Telehealth refers to the application of healthcare and health-related services via phone and online platforms. Especially in the US, the traditional healthcare care system has long been plagued with escalating issues of cost and accessibility. Telehealth tools supplement the traditional healthcare care systems, thereby adding value to major stakeholders in the greater healthcare ecosystem, including providers, patients, payors, hospitals, and the government.
Telehealth uses four main types of models to deliver services: 1) general telemedicine; 2) specialized telemedicine; 3) asynchronous store and forward services; and 4) remote patient monitoring services. These service delivery models often complement one another, and in practice can be used in conjunction to deliver remote care to patients.
Teladoc visits grew by 206% YoY in Q3 2020 to 2.8 million.
MDLIVE visits increased by more than 95% YoY during the first half of 2020, compared to 45% average growth over the past five years.
Amwell visits jumped 450% YoY to reach 1.4 million in Q3 2020.
98point6 reported a 274% YoY surge in memberships in October 2020.
Doctor on Demand virtual visits reached nearly 3 million by July 2020, up from 2019’s projection of 2 million.
While the main incumbents have enjoyed a stronger presence in the telehealth space for more than a decade, the industry’s leading disruptors have successfully increased their foothold in the market, thanks to their growing user network. Most disruptors are heavily concentrated on the telemedicine segment, given its popularity of facilitating live consultations as an alternative to physical doctor visits. This is followed by the remote patient monitoring segment due to the high prevalence of chronic conditions.
While a few large telehealth companies have existed since the early 2000s, the industry has attracted a host of new startups beginning in the early-to-mid 2010s. Venture capital funding for telemedicine companies surged in H1 2021—up to USD 4.2 billion from USD 1.7 billion in 2020—due to the rising popularity of virtual delivery methods brought about by the Covid-19 pandemic.
For investors, Babylon Health and Kry are among the largest disruptors in the general telemedicine segment having raised USD 631 million and USD 569 million, respectively, as of August 2021. Both companies have an international presence including the US and UK.
Hims and Ro are key players in the asynchronous store and forward service segment, both serving similar markets with comparable business operations. For startups focused on chronic disease management, Hinge Health and Virta Health are among the largest disruptors in the remote patient monitoring segment while acute care telemedicine provider, SOC Telemed, is a key player in the specialized telemedicine space.
Babylon delivers access to healthcare for many acute, chronic, and psychological conditions, including personalized health assessments, activity tracking, treatment advice and 24/7 face-to-face appointments with a doctor. It leverages artificial intelligence (AI) in assisting practitioners to diagnose the conditions of patients and has developed many AI-based health services, including the chatbot used by the National Health Service in the UK to diagnose the ailments of patients.
Babylon has partnerships with Tencent (to tap into the Chinese market), TELUS (to offer services in Canada), and also offers services in the US, Rwanda, and multiple countries in Asia and the Middle East. It also offers end-to-end clinical services in the UK, Rwanda, and Canada. As of May 2021, Babylon Health has served over 24 million patients across the US, Canada, Europe, Africa, and Asia. Annual membership costs GBP 149 (USD 192), but it also offers the opportunity to schedule one-off appointments. A general, one-off consultation is priced at GBP 39 (USD 50) per visit and GBP 49 (USD 63) per specialist visit.
Babylon raised USD 550 million in a Series C funding round led by Saudi Arabia Public Investment Fund in August 2019, bringing the total funding to USD 635.3 million and valuing the company over USD 2 billion as of September 2020. The funds raised were expected to be used for its expansion in the US and Asia, and funding its research to diagnose more serious chronic conditions.
Babylon Health’s revenue grew by 400% YoY in 2020 and the company expects the revenue to increase by 300% YoY in 2021. In March 2021, Babylon announced it is planning to sell its Canadian operations to former partner Telus Health. Telus has reportedly signed a multi-year licensing deal estimated at around USD 70 million with the intention of using Babylon’s technology after taking control of operations. In addition, Babylon Health is reportedly in talks to go public through a merger with Alkuri Global Acquisition Corp., a special purpose acquisition company. The transaction is to be completed during H2 2021 and the combined entity will trade under the ticker symbol “BBLN”. The deal will set the equity value of the new entity at USD 4.2 billion.
Asynchronous Store and Forward Service:
Among the incumbents of telehealth, hospitals have been quite active in implementing telehealth facilities as part of their wider healthcare delivery system. Telehealth adoption among hospitals has increased substantially over the years with more than three-quarters of the hospitals in the US having adopted telehealth either fully or partially in 2017—a significant increase from 35% in 2010. In 2019 alone, 106 hospitals and health systems adopted telehealth in some form.
Early entrants to the telehealth industry (in the 2000s) are also considered incumbents, as they are now well established and much larger in scale thanks to their substantial funding. Several of these big players have resorted to M&As in addition to the pursuit of aggressive customer acquisitions in their legacy businesses.
In-house Product Development
Teladoc Health is one of the well-established and leading players in the US telehealth market and is considered to be the first to enter the telehealth business in the country with its formation in 2002. Recently, the company has expanded into other related virtual healthcare services, such as mental health and expert medical consultation, through a series of acquisitions over the years. The recent acquisitions include, Betterhelp (a telepsychiatry company, founded in 2013) in 2015, Best Doctors (a world leading provider of expert medical consultation, founded in 1989) in 2017, Advance Medical (a leading expert medical care provider, founded in 1999) in 2018, and InTouch Health (a leading provider of enterprise telehealth solutions, founded in 2002) in early 2020 in a USD 600 million deal.
The company operates through a business-to-business (B2B) model by establishing partnerships with employers (comprising of 40% of the Fortune 500 companies), hospitals (currently around 300 hospitals) and health plans (currently over 50 health plans) and insurance companies (currently over 70 global insurance companies), covering their employees, patients, and benefactors. In addition, it also operates through a business-to-consumer (B2C) model for its mental health business. The paid membership base currently stands at around 51.5 million (as of June 2020).
The company was listed was listed on the New York Stock Exchange (NYSE) through an IPO in 2015 and remains the only publicly listed telehealth player in the US with a market of USD 15 billion (as of June 2020). The Covid-19 pandemic has significantly benefited the company’s stock driven by the focus shift towards remote healthcare necessitated by social distancing.