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 provides online access to healthcare for many acute, chronic, and psychological conditions, including personalized health assessments, activity tracking, treatment advice, and 24/7 virtual consultations with a healthcare provider. It leverages AI in assisting practitioners to diagnose the conditions and has developed many AI-based health services, including a chatbot for the National Health Service in the UK to diagnose illnesses. As of September 2021, Babylon had served over 24 million patients across its markets. The company launched new contracts in H2 2021 adding 135,000 members in line with its plans to manage more than 350,000 lives globally by the start of 2022. Annual membership costs GBP 149 (USD 199), but it also offers the opportunity to schedule one-off appointments. A one-off general and specialist consultation is priced at GBP 49 (USD 65) per visit.
Babylon has partnerships with Tencent (to tap into the Chinese market), and also offers services in the US, Rwanda, and multiple countries in Asia and the Middle East. Babylon sold its Canadian operations to former partner Telus Health in 2021, signing a multi-year licensing deal estimated at around USD 70 million with Telus for the use of Babylon’s technology after the sale. The company has announced two acquisitions so far in 2022 comprising Higi SH Holdings , a health-checking kiosk developer, and a patient engagement platform DayToDay Health . Higi's acquisition will allow Babylon to expand its market reach and coverage of its digital care offerings across. It also plans to offer DayToDay Health's engagement programs and clinical services to its members as they prepare for and recover from medical interventions and major health events.
Babylon Health’s revenue grew by 400% YoY in 2020 and the company expects the revenue to increase by 300% YoY to USD 321 million in 2021. For 9M 2021, the company recorded a 5.3x YoY increase in revenue to USD 203.2 million, despite incurring USD 141 million operating losses.
In terms of funding, the company raised USD 550 million in a Series C funding round led by Saudi Arabia Public Investment Fund in August 2019, valuing the company over USD 2 billion. It also secured up to USD 200 million in a sustainability-linked investment from European credit specialist AlbaCore Capital Group in October 2021. The debt capital will be a five-year unsecured note with 0.5% penny warrants capped at USD 15 per share. In addition, Babylon Health went public through a merger with Alkuri Global Acquisition Corp., a special purpose acquisition company in October 2021, trading on the NYSE under the ticker symbol “BBLN”. It received gross proceeds amounting to USD 460 million from the deal.
General Telemedicine:
Specialized Telemedicine:
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.
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