Tag: telehealth

Wheel Reveals How Patients Actually Engage With Virtual Care

Posted on by Jason Barry

Wheel just published its third annual Virtual Care Horizons report, and it was overflowing with great data on where telehealth is scaling – and which models are built to last.

Virtual care is all grown up. Adoption has stabilized, competition has intensified, and success is no longer driven by first visits. It’s driven by continuity.

  • That means that scale alone is no longer the headline. Data from 1.4M visits on Wheel’s Horizon telehealth platform shows that sustained engagement is the new unit of growth.

New year, new trends. Wheel answered a trio of important questions using real behavioral data from its users rather than the usual survey approach.

  • How do patients actually move from entry points to ongoing care?
  • Where do they stack services?
  • Which models support durable engagement over time?

Women’s health is the new growth engine. In 2025, women’s health became the largest service category on the platform, accounting for about 50% of all visits.

  • One in three new customer launches or expansions focused on this vertical, which seems like a strong signal that this is a long-term category strength rather than a one-off volume spike.
  • Women’s health offers a uniquely durable foundation for virtual care. It creates demand for a wide range of high-frequency touchpoints early in life (sexual and reproductive health), then naturally extends into more complex, longitudinal needs (menopause support).

Weight management is the clinical anchor. It’s the connective tissue between hormonal, metabolic, and chronic care, effectively converting single-point entry into integrated care models.

  • Patients entering through this vertical are more likely to stack services ranging from follow-up care to diagnostics. As GLP-1s went mainstream last year, Wheel saw a 263% surge in demand for downstream chronic condition and preventive care visits.

Virtual care is the operating layer. It’s evolved from an access channel to the infrastructure for multi-condition management, and the retention metrics look a lot different than the days of transactional telehealth.

  • 69% of Wheel-powered visits were created by returning patients in 2025. 
  • 70% of patients engaged in chronic and preventive care programs return for 2+ visits.
  • 58% of women’s health patients return for a second visit or beyond.

The Takeaway

Most vendor reports read like a billboard for their services, but Wheel just gave us one of the best recent snapshots of how patients are actually engaging with virtual care.

The ATA Makes the Case for Telehealth

Posted on by Jason Barry

The American Telemedicine Association just teamed up with nine major U.S. health systems to deliver one of the most comprehensive looks at Medicare telehealth utilization to date, and the numbers look good for virtual care.

The analysis of 1.67M Medicare beneficiaries from 2019 to 2023 found that telehealth is primarily a substitute for in-person care, replacing office visits rather than adding new ones.

  • Despite the pandemic fueling a 31x increase in telehealth use at the health systems, Medicare patients averaged just 0.25 additional visits per year.
  • The real-world operational data shows that 74% of those telehealth visits were a substitute for in-person care.
  • Not too surprising, except that the CBO has that substitution rate pegged at 30%.

Real-world evidence beats theoretical models. The findings offer a window into how telehealth is embedded in everyday care – with real workflows and patients – suggesting that actual substitution patterns might be a ways away from current budget modeling assumptions.

  • The analysis spanned academic medical centers, integrated pay-viders, and rural hospitals – all showing that telehealth was a substitute during both the pandemic and “steady-state operations” in 2023.
  • Each of the systems also saw costs remain stable or decrease with telehealth adoption, with one of the rural systems avoiding 2,551 patient transfers and saving $8.1M from sidestepping referrals and transportation costs
  • That not only suggests that virtual care is still beneficial post-pandemic, but it might also have lower federal costs than currently forecasted.

The clock is ticking. Medicare telehealth reimbursement flexibilities are set to expire January 30th, and the ATA hopes that these results will inform policy discussions ahead of the deadline.

  • “This data represents the current state under a patchwork policy environment. We’re just scratching the surface of what health systems could achieve with predictable legislative frameworks that let us build infrastructure to serve patients regardless of who’s paying the bills.”

The Takeaway

Most qualitative evidence already told us that telehealth is convenient for patients and clearly a substitute for in-person care. The ATA just provided the quantitative data to back that up.

Function Lands $298M for Medical Intelligence

Posted on by Jason Barry

The face of the health membership movement is now worth $2.5B after Function landed $298M of Series B funding to prove that subscription care is here to stay.

Function is building an “operating system for human health.” The OS “fuses AI with medical expertise to empower 8 billion people to take control of their health and get ahead of disease.”

  • Translation: Function offers personalized nutrition and lifestyle recommendations based on a massive menu of lab tests that members can access for $365 per year.
  • Unlike most annual physicals that measure ~26 biomarkers, Function offers 160+ tests spanning from the heart and hormones to heavy metals and cancer signals.
  • It also doubled down with the acquisition of Ezra earlier this year, adding AI-guided full-body MRIs (for detecting cancers, endometriosis, strokes) and CT scans (for lung tumors, heart plaque, soft tissue damage).

