Speaker 1:
From the library of the New York Stock Exchange at the corner of Wall and Broad Streets in New York City, you're inside the ICE House, our podcast from Intercontinental Exchange on markets, leadership and vision and global business. The dream drivers that have made the NYSE an indispensable institution of global growth for over 225 years.
Speaker 1:
Each week, we feature stories of those who hatch plans, create jobs, and harness the engine of capitalism. Right here, right now at the NYSE and at ISIS 12 exchanges and six clearing houses around the world. And now welcome, inside the ICE House. Here's your host, Josh King of Intercontinental Exchange.
Josh King:
I have a particularly vivid memory from growing up outside of Boston. In fact, it was a repeated memory every night. From the time I got home from school, through the family dinner, until the time I went to bed, the telephone would ring. Not the main house phone, but a second line. The one that also rang in my dad's office. My dad was a pediatrician, a sole practitioner, sort of a pediatrician to the whole town where I lived and in the surrounding towns as well.
Josh King:
At dinner, if he hadn't signed out to his answering service, the phone would ring and my dad would excuse himself, walk into the kitchen and answer the phone. "Hello. Dr. King," he'd say. Be getting call after call in the evening.
Josh King:
Over the years, overhearing one side of the conversation, I learned a lot about the range of childhood maladies and their corresponding remedies. If these phone consultations, which I don't think were ever charged for, Dad would end the conversation, making an appointment to see the parents' kid the next morning in the office, or if couldn't wait, at the ER that night.
Josh King:
Those were the days we've all come to expect that any product or service we need should be easy to get and available wherever we are and around the clock. High tech makes high touch service available to the entire population. You longer have to be a high net worth person to beckon a chauffer, eat gourmet at home, or get a personally tailored suit. The same is increasingly true for medical care, but using a highly more efficient, more scalable business model than my dad's.
Josh King:
Today healthcare accounts for 18% of the US economy and is a major for focus of investment on both the public and private market. The New York Stock Exchange currently has 145 healthcare companies with a combined market cap of 3.5 trillion. And last year, venture capitalists invested over 23 billion in healthcare companies. Just this week, dispensed a weekly newsletter from business insider on the future of pharma biotech and healthcare launched a new series focused on the convergence of technology in healthcare.
Josh King:
In the introductory article, disrupted editor, Zachary Tracer summarizes the problem and the solution. And I quote from him. "People in the US are increasingly worried that costs may put their healthcare out of reach or that they'll face unexpected charges after going to the hospital. In politics, that frustration is showing up in the push for Medicare for all, a guarantee of health coverage for every American. In the corporate world, that means healthcare is ripe for innovation and disruption, whether from startups or entrenched players."
Josh King:
The impact of technology on healthcare is a topic this podcast has touched on in past episodes with JLABS, Melinda Richter and QIAGEN's Peer Schatz. Today, we turn our attention to telehealth, the update of my dad's old pediatric practice with Jason Gorevic, the CEO of Teladoc Health who's leading the pack in the virtual health space. Our conversation with Jason on the state of telehealth, how technology will continue to disrupt healthcare and the future of virtual health right after this.
Speaker 3:
And now a word from Planet Fitness. NYSE ticker, PLNT.
Speaker 4:
The Planet Fitness teen summer challenge is on. Now through September 1st, teens ages, 15 through 18 can work out a Planet Fitness totally free, no catches, no commitments. Come in and use tons of cardio and strength equipment on your own, or sign up for one of our free teen fitness training classes. Visit any Planet Fitness to a sign up for your free summer membership. Under 18 must have a parent or guardian present at sign up. Check out planetfitness.com to find a club near you. Participating locations only. Independently owned and operated. See club for details.
Josh King:
Our guest today, Jason Gorevic was named CEO of Teladoc Health in 2009. Under his leadership, the company's annual revenue has grown from 4 million to over 400 million, on its way to becoming the largest virtual care company. On July 1st, 2015, Jason was on the podium of the New York Stock Exchange ringing the closing be to cap off the first day of trading for Teladoc, which IPOed that morning under the ticker symbol, TDOC.
