In an interview, Teladoc Health CEO Jason Gorevic shared how the company has changed, especially since the onset of the pandemic, from primary care services to support it provides to hospitals and health systems.
Given the physician and nursing shortage we’ve seen in healthcare, worsened by the fatigue of Covid-19, how do you find enough providers to support your needs in telemedicine?
At our heart, Teladoc Health is all about connecting people to healthcare in new ways. We’re bridging the gap for millions of people who might not otherwise get the care they need.
The Teladoc Health Medical Group is comprised of more than 7,000 licensed care providers working across more than 100 virtual care clinical protocols to deliver evidence-based care at scale. Our clinicians are responding to more than 100,000 patient messages via text and chat – and providing more than 30,000 virtual visits – every day.
Despite the physician and nursing shortage, we have a waitlist of physicians wanting to participate with us. Many are burnt out from the traditional, physical delivery model, especially coming out of the pandemic, and being armored with PPE for so long.
You developed a virtual nursing unit that you highlighted at the HIMSS conference in March. Can you explain how it works since it focuses on in-patient care, which seems like a departure for Teladoc Health?
Today—more than ever—hospitals and health systems are being forced to operate with decreasing resources, significant financial challenges, staffing shortages and shifting consumer expectations. Virtual care offers new strategies to address the challenges in delivering in-person care.
An important portion of our business provides technology and services to hospital systems so that they can deliver virtual care to their patient populations. Our inpatient solutions complement in-person care by extending the reach of clinicians, streamlining patient triage to help reduce intervention treatments, and providing a positive clinician and patient experience.
The virtual nursing program you reference is in place at Saint Luke’s Health System in Kansas City, Missouri, and has helped address the nursing shortage by having virtual nurses support bedside nurses. The virtual nurses can assist with non-hands-on care, education, documentation, admission, discharge, answering questions, and reviewing the care plan or physician rounding with the patient and their loved ones, among other tasks.
The unit has enhanced Saint Luke’s bedside care response rates, increased patient and nurse satisfaction, reduced the burden on bedside nurses, and positively impacted quality and safety for a better work environment.
About 10 years ago, the perceived role of telemedicine was fairly limited – mainly a supportive role in primary care. What are some of the ways that’s changed and some factors behind that, pre and post Covid-19?
I think pre-pandemic, a lot of people thought virtual care was a “lesser form” of care, and limited to urgent or episodic care, but once they engaged board-certified physicians on our platform and saw the quality of the care, we had a lot of converts.
I think we have also proved over the last few years that virtual care is not just convenient care, but better care. There is a big difference between putting a doctor on a screen and delivering whole-person care. While the need has always existed, the pandemic certainly exacerbated the demand for virtual mental health care, chronic condition management, and virtual primary care as it is a significant driver of chronic, specialty and mental health care and thus is the key factor in influencing outcomes.
And in addition to having the broadest range of virtual health services, consumers want integrated levels of care within those services. There is a growing desire and expectation to get the right care at the right time, whether that be support from self-care experiences, certified coaches or licensed clinicians.
Your CFO has observed that mental health visits have been a big driver of telehealth. Can you provide some details about the mental health services provided by Teladoc Health, including the development of your BetterHelp brand?
Mental health needs and utilization rates have grown dramatically since the pandemic began, paving the way for a new mental healthcare consumer – one who embraces virtual-first and digital channels for support.
This past year we launched myStrength Complete, an integrated mental health service providing personalized, targeted care to consumers in a single, comprehensive experience. The launch came as more than half of people with mental health concerns report that they do not know where to start when getting care, highlighting the importance of the digital front door myStrength Complete will provide.
myStrength Complete’s proprietary stepped-care model seamlessly combines app-based tools and coaching expertise with Teladoc’s licensed therapists and psychiatrists to ensure that consumers get the level of mental health support and care they need, when they need it in a unified experience.
Employers in particular understand that mental health care is a central benefit their employees want and need. myStrength Complete delivers clinical-based care that is cost-saving, easy to use, and effective, and the stepped approach make it appropriate for the entire population. Beyond the clear employee and consumer demand, the right care raises worker productivity and general feelings of well-being.
BetterHelp, the largest direct to consumer provider of mental health services, is also an important part of our company and fills an important societal need for consumers that don’t have mental health coverage or cannot find a therapist in their health plan network.
In February, Teladoc Health launched Chronic Care Complete. Can you offer an overview of that program?
Chronic Care Complete is a powerful and differentiated combination of our strengths. It combines connected technology, data science and virtual care capabilities with expert coaches and physician oversight for a comprehensive and integrated experience that streamlines chronic condition management and improves clinical outcomes. The program provides a complete solution through connected devices, personalized health signals, expert coaching support, physician-based care and integrated mental health care.