The Medical Intelligence Lab takes the vision even further. Function just launched its Medical Intelligence Lab to unify all of its data – labs, imaging, wearables, and medical records – into a continuously learning model designed to reveal patterns and surface actionable insights.

The lab gives members immediate access to three new AI capabilities:

  • Private AI Chat – answers health questions with responses informed by member data.
  • Protocols – translate complex data into health plans with easy-to-follow steps.
  • Health Records – members can securely upload lab results, visit notes, and medical records to feed into Private AI Chat and Protocols.

The testing gold rush is here… but that might not be great for everyone. Research has shown that direct-to-consumer testing companies have a history of wading into murky waters, particularly misleading marketing and a lack of care continuity.

  • Function will have to prove that its benefits outweigh those risks, but hundreds of thousands of members are already voting with their wallets that the math checks out.

The Takeaway

Function will tell you that it isn’t just leading a new category, it’s setting the standard for how we understand, manage, and extend human health. If that turns out to be true, then $298M should go a long way toward proving it.

Text Nudges Show Potential in Primary Care

Posted on by Jason Barry

Even the simplest text messages can help patients get more out of their primary care visits, at least according to new research published in NEJM Evidence.

The study out of Ascension health system – “A Digital Care Plan Nudge to Improve Primary Care Outcomes” – spanned 76 primary care practices and 29,000+ patients.

  • Patients were randomized to receive either usual care, or a digital nudge sent three days prior to their appointment.
  • The nudges were a simple text message highlighting up to three preventative care needs to address during the visit, such as cancer screenings or vaccinations.

The results speak for themselves. The digital nudge group saw:

  • An increase in appointment completions (+2.8 percentage points over usual care)
  • A decrease in appointment cancellations (-1.5 percentage points)
  • A decrease in appointment no-shows (-1.2 percentage points)

What about the care gaps? The digital nudge group addressed a care gap during 23.5% of visits, compared to 20.3% for usual care (P=0.08). In case anyone skipped stats class, that’s a bigger P value than we were going for, which basically means the jury’s still out on this one.

  • On the bright side, digital nudges did show a statistically significant improvement to care gaps closed at 90 days (+5.4 percentage points over usual care), specifically for breast and colorectal cancer screenings, diabetes testing, and flu vaccines.

Although the study didn’t meet the primary outcome of addressing gaps on the day of the visit, digital nudges showed promise as a scalable way to improve outcomes over time by encouraging patients to be proactive with their health.

  • Not a bad outcome considering that many patients arrive to primary care visits focused on immediate concerns, and springing new topics on them isn’t exactly a great way to inspire quick action.

The Takeaway

Patient activation works, and this study adds to the mountain of evidence supporting it. In the words of Ascension Chief Clinical Transformation Officer Mitesh Patel, “Most importantly, it reflects what’s possible when we combine behavioral science, digital tools, and a learning health system mindset.”

Teladoc Adds In-Network Therapy With Uplift Acquisition

Posted on by Jason Barry

Teladoc wrapped up a bumpy Q1 with the acquisition of virtual therapy provider Uplift, a move that it hopes will help turnaround its persistently problematic BetterHelp segment.

UpLift provides virtual therapy, psychiatry, and medication management services – all crucially covered by most major commercial payors, as well as Medicare and Medicaid.

  • The deal adds over 100M covered lives and a network of 1,500 mental health clinicians, which Teladoc plans to integrate with BetterHelp to give its customers access to in-network treatment options.

The $30M acquisition shores up one of the most glaring weaknesses of BetterHelp’s cash-pay-only DTC mental health offerings, with Teladoc citing out-of-pocket costs as one of the primary barriers preventing potential customers from signing up.

  • UpLift generated $15M of revenue last year – a drop in the bucket compared to the $1B that BetterHelp brought in – but it’s anyone’s guess as to how much of a lift Teladoc will see from the “significantly higher conversion rates” it expects for new members.

In the wake of the pandemic, BetterHelp has eroded from one of Teladoc’s most promising assets to a constant pain point on investor calls, including a $790M impairment in Q2 2024.

  • Setting aside the scathing short report that accused BetterHelp therapists of using ChatGPT to respond to patients during sessions, the segment’s also been facing pressure from rising ad costs that have made it difficult to keep user growth steady.
  • Teladoc now expects BetterHelp revenue to fall between 7.5% to 11.25% next quarter, before returning to form later in the year thanks to stickier relationships courtesy of Uplift.

It’s also interesting to see Teladoc pick up another company at a 2X revenue multiple after paying the same rate for Catapult Health back in February.

  • Not exactly a lofty valuation for an established company with real revenue, especially considering the fairytale multiples we’re seeing startups command in AI Land.