Josh King:
Jason's a nationally recognized thought leader and trail blazer in the virtual delivery of healthcare with a career that began at Oxford Health, now part of United Health Group, and that's NYSE ticker symbol, UNH. Jason also held executive leadership roles at Wellpoint and Empire Blue Cross Blue Shield, both now part of Anthem, which trades under the NYSE ticker symbol ANTM. Welcome Jason, thanks for joining us in the ICE House today.
Jason Gorevic:
Thanks for having me. I'm excited to be here.
Josh King:
Last summer, Jason, you joined Jim Kramer on Mad Money where he was somewhat taken aback by some of the client testimonials he received about Teladoc Health. Let's take a listen.
Jim Kramer:
One of the tweets was someone that's sick in the car, pulled over, called, got a diagnosis. Can it be that simple?
Jason Gorevic:
Oh, it really can. Yeah. I mean, technology being what it is, we can now match a doctor with a patient in their jurisdiction, where they're licensed, matched up with their specialty and take care of them in a matter of minutes. And look, people get sick, not on regular schedules.
Josh King:
So let's pick up where Kramer left off. Where were you back in the 1970s when our family was trying to have an uninterrupted family dinner?
Jason Gorevic:
Well, I was born in 71, so I was a child, and we had a family physician probably much like father who would take calls and he'd say, "Yeah, Jason probably has any other ear infection." He'd say, "Stop in for your vials of penicillin that you can put on the door of your fridge." And that was like having a doctor in the family. We've just modernized that.
Josh King:
Sometimes I wonder if having a dad as a doctor was good for my own health. The prescription was usually bedrest and flat Coke. Stanford University recently put out a study that said having a doctor or nurse in the family improves mortality rates and lifelong health outcomes. You tweeted out that, "While we all can't have a doctor in the family, virtual care is helping to bridge access gaps. Certainly the great equalizer," you said. What are the access gaps and why is virtual care the great equalizer?
Jason Gorevic:
Well, globally, consumers have a hard time getting access to healthcare. This is not just a US problem, this is not just a rural problem. This is a global issue. And it's a global issue because supply and demand for physicians is going in opposite directions. We're seeing increased demand from the aging population, from people becoming more aware of their healthcare needs. And at the same time, you're seeing shrinking supply of physicians.
Jason Gorevic:
And that's really where Teladoc Health comes in. We bridge the gap, we match supply and demand in real time by breaking down geographic barriers, to getting care. It's a lot like having Uncle King as your physician across the country. And undoubtedly, he got those calls, not only from people in your town, but also family members.
Josh King:
I heard one of your podcasts in which you said your initial business model was with medical providers, but then you started to focus really on the consumers. So let's say I'm a consumer like I am here in New York City and my preference would be to go see the doctor for that cough. How do I then engage with Teladoc instead? And what's the experience like?
Jason Gorevic:
Well, the majority of our membership still comes through insurance companies, large employers who have telehealth as part of their benefit package. We do provide behavioral healthcare services, especially on a direct to consumer basis. And that's an example of one where if access to care is a problem for general medical services, it's a crisis for behavioral health. And that also lends itself incredibly well to remote care where the patient and the physician are not in the same place.
Josh King:
Who are these physicians? And what's their work of experience like? They're on the phone or looking in a camera and relating directly to the patient?
Jason Gorevic:
Well, that's exactly right. And it's frequently physicians or therapists, master's level social workers or psychologists who are supplementing their income and making themselves available during slices of time that would otherwise go unused.
Jason Gorevic:
When I got into this almost 10 years ago now, one of the things I really liked about it was that it actually increases the supply of physicians and therapists because it puts those little pieces of time that would otherwise go unused to use. Whether that's a cancellation, whether that's an extra hour on a weekend, and it actually increases the capacity of the whole system.
Josh King:
Are they sort of like Uber drivers for healthcare? They'll tell you when they're available and they just power up their phone and the relationship with availability?