The program provides comprehensive support to patients with pre-diabetes, diabetes, hypertension, weight management and mental health concerns and is distinctively designed to assist and guide members through every step of their healthcare journey, from initial diagnosis to mental health support for dealing with a potentially life-changing diagnosis.
You’ve also packaged a suite of services for large employers under Primary360. Could you offer an overview of what’s included with that?
As healthcare costs continue to rise, health plans and employers strengthen their focus on innovative solutions to both manage costs and reduce overall spend. Primary care is widely accepted as a valued care model that helps contain rising costs. Those who engage with primary care identify their health issues earlier and more effectively, have better medication adherence, enjoy better chronic disease management, and ultimately gain better health outcomes.
Primary360 (P360) reimagines primary care by understanding a member’s needs over time, proactively and seamlessly navigating members to the right care, whether for urgent needs, specialty care, a wellness visit, or beyond. P360 offers primary care through a continuous relationship with a dedicated primary care physician and care team where members benefit from virtual access to 24/7 urgent care, prevention, screening, and ongoing condition management in one experience that is convenient and highly personalized.
As I mentioned, primary care is a significant driver of chronic, specialty and mental health care usage and thus is the key factor in influencing outcomes. P360 is therefore optimized to act as a hub for Teladoc Health’s broader suite of specialty care, chronic care, mental health, and complex care offerings. The result is better access to convenient, tailored healthcare that drives high member satisfaction paired with better outcomes and lower overall cost for our clients.
What are some of the trends impacting employer benefits over the next 12 months?
Providing benefits to any workforce, big or small, can be a challenge for employers. Every employee is unique and so are their healthcare needs and preferences. Virtual care has certainly risen as a solution to this conundrum, but employers need to ensure their virtual care strategy is scalable to meet the needs of every employee.
First, employers need an integrated platform that spans the continuum to allow whole-person virtual care. A platform that can address chronic care, mental health, primary care, and acute, complex and specialty care all through a virtual-first approach.
As mentioned earlier, in addition to having the broadest range of virtual health services, employees want integrated levels of care within those services. Employers need to consider if the solution in place is both personalized and able to address all acuity levels for each individual healthcare need. A stepped-care model will define a clear path to the optimal care and drive engagement. The services can scale up or down to ensure members are receiving the right level of care at the right time.
Lastly, the move to virtual first will continue, and I think virtual-first health plans will be commonplace by the start of 2023. Embedded in a virtual-first health plan, virtual primary care also offers an alternative for employers looking to improve outcomes, drive member engagement and lower costs. Virtual-first health plans create a benefit design that is optimized for members who prefer a virtual front door to care. Benefit designs focused on virtual care solutions will play a central role in meeting member needs and improving the quality of primary care.
With an eye to health equity, rural communities have struggled with WiFi access. How much of an obstacle does this pose for Teladoc Health’s growth?
With virtual care we are ready to care for everyone. We are committed to expanding care access and eliminating persistent disparities because we believe virtual care has the power to be “the great equalizer” in healthcare.
We have a long history of expanding access to care, through the phone, online, with cellular remote monitoring and now through voice-enabled devices in partnership with Alexa. We’ve been incredibly active in trying to close the digital divide, while ensuring consumers also have access to non-digital options, specifically non-video options for low-bandwidth areas. Additionally, our virtual options and providers with multiple state licenses continue to bring care to healthcare deserts across urban and rural America.
While there is more we all need to do to bridge long-standing disparities as a society, we are innovating and creating more options for consumers to help close the gaps.
Has the rapid scaling of telemedicine by health systems to cope with the pandemic created more opportunities for businesses like yours or do you see a more competitive landscape? Does your market outlook include more consolidation? Or more niche players focusing on specific areas of healthcare?
The reality is that people are jumping in to do parts of what we do, and there are a lot of different problems to solve in the healthcare ecosystem. This has created a tidal wave of point solutions designed to tackle very specific problems as opposed to whole-person care.
Unfortunately, patients today face cognitive overload as they bounce between providers, specialists, labs, and apps. These individuals need their care teams and data to be centralized and accessible.
No one else is enabling and delivering the full spectrum of connected health care virtually at a global scale – and using the resulting trove of data to make care better.
What is on your to-do list for 2022?
As we move through another year, our mission and vision remain the same: to empower all people everywhere to live their healthiest lives by transforming the healthcare experience. Everyone should have access to the best healthcare, anywhere in the world on their terms, and we will continue to deliver on our mission by providing whole-person virtual care that includes primary care, mental health, chronic condition management and more.
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