The Takeaway

Acquiring Uplift’s existing payor partnerships should definitely accelerate BetterHelp’s ability to start accepting insurance, a much needed move given its recent difficulty wrangling new customers. Although an immaculate M&A track record isn’t something that Teladoc has going for it, this particular acquisition seems to make a lot of sense on paper.

Dr. Oz Sheds Light on Potential Priorities at CMS

Posted on by Jason Barry

Dr. Mehmet Oz appears to have passed his Senate testimony with flying colors, and the surgeon-turned-TV-personality’s confirmation as CMS administrator seems all but locked in.

The nearly three hour testimony wandered through a range of topics with a direct impact on digital health, giving us a first look at what might change – or get axed – in the years ahead.

  • Prior auth topped the hit list. The most concrete policy idea that Oz offered was limiting the number of procedures subject to prior auth in Medicare Advantage to 1,000, a steep reduction from ~15,000 today. Oz said the “pre-approval process is expensive and wastes time,” especially when we have AI that can “pretty quickly adjudicate whether you should have to wait even a day to have the medication that will get you out of pain.”
  • AI was a major theme throughout the testimony. Oz plans to use AI to help doctors “optimize care” and focus on their patients, making several references to its ability to augment treatments and cut down on paperwork. He also said “we should be using AI within the agency to identify [fraud] early enough so that we can prevent it.”
  • Medicare Advantage was another big focal point. Oz cited MedPAC research showing that MA is more expensive than traditional Medicare, but attributed much of the cost to upcoding from payors. He promised to hit the problem head-on with an AI hammer.
  • Medicaid was a mixed bag. While Oz said he fully supports the program, he also agreed that spending has gone off the rails since the ACA, and was in favor of implementing work requirements. Oz sidestepped questions about potential cuts by saying “the way you protect Medicaid is by making sure that it’s viable at every level,” which includes having enough practitioners, compensating them fairly, and improving patient access.

The Takeaway

It’s hard to take the other side when a charismatic doctor vows to fix a broken healthcare system, but it’s also tough to tell the difference between empty promises and real reform until action backs it up. Part of that will have to wait until the actual confirmation, but as Oz put it, “part of this is just recognizing there is a new sheriff in town.”

Hybrid Care: Interest Outstrips Infrastructure

Posted on by Jason Barry

Provider organizations are hungry for more hybrid care, but new research in NEJM Catalyst highlights a notable gap between their interest and infrastructure.

A survey of the NEJM Catalyst Insights Council – made up of clinical leaders and executives from care delivery orgs across the globe – showed that a majority of the 730 respondents believe hybrid care improves overall quality (74%).

  • 55% of respondents’ organizations already offer hybrid care (68% for U.S. orgs)
  • 42% offer primarily in-person care
  • Only 3% offer primarily virtual care

Hybrid was ranked as the preferred mode of care delivery for the usual areas like primary care and chronic condition management, largely because of the convenience it offers patients, but several barriers still stand in the way of supplementing in-person care with virtual services.

Provider organizations are also facing their own set of challenges.

  • Only 58% report adequate technological infrastructure to enable hybrid care.
  • Even fewer report sufficient tech support for troubleshooting during virtual visits (27%).
  • Just 38% agree they give providers sufficient training to deliver hybrid care effectively.

Although technology barriers are a common scapegoat for limiting access to hybrid/virtual care, the authors point out that digital literacy and clinician support are the bigger culprits. They also suggest a practical solution: dedicated digital navigators.

  • Dr. John Torous, Digital Psychiatry Director at Beth Israel Deaconess Medical Center, believes embedding trained digital health navigators within health systems is “the missing link” to bridge the gap between clinical care and digital tools.
  • BIDMC has reportedly seen significant benefits from using digital navigators to help facilitate both patient engagement and clinical utilization, yet only 21% of organizations currently employ such specialists.

The Takeaway

Technology access is a constant barrier for hybrid care delivery, but this survey shows that digital literacy for patients and support for clinicians could be the actual limiting factors. Luckily, as the authors put it, digital navigators and training programs are also “low-hanging fruit.”

Teladoc Aims to Catapult Over Obstacles With Acquisition

Posted on by Jason Barry

Teladoc is looking to catapult over some of its recent obstacles with its first acquisition under CEO Chuck Divita, picking up Catapult Health for a lofty $65M.

The closing price is over three times what Teladoc shelled out for BetterHelp in 2015, which could be justified if Catapult’s at-home testing synergies pan out as intended. 

Catapult offers an at-home wellness exam called VirtualCheckup, giving members a diagnostic kit to collect blood samples, check their blood pressure, and screen for mental health conditions like depression or anxiety.