Jason Gorevic:
Well sort of, yes. We do a lot of work to make sure that they're the right physicians, and the highest quality physicians, and that they follow our quality standards. But yes, they work as their schedule allows, some of them are more structured than others. So when we're doing an expert medical opinion, for someone who may have a recent cancer diagnosis or something like that, it's a more structured engagement and we're feeding that a lot of information about the patient's history so that they can make sure that they get to the right recommendation.
Josh King:
I think you said that a Teladoc visit is $40 a visit. What's the revenue breakdown? How much does the doc get from that experience?
Jason Gorevic:
The doctor gets about $25 out of that, which actually when you do the math on their normal office visit and you take out all of the costs of operations, it corresponds pretty closely to what they would get for a normal office visit. We're just enabling them to do it on their terms and we're taking all the hassle of administration out of their day.
Josh King:
So you joined Oxford Health Plans in 1993 to build out the first telephone medical advice service in the industry against a backdrop of a national healthcare conversation that was going on at the time. I was working for president and first lady, Hillary Clinton at the time at the White House with many events focused on the healthcare plan that was promised in the 1992 campaign. I want to hear a little bit of a news clip from way back then and talk to you about it on the other side.
Bill Clinton:
Believe it or not, in the first two decades of this century there was one instance in which the American Medical Association wanted a national health program and the AFL CIO opposed it. Didn't take long until that turned around. Then there were times when Democrats wanted to do it but Republicans didn't. And then there was President Nixon who offered an employee lawyer mandate to get universal coverage in their political consensus for it. Wasn't there. It's almost like for this whole century, someone would decide that this was a terrible problem that someone ought to do something about it, but all the other players were like ships passing in the night.
Josh King:
Like ships passing in the night, Jason. And I think 1992, you're probably just beginning to get ready to leave U Penn, probably destined for life in the family jewelry business, but you begin to really catch hold of what's the problem here and the opportunities that a bright young kid out of U Penn could be able to address.
Jason Gorevic:
Well, it's funny you say that. As a senior sitting at Penn, trying to figure out what I was going to do with my life, it was actually the Clinton healthcare debate that inspired me to go into healthcare. I was considering going into the family jewelry business and after a couple of summers of doing that, decided I wanted to do something that hopefully had a little bit more impact on society, and healthcare was clearly a massive problem that needed to be solved. And I wouldn't go so far as to say that I've solved it, but I hope that at Teladoc Health we've actually done something to improve the functioning of the system and people's lives and experiences with it.
Josh King:
Was pre-med any of your focus back then?
Jason Gorevic:
No, I never wanted to be a doctor. I always thought that there were other ways to fix the system and that maybe I could help a few people by becoming a doctor, but hopefully I could help a large population by going into the healthcare system.
Josh King:
I mean, you have said in the past, I think, that you're natural strengths lended themselves more toward marketing. You did the kind of jobs growing up that all of us who look at people that say, "That is a burgeoning entrepreneur did," which is basically start a house painting business.
Jason Gorevic:
Yeah, that's exactly right. The summers that I wasn't working in my father's jewelry business, I ran house painting companies. That's probably the hardest I've ever worked, except for maybe on the road show before our IPO. But I would say that's where I really learned how to manage people, how to manage a team. And the part that I actually enjoyed the most was the marketing and actually generating business. So when I got an opportunity to go into marketing at Oxford Health Plans, it seemed like the perfect opportunity coming out of Penn.
Josh King:
I've heard you also talk about the late nineties as a time when you began to gravitate out of the experiences that you were having with the health plans. Did you continue to track what was happening with the evolution of telehealth when you moved from Oxford to the tech startup mail.com and then your subsequent return to the healthcare industry to lead Teladoc in 2009.
Jason Gorevic:
So when I went into technology at mail.com, I was all in. It was the boom time of the dot com era and we took mail.com public in 99. It had the fate of many of the dot coms at the time to go through a little bit of a boom and bust. It did give me a lot of insight though into how to use technology to make something really ubiquitous. This was the time of internet email first becoming available. And every site on the internet, most of which are now defunct, like Ghost, and Alta Vista, and Geocities, and all these companies that don't exist anymore, but they all had to have internet email. And that was the beginning of the time when everyone had access to email. And I think that really lent itself a lot to how I think about healthcare and accessing healthcare and using Teladoc Health to give everybody access through mobile devices and the web and their phones.
