the telehealth portal for Mayo Clinic Health System patients in Onalaska, Wisconsin.[69] The company cut 300 positions from its non-clinician workforce during an office space restructuring in January 2023.[70] In early 2023, the company projected total 2022 revenues of approximately $2.4 billion, with around $1 billion of that provided by BetterHelp. At the time, Teladoc claimed it reached "80 million people across its virtual care products" overall. It also announced plans to spend $400 million on research and development that year.[4]

In 2023, the company had over 5,000 employees, 56 million paid members in the United States, and 12,000 corporate clients.[6] Jason Gorevic remained CEO, with Mala Murthy as CFO, Vidya Raman-Tangella as Chief Medical Officer, and Mike Waters as Chief Operating Officer.[71]

Services and business model

Currently headquartered in Purchase, New York,[7] Teladoc Health divides its services into six categories: platform and program services, guidance and support, expert medical services, mental health services, telehealth, and integrated virtual care.[9] As a technology company, Teladoc Health is involved with artificial intelligence, analytics, telehealth devices[72][73] and "licensable platform services."[2] The company uses telephone and videoconferencing software to provide on-demand remote medical care,[8][74] with patients able to log on to the service at any time and be connected with a board-certified, state-licensed physician.[10] In early January 2023, Teladoc launched a new app that offered all services and programs in one central place for its members and clients.[4]

With different medical subspecialties,[75] the company's physicians treat non-emergencies such as the flu, mental health issues, and dermatological conditions,[10] and can prescribe medication remotely. In 2014, Teladoc Health reported that it sent around 1% of consultations to the emergency room, and around 6% to a primary care physician or urgent care center.[8] In 2019, the company also claimed that 92% of medical issues were resolved after the first visit.[76] Physicians overall follow "more than 100 proprietary clinical guidelines" developed by Teladoc Health,[10] and are prohibited from physically meeting their telemedicine patients.[8] Teams of nurses review around 10% of each physician's consults monthly.[10]

Contracting largely with insurers and large employers,[20] Teladoc Health generates revenue through a yearly[8] or monthly fee charged per subscriber, as well as a fee for individual consults.[10] Some companies waive or subsidize the consult fee for their employees.[8] Teladoc Health has around 7,000 licensed care providers[77] and services offered in about 30 languages.[1] By July 2020, the company stated it served "60 of the top 100 hospitals,"[73] with telemedical robots being used at hospitals such as Providence Regional Medical Center in Everett, Washington[78] and Sheba Medical Center in Israel, minimizing the potential spread of coronavirus.[72]

Disaster aid

Teladoc Health has provided free telehealth visits to natural disaster and hurricane victims in the United States,[79] including to victims of incidents such as the 2018 Camp Fire in Paradise, California,[80] and Hurricane Ida in 2021.[81] In March 2023, it began providing free care to residents in Mississippi affected by recent tornadoes.[82]

Lobbying and legislation

Teladoc Health has been involved in lobbying for legislation in several states.[10] In 2015 the Texas Medical Board ruled that state physicians had to physically meet patients before remotely treating ailments or prescribing medication. The bill undermined Teladoc Health's business model in Texas, where it had around 2 million subscribers. Teladoc Health sued[83] in federal court over the rule in Teladoc v. Texas Medical Board, arguing the bill violated antitrust laws[84] by inflating prices and limiting the supply of health care providers in the state. The bill, meant to go active on June 3, 2015, was stalled[83] while the lawsuit went through a federal appeals court, allowing Teladoc Health to continue operating in Texas in the interim.[10] Teladoc voluntarily dropped the lawsuit in 2017 after Texas passed a new bill allowing for remote treatment without a prior in-person interaction, which Teladoc Health had lobbied heavily for.[84]

In January 2019, Teladoc Health opposed a telemedicine bill proposed by the North Dakota Board of Medicine, which required telemedicine providers to perform initial video examinations or have initial exams done by another physician. Proponents argued the bill protected patients, while Teladoc Health and critics argued it decreased access to healthcare in rural areas. The year prior, Teladoc Health had completed 1,500 virtual visits in the state.[85] In May 2019, the company created a virtual care patient safety organization (PSO) dubbed the Institute for Patient Safety and Quality of Virtual Care.[86]

In December 2021, Teladoc along with the American Medical Association, American Hospital Association, AARP, Amazon, Walmart, and CVS formed Telehealth Access for America, a coalition pushing for the extension of telehealth policies implemented by US Congress in response to the COVID-19 pandemic.[87] Subsequently, US Senators Bill Cassidy and Tammy Baldwin introduced the Health Data Use and Privacy Commission Act in February 2022, which proposes creating a commission to study modernizing health data and privacy laws. The proposed legislation was supported by Teladoc and companies such as the American College of Cardiology, IBM, and the United Spinal Association.[88]

See also

References
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