  • From there, members have a virtual visit with a licensed nurse practitioner to discuss their test results, review top health risks, and develop an individual health action plan.
  • If VirtualCheckup turns up anything that requires more intensive care, Catapult can now directly enroll eligible members into Teladoc’s chronic condition management programs or refer them to its virtual therapists and primary care providers.

Teladoc hinted that growing membership for its integrated care segment was a top priority during last month’s JPMorgan Healthcare Conference, with BetterHelp’s rising ad costs and dwindling user base prompting a change of course.

  • It was also reported that Teladoc will be a central component of Amazon’s efforts to move deeper into healthcare by allowing its customers to access chronic care programs for diabetes, hypertension, and weight management.
  • Revenue for Teladoc’s integrated care segment was up 2% year-over-year as of its Q3 earnings call in September, compared to a 10% dropoff for BetterHelp to $257M.

An immaculate M&A track record isn’t something that Teladoc has going for it. When it acquired Livongo at the height of the pandemic for $18.5B, the companies boasted a combined value of $37B. 

  • A few billions in write-offs later, Teladoc’s market cap now stands below $2B, but lessons learned from past experiences could set the Catapult integration up for more success.

At-home testing has historically been a significant limitation for many virtual care players, so Catapult could help Teladoc distance itself from the competition with an integrated platform that can tackle both.

The Takeaway

Teladoc is shifting its focus to chronic condition management with the acquisition of Catapult, and adding at-home testing to its diabetes and hypertension programs should be good news for their position in the market (assuming the integration avoids some past missteps).

Telehealth Prescribing Extended Through 2025

Posted on by Jason Barry

In a move that surprised basically no one, the DEA is extending pandemic-era telehealth prescribing flexibilities for controlled substances through the end of 2025.

The “Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications” was officially published on November 19th, ending a months-long stalemate among regulators.

The third time’s the charm (hopefully). The extension gives providers another year to prescribe Schedule II-V medications for conditions like ADHD and opioid addiction without first conducting in-person evaluations.

  • The move maintains the status quo that’s been in place since COVID hit, while effectively punting the decision on formal legislation to the new White House.
  • Both the DEA and the HHS will have fresh leadership, and it remains to be seen how the two agencies will work together to address the matter.

The policy hot potato just got passed to the Trump administration, so telehealth companies and patients will both have to prepare for another year of regulatory limbo.

  • By failing to issue a final rule, the DEA at least gains time to revise its most recent draft rules that sparked nearly 40k comments worth of industry pushback.
  • Those rules included requirements that half of a provider’s controlled substance prescriptions be written for patients seen in-person, and that every patient must be checked against drug monitoring programs in all 50 states. 

It’s a classic tension in healthcare: balancing legitimate access against potential abuse.

  • While the extension acknowledges the “urgent public health need” for access to addiction treatment meds like buprenorphine, the lack of legislation still leaves telehealth in a bucket of “stopgap measures” instead of “absolute necessities.”
  • Punting the decision should also mean better guardrails can be developed to prevent abuse at a time when the founders of pandemic-era pill mills are either fleeing the country or forking over millions in fines.

The Takeaway

The telehealth prescribing can has been kicked down the road for another year, and the industry will now be watching to see whether the Trump administration decides to repeal it. It’s more likely than not that the extension will stick – this isn’t exactly a hot button issue like raw milk.

Telehealth Doesn’t Lead to Low-Value Services

Posted on by Jason Barry

University of Michigan researchers just delivered some compelling evidence that telehealth doesn’t increase wasteful care, and may actually reduce it in several key areas.

This wasn’t a small study. The analysis in JAMA Network Open leveraged Medicare FFS claims data spanning 578k beneficiaries across 2,552 primary care practices between 2019 and 2022.

The researchers tracked eight measures of “low-value care” – services that provide little clinical benefit while racking up costs – across four categories: office-based, laboratory, imaging, and mixed-modality services.

The practices with the highest telehealth usage (top third) showed:

  • Significant reductions in unnecessary cervical cancer screenings (-2.9 per 1,000 beneficiaries)
  • Lower rates of low-value thyroid testing (-40 per 1,000 beneficiaries)
  • No increase in wasteful imaging or other diagnostic services

Low-value care costs the healthcare system close to $100B annually, and while wasteful services have been extensively looked at using Medicare data, this was the first study to do so within the context of telehealth.

  • On one hand, virtual visits eliminate chances for clinicians to perform low-value services that need to be performed in-person.
  • On the other, it’s hard to imagine that the inability to conduct a physical examination won’t lead to more clinical uncertainty and low-value diagnostic testing, although that’s exactly what this research seems to disprove.

The Takeaway

This study tackles one of telehealth’s most persistent criticisms head-on, and the lack of a clear link between telehealth and low-value care should reassure policymakers weighing how to finance and regulate the segment going forward.

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