Josh King:
So now fast forward to the present. You did, Jason, your first quarter earnings for 2019 on April 30th. You started off by saying, and I quote, "We met or exceeded all our financial and operating expectations in the first quarter, in comparison to Q1 2018, total revenue grew 43% to 128.6 million, including 23% organic growth when you exclude advanced medical." Jason, you talked about visit volume of 1.06 million, that's up 75%, membership at 26.7 million members. What are these numbers telling your investors? And how, as a whole, did they tell the story of Teladoc since you rang that bell here on July 2015?
Jason Gorevic:
I think the visit volume metric is probably the best way to describe the trajectory of growth. And it still shocks me. In 2015, we completed our millionth visit in the history of the company since it was formed in 2002. 2017 was the first year where we did a million visits in a single year. In the first quarter of 2019. We did a million visits in just a quarter. You talk about half lives in terms of growth, or you talk about Moore's law, this is a massively increasing growth curve of when it comes to the visit volume, which is an exact representation of consumer adoption.
Josh King:
Consumer adoption, but is also partnership with health plans really starting to ramp up? Are they seeing the ability to contain costs if they just market these services better to their members?
Jason Gorevic:
Yeah, there's no question. Virtual care has moved from the corner of somebody's desk to the center of their strategy in the C-suite. And we're now talking about virtual first plan designs where virtual care becomes central to the delivery of care. And the health plans start to design their plans, their benefits, all of their structures around virtual care, because it really has the opportunity, just like your father experienced, to be the front door into the healthcare system.
Josh King:
Let's go back to the beginning of Teladoc's history. Started in 2002 when the top selling smartphone in the world was the Nokia 6610, which featured an addictive snake game but no camera. Was the company initially offering a solution that the public look wasn't ready for? And how has the general population's comfort being treated over the internet or a phone connection changed since then?
Jason Gorevic:
Well, at the beginning, it was just telephonic. You could talk to a doctor just like people have been since Alexander Graham Bell invented the phone. But there was no video visit. There were no taking a picture and upload the shot of your pink eye or your skin rash or the back of your throat. Today, obviously, all of that has changed.
Jason Gorevic:
But there was clear demand. It was really then a question of making sure people knew that it was available to them. And quite frankly, that's still our challenge. While virtual care is becoming mainstream, our biggest challenge is employing or deploying our surround sound engagement platform to get people to know that it's available as an option for them. Because once people use it, then it's very clear the value that it provides and they become repeat users.
Josh King:
I mean, Teladoc Health recently announced a partnership with Cincinnati Children's Hospital to create a pediatric telehealth platform. Building on my dad's history of dealing with patients and their parents from the 1960s until just a few years ago when he retired, what are some of the unique issues facing pediatric telehealth that the project will address?
Jason Gorevic:
Well, as anybody who kids know, kids never get sick nine to five, Monday through Friday. It's only two o'clock in the morning when the only option is the emergency room. And as a result, about a quarter of the visits for kids in the emergency room are sore throats, temperature with no other symptoms, upper respiratory issues, or ear aches. All of those things could have been handled by your father and certainly could be handled by a virtual visit from Teladoc Health.
Jason Gorevic:
So those are the most frequent situations. What Cincinnati Children's brings is a massive expertise in subspecialties that are very difficult to come by because there just aren't enough physicians across the country. So if you can imagine a pediatrician in a rural town in the middle of the country who has a complicated patient, they can now access a subspecialist to pediatric endocrinologist, for example, who can help to really figure out what's going on with that child.
Josh King:
And just picking up on that relationship between this rural doctor and the doctors that are on Teladoc Health through this partnership with Cincinnati, how should the virtual care work together with the brick and mortar healthcare and the rest of the healthcare ecosystem?
