Teledoc Looks Global with Best Doctors Acquisition

Teledoc CEO Jason Gorevic says the acquisition of Best Doctors will create a combined company that can offer a range of virtual care options for markets that include employers, health plans and health systems. The deal also allows Teledoc to develop global expansion plans.

In an interview with HealthLeaders Media, Teledoc CEO Jason Gorevic detailed the Purchase, NY-based telehealth company’s $440 million acquisition of Best Doctors. The following is a lightly edited transcript.

HLM: Why did you make this acquisition?

Gorevic: The combination opens up a tremendous set of possibilities for the healthcare consumer, ultimately providing a comprehensive platform of virtual healthcare delivery services. Teledoc came at the telehealth market at the low end of the acuity spectrum, focusing on high-frequency, low-severity conditions. Best Doctors came at it from the top of the pyramid, focusing on the most-costly and complex issues. Together we can provide a single, centralized resource for the consumer, regardless of what their healthcare issue is.

HLM: Who can access Teledoc? Is it open to the general public?

Gorevic: Most of our businesses are distributed through sponsoring organizations; employer health plans, health systems, insurance companies, financial service companies. Together we have millions of members around the world.

HLM: How will Teledoc be different after the acquisition is finalized.

Gorevic: Historically, our business has been focused on providing care for consumers across the country who are experiencing episodic conditions such as flu symptoms, allergies, pink eye, urinary tract infections, things like that. This year, we will do that almost 1.5 million times for our 20 million members. Over the last 18 months, we added additional clinical specialties, such as behavioral health, dermatology, a sexual health program, a tobacco cessation program, the ability for our consumers to get on a three-way interaction with a doctor for an aging family member who they are providing care for, and themselves, and help to facilitate the delivery of care. We’ve been consistently expanding the scope of our clinical services.

Once the Best Doctors transaction closes we will be able to direct consumers to their network of more than 50,000 Best Doctors around the world, provide a specialist who can answer detailed medical questions, and be able to provide an in-depth expert second opinion for someone who’s been diagnosed with a musculoskeletal issue, and maybe surgery has been recommended, or has a heart condition, maybe was diagnosed with cancer and is being recommended for chemotherapy. By leveraging Best Doctors in more than 450 specialties we will be able to collect the medical records, assemble a summary of the case, and provide for an expert opinion.

HLM: What are the limitations of tele-medicine?

Gorevic: Obviously, we are not setting broken bones or suturing lacerations. There are certain things that need to be seen in person. Both organizations share a focus on quality and so Teledoc is able to send the consumer for a lab test if it is necessary and similarly Best Doctors will retake pathology or testing if necessary to get a clear view and ensure the accuracy of their second opinion.

HLM: Will the consumers do this out of their homes, or will they do it in a physician’s office?

Gorevic: The consumer should be able to access the highest quality care from wherever they are. They don’t have to be in a facility or a physician’s office. The Best Doctors expert opinion report is delivered to both the consumer and the treating physician. It’s complementary to the local delivery system, regardless of where the patient is.

HLM: Provide an example of how this might work.

Gorevic: Let’s take the example of a shoulder injury. The patient has gone to see an orthopedic surgeon who is recommending surgery. In that case, it would be common for the patient to come to Best Doctors and ask ‘I’d like a second opinion so I know whether surgery is the best course of treatment.’ The member will work with the Best Doctors case manager, who is usually a nurse, and the specialist, who will first interview the patient, then go through an extensive medical records collection process, including collecting the actual films from an MRI, or something like that. If the films are inconclusive, they will order a new set of films to be taken so that they can ensure that they have all the information they need.

That information will be put into a summary report that is sent to a subspecialist, who in this case would be not just an orthopedic surgeon, but an orthopedic surgeon who specializes in shoulders. That specialist will review the record and either confirm or refute the diagnosis, and either confirm or recommend a modification to the treatment plan. Once that report is completed, it is delivered to both the patient and the original treating orthopedic surgeon, who will get continuing medical education credits for reviewing that information.

HLM: How are Best Doctors compensated?

Gorevic: They are paid on a case-by-case basis. They are consultants to Best Doctors. It’s important to understand that Best Doctors assembles this network of experts by going out to the physicians in the community and asking them to nominate and vote on the best physicians in their peer groups. Again, the advantage here is bringing together two organizations with a common focus on ensuring that consumers can access the highest quality care from wherever they are in a virtual environment that will be able to delivery across the healthcare spectrum.

HLM: Are there regulatory issues related to using international doctors, or specialists from other states?

Gorevic: This is an expert consultation that is being provided to local treating physicians. The Best Doctors expert isn’t treating the patient. They are acting as a consultant to the treating physician.

HLM: Are you developing a global network of physicians?

Gorevic: We talk about global because 40% of Best Doctors business comes from outside the United States. About half of that comes from Canada. They have members around the world in more than 100 countries.

HLM: What percentage of Best Doctors physicians are US-based?

Gorevic: About 80%.

HLM: What is your outlook for the telemedicine industry?

Gorevic: We’ve seen our utilization increase significantly year-over-year. Our first quarter utilization was up 127 basis points over the same time last year. And, while I wouldn’t say that we’ve yet achieved the ultimate potential, we’ve certainly hit the inflection point of adoption for telemedicine.

Awareness among consumers continues to be the biggest obstacle to expansion. This combination of the two companies who are both leaders, both have market leading brands, with complementary attributes, I believe will help to increase awareness and increase adoption.