Jason Gorevic:
I think that's a really excellent point. We actually say we're not in the business of disrupting healthcare, we're in the business of transforming it with the healthcare system. We work with the likes of Cincinnati Children's, with the health plans, with the employers, because we're not here to turn the healthcare system on its head. We're just here to help make it work more efficiently and create better access that is really more friendly to consumers.
Josh King:
I spent a lot of time in upstate New York where hospitals and medical care facilities are you and far between like that example you just made, and the population is generally older. So unlike most technologies, telehealth has a high adoption rate among the senior population as an alternative to the live, live-in aid or relocation to an assisted care facility. Is Teladoc exploring the proactive health space where its offering would include applications that would allow clients to be monitored using technologies such as wearables?
Jason Gorevic:
Absolutely. I think wearables is a huge opportunity to expand the scope of what virtual care can do. It's an evolving landscape and there isn't, unfortunately, a ubiquitous solution. So there isn't one device that has really become a standard and the data flow isn't necessarily as regular as we would like to see. But we stand ready to be able to bring our expertise and the network of physicians we have to bear are for consumers as this becomes more ubiquitous. And there are places where we've taken a big step forward, where it can be really very practical.
Jason Gorevic:
So for example, we have a partnership with a company called Kinsa that creates a connected thermometer, and that enables us to take the information that is coming out of your cell phone and populate it for the doctor so that they can see what the temperature's been over a longitudinal period of time, because it turns out that that's actually instructive relative to what's going on with the patient.
Josh King:
We read all sorts of stories about technology companies like Apple and what the iPhone can do attached to your hip. And we certainly think about legacy products like MedicAlert that will go off if you have a fall. But what have you seen that really excites you about the ability for instance, artificial intelligence, to monitor your vital signs, using a wearable and give you the heads up early, or engage a doctor quickly if things seem to be going south?
Jason Gorevic:
Well, I think that's really where the rubber meets the road. It's one thing to collect the data and to have alerts go off. It's another thing to actually be able to act on it and intervene with the patient in the moment when something's going maybe off the rails. And I think it's actually a fine line between too much information for the consumer that can be scary, without having that delivery of care to be there for the patient in their moment of need.
Josh King:
Another major focus area for virtual care, Jason, is the ability for patients to receive healthcare that is often stigmatized. Not a bug bite. I want to listen to an interview by WTF Health, by Dr. Chris Dennis who's Chief Behavioral Health Officer for the healthcare provider Landmark and get your thoughts on the other side.
Chris Dennis:
I had a great example. The other day, there was a patient who was a pastor in a local community, in a small town in Alabama, who for whatever reason was driving an hour and a half to go to a psychiatrist because he didn't want to be able to see ... know anybody in the community he was seeing a psychiatrist. So he would drive an hour and a half each way to go see a psychiatrist. He found out he had the benefit, was able to then see the psychiatrist through Teladoc Health, and also engage in therapy. And because of that, I'm able to see the therapy notes, the therapist is able to see my notes, we're able to communicate back and forth and address his issues holistically.
Speaker 9:
Okay. And now just because I'm not as familiar with the offering from Teladoc Health. So it is not only just the evaluation that you can do, but you can also do your therapy online as well.
Chris Dennis:
Absolutely. There's both therapists as well as providers and psychiatrists to be able to provide prescribers. So I can prescribe medication as well as do therapy. I have patients that I see every two weeks for an hour visit. And I also have, it's just like a regular practice.
Josh King:
Jason, the mental health field is both stigmatized and suffers from a shortage of providers. What's the potential for virtual health to fill this void?
Jason Gorevic:
I think it's one of the best use cases that's out there relative to virtual care. It is exactly as you said, and as Dr. Dennis described. There are many, many places in this country and some times we forget in places like New York City or San Francisco, that it is really stigmatized and people don't want to park their car in front of the therapist's office in their local town.
Jason Gorevic:
We talk to patients who also can't get out of their own homes. So we have PTSD patients whose first interaction with the therapist is literally locked in a closet with the telephone. And it takes weeks for them to graduate to be able to have a live video interaction. Those patients aren't leaving their home. And so it increases not only access, but compliance, and gives a whole flood of solutions for consumers who are desperately in need of care. This is one of those true game changers in an area that is massively underserved.
Josh King:
We've talked about general health, pediatrics, mental health. Are you seeing an acceleration in the types of care that have become viable telehealth fields? Is there any limit to what you can do?
Jason Gorevic:
Well, there certainly is a limit. We're not setting broken bones or suturing lacerations remotely. We're pretty realistic about that. But the scope of what can be done and what's accepted to be done has massively increased since I started 10 years ago. I mean, 10 years ago, I would say Teladoc. And they would say, "Tele-what? You can't do that. That's not legal."
Jason Gorevic:
Today, literally I can't walk around a party without someone saying, "Oh yeah, my company has that. Oh, I used Teladoc the other day." And it's one of those things where it is truly becoming mainstream and has gone from the obscure to the natural part of how people get care.
Josh King:
And yet still when I get my bill or my direct mail from my health insurance plan, it's still an insert that tells me about Teladoc. What do the extra efforts that help it go from just being that piece of paper in the envelope to telling me the patient how I can really use this?
Jason Gorevic:
Well, that's where our surround sound engagement strategies come into play. And that is our challenge, but it's also our opportunity to make sure that you know, no matter where you are, and you're reminded in your moment of need that Teladoc Health is here for you. And we now do that, not only here in the US, but all around the world. About a quarter of our business is global outside the US. And we're deploying those same strategies all around the world in various markets. And I think that's really what will move virtual care from being called virtual care to just being healthcare and how people, everyone thinks about getting their healthcare.
Josh King:
After the break, Jason and I discuss how Teladoc is prepared to expand domestically through Medicare advantage and continue its growth as the largest global telehealth provider. That's right after this.
Speaker 1:
Now a word from Jennifer Tejada, CEO of PagerDuty, NYSE ticker symbol PD.
Jennifer Tejada:
PagerDuty is a digital operations management platform, leveraged by developers, customer support, IT, and security to help ensure that the brand experience for their end consumers runs perfectly all the time.
Jennifer Tejada:
Our organization reflects the diversity and the richness of our community. We're really excited about global impact. We chose the NYSE because it's a place where iconic companies are truly born in the company of giants.
Josh King:
Welcome back. Before the break, Jason Gorevic, CEO of Teladoc Health and I were discussing the growth and current state of the virtual health space.
Josh King:
Going back to your earnings announcement on April 30th, as we were talking about at the beginning of the show, Jason, as we talked about it, you opened up that quarterly call with the numbers announcing the company broke through the one million visit mark for the quarter in its history, through a combination of organic growth and acquisitions. That's a nearly tenfold increase from your last quarter as a private company in 2015. Do you have any thoughts on what the right balance is between organic and acquisition for you? You were talking about international right before the break.
Jason Gorevic:
Well, we think about organic growth as being consistently in the 20 to 30% annual range. I think that's sustainable for the foreseeable future. When we look to acquire, we really look to acquire strategic assets that we can deploy against our different markets or assets that could take us into additional markets. And so the acquisition a year ago of Advanced Medical is a good example of that. That took us much more seriously into the global markets and really gave us a foothold to massively expand not only in Europe where we have a strong presence, but also into Asia and South America.
Josh King:
You're here listed in the New York Stock Exchange. Does Teladoc's position as the only public, pure play telehealth company offer advantages for you in the competitive market. I mean, so many other health plans are listed here as well. We mentioned the number of healthcare companies that are listed here.
Jason Gorevic:
Well, when we went public back in 15, we had a thesis that there would be several advantages. One would be legitimacy in transparency. We were creating a new industry and being a company that was publicly listed on the New York Stock Exchange really lent itself to that.
Jason Gorevic:
In addition to that, we felt like access to the capital markets would enable us to extend our existing lead on the rest of the market by being inquisitive and having a publicly validated currency. Both of those have really played out exactly as we had hoped, and certainly being the only company from an investor perspective, if you believe in the emergence of the virtual care space, there's only one public company to bet on.
Josh King:
The second question, Jason, that you got on that earnings call a couple days ago was from Jamie Stockton of Wells Fargo concerning how the addition of telehealth coverage in the 2020 Medicare advantage rules would affect your business. What does government approval of telehealth mean for the future of the industry and why do you feel that Teladoc is uniquely positioned to react to the ruling?
Jason Gorevic:
I would call this the most significant federal endorsement of virtual care that has ever happened. And that's a big statement, but it's the first time that the government, that CMS is saying, "We think virtual care should be a core component of the Medicare offering and it should be reimbursed as such." And so it starts with the 20 or 21 million Medicare advantage members. And my significant hope is that that expands then shortly thereafter to the Medicare fee-for-service population.
Josh King:
We started the conversation going all the way back to 1993 in the beginning of the healthcare debate in the Clinton administration. Now, all these years later, how does the US regulatory changes that we're talking about compare to what you're seeing globally? Are advances happening fast enough here? How do they compare with the rest of the world that you're seeing?
Jason Gorevic:
It's interesting, the rest of the world is following suit with the US. And we started on state by state basis and we have many, many scars to show for it. But we're now seeing the rest of the countries around the world follow suit in embracing virtual care. Places like Portugal, who are now endorsing diagnosis and prescription and treatment with virtual visits. France, we recently announced an acquisition of Medecin Direct in France. That's a recent change to the regulatory environment. We're seeing the same thing in Brazil, which is a massive private health insurance market. And we're seeing that across multiple of the developed markets and developing markets around the world.
Josh King:
When you acquired Advanced Medical last year and followed that up a few weeks ago with the announced acquisition of the French telehealth company, Medecin Direct, are there particular international regions that you're looking at as potential growth markets?
Jason Gorevic:
Certainly the list is long and distinguished. We've been strong in Canada, the UK, and Australia, New Zealand for years. And in fact, Best Doctors, when we made that acquisition, had a strong footprint there. Advanced Medical really gave us the rest of Europe in a very meaningful way, as well as offices in Shanghai, in Chile, in Brazil. And we see those as longer term developing markets.
Josh King:
I think of the opportunities that my family and I have to travel overseas. And one of the anxieties one always has about is what happens if something happens to you medically and being able to access the relationship you have, or the systems that you have for medical care. Teladoc recently launched a service in Canada that allows coverage of Canadians, even while they're visiting the US. Is this a unique aspect of just the Canada plan or part of a larger transnational strategy to cover patients globally?
Jason Gorevic:
It's really the latter. This is a global strategy to make sure that we can take care of people regardless of where they are. And I give you a good example. Having a doctor in the family is wonder if you're traveling and you need to be diagnosed or have some assistance for something simple. But if it's something that's more critical or more complicated, you want a local doctor who really knows the local delivery system. So we have a whole network of physicians in China who understand the local delivery system, understand who the doctors are, who can relate to you as an expat, who accepts your insurance and where you're able to go on a seamless basis. So you may be able to get someone from home who's going to do an initial assessment of you, but you're going to have a doctor locally to make sure you're getting the right care.
Josh King:
Looking domestically, Jason, talking about of things you might see on one of these international junkets. The elephant in the healthcare room is Haven. The joint venture between Jeff Bezos, Jamie Diamond, Warren Buffet, announced last year. CNBC's Becky Quick asked Warren Buffet for an update last month, and he had this to say.
Warren Buffet:
So we've got to stop the cost situation. But what we're hoping to find is something that will not only do a better job for our employees, but have them feel better about it, and stop the ascending rate. Because every point you chew up of GDP comes from somebody else. I mean, there are only a hundred cents in the dollar.
Josh King:
The Oracle of Omaha reiterated that Haven remained far from market ready. But do you have any insight in how Haven will impact the virtual healthcare and the overall healthcare space?
Jason Gorevic:
Well, I'll try not to prognosticate on what they're going to do for the overall healthcare landscape. But I will say that I fully expect that virtual care will be part of the Haven new healthcare model for their own employees, which of course is where they're starting.
Josh King:
Amazon is one of your clients.
Jason Gorevic:
Amazon is one of our clients. We have a lot of the big tech companies as clients of ours. And there's no question to me that virtual care plays a role in the model of the future. I think it's exciting when companies like that get into the healthcare space and try to mix things up and come up with a new model because it requires sponsors like that who are willing to go out on a limb and do something a little different. And that's what we're seeing from our clients who are looking at virtual first models.
Josh King:
You mentioned in an interview that you often advise healthcare are startups. What are the trends and disruptors that you have your eye on and the guardrails that you talk to entrepreneurs about based on both of your failed experiences and also your successful one?
Jason Gorevic:
Well, what I talked about earlier about transforming from within and not disrupting from the outside is a really important one with healthcare. Healthcare is famous for organ rejections of things from the outside. I think it's really important to work with the system. I also would say ambiguity and comfort with ambiguity is pretty critical for any entrepreneur. There are rarely black and white answers when you're in an early stage endeavor, there are just choices. And making those choices, committing to them, and then really measuring whether they're the right choices, and having the check on your ego to be willing to admit when they're not the right choices is critical to success.
Josh King:
Specifically in the healthcare space, as you think of about inorganic growth and you look around and see stories of what people are doing, what really sets your heart on fire? What's really exciting you about what people are doing in the healthcare space?
Jason Gorevic:
Well, I'm biased. I recently joined the board of a company called Doximity. It's sort of like a social network for doctors and provides them with a whole support system. And you see them frequently interacting with each other to work through cases, and get advice, and network for different opportunities. And so I think that's sort of like LinkedIn and Facebook meets healthcare. That's pretty exciting to me. But again, I'm biased because I'm on the board.
Josh King:
So Doximity is something we should keep an eye on. What should we expect from Teladoc Health in the coming years after people go back and listen to your first quarter conference call?
Jason Gorevic:
Well, so on an organic basis, we'll continue to deliver 20 to 30%. But we also have lots of opportunity for build, buy and partner. The areas I like the most are continued international expansion. There are lots of markets where we are an under penetrated and there would be a partner who could potentially accelerate our growth.
Jason Gorevic:
The second area is chronic care management. I really like that space. I think we're uniquely positioned. The challenge there is, there are a lot of point solutions that take care of a single condition and we really have to be ubiquitous across multiple conditions.
Jason Gorevic:
And then the last area is what you referenced with Cincinnati Children's. The hospitals and health systems are really asking us for more services and an expansion of our capabilities as they look to virtualize more of their clinical services. And that's definitely an area for us to continue to expand.
Josh King:
Well, as you continue to expand, as we continue to watch you, we and everyone else will keep our eye on Teladoc Health and NYSE ticker symbol, TDOC. Thanks so much for joining us inside the ICE House.
Jason Gorevic:
Thanks, Josh.
Josh King:
That's our conversation for this week. Our guest was Jason Gorevic, CEO of Teladoc Health. If you like what you heard, please rate us on iTunes so other folks know where to find us. And if you've got a comment or question, you'd like one of our experts to tackle on a future show, email us at [email protected]. Or tweet at us at icehouse podcast. Our show is produced by Pete Ash and Theresa DeLuca, with production assistance from Ken Abel and Ian Wolf. I'm Josh King, your host, signing off from the library of the New York Stock Exchange. Thanks for listening. Talk to you next week.
Speaker 1:
Information contained in this podcast was obtained in part from publicly available sources and not independently verified. Neither ICE nor is affiliates, make any representations or warranties, express or implied as to the accuracy or completeness of the information and do not sponsor, approve, or endorse any of the content herein, all of which is presented solely for informational and educational purposes. Nothing herein constitutes an offer to sell, a solicitation of an offer to buy any security or a recommendation of any security or trading practice. Some portions of the proceeding conversation may have been edited for the purpose of length or clarity.
