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Teladoc – Innovation and Investment Opportunity and Growth Investment, Opportunity and Growth National Healthcare Innovation Summit | 10 June 2013 All material proprietary and confidential. Presented by Teladoc, Inc.

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Page 1: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc – Innovation and Investment Opportunity and GrowthInvestment, Opportunity and GrowthNational Healthcare Innovation Summit | 10 June 2013

All material proprietary and confidential. Presented by Teladoc, Inc.

Page 2: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Agenda

1 Investment thesis why invest in the Telehealth space?1. Investment thesis - why invest in the Telehealth space?2. Evaluating investment opportunity – why Teladoc?3. Closer look at Teladoc - corporate overview4 Market problem healthcare issues4. Market problem – healthcare issues5. Teladoc solution6. Market opportunity7 C t di d ROI7. Case studies and ROI8. Future vision & strategy

All material proprietary and confidential. Presented by Teladoc, Inc.All material proprietary and confidential. Presented by Teladoc, Inc.

Page 3: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Top Down Telehealth Revenue and Cost Savings Opportunity

Total Estimated U.S. Acute Care Visits 264M

Today

Addressable by Remote Consultation 264M

Avg. Cost per Visit Today $178Total “Avoidable” Cost $47BCost if delivered through Telehealth*

(i.e., Revenue opportunity for Teladoc)$12B

Cost Savings to System $35B* Includes $38 per visit plus assumed PMPM of $.40S At M h t M t C W J dith R L J h L Ad d Eli b th A M Gl R t il Cli i P i C

All material proprietary and confidential. Presented by Teladoc, Inc.3

Source: Ateev Mehrotra, Margaret C. Wang, Judith R. Lave, John L. Adams and Elizabeth A McGlynn Retail Clinics, Primary Care Physicians, and Emergency Departments: A Comparison of Patients’ Visits Health Affairs, 27, no.5 (2008): 1272-1282

Page 4: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Volume and price trends drive 40% opportunity growth

Total Estimated U.S. Acute Care Visits 264M

Today

291M

5 Years

Addressable by Remote Consultation 264M

Avg. Cost per Visit Today $178291M$217

Total “Avoidable” Cost $47B $63BCost if delivered through Telehealth*

(i.e., Revenue opportunity for Teladoc)$12B $14B

Cost Savings to System $35B +40%

ROI4 1:1 4 5:1* Includes $38 per visit plus assumed PMPM of $.40 “Today.” Assumes $42 per visit and $.44 PMPM “In 5 Years.”Source: Ateev Mehrotra Margaret C Wang Judith R Lave John L Adams and Elizabeth

$49B

All material proprietary and confidential. Presented by Teladoc, Inc.4

ROI4.1:1 4.5:1Source: Ateev Mehrotra, Margaret C. Wang, Judith R. Lave, John L. Adams and Elizabeth A McGlynn Retail Clinics, Primary Care Physicians, and Emergency Departments: A Comparison of Patients’ Visits Health Affairs, 27, no.5 (2008): 1272-1282

Page 5: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

A Solution to Help Increase Access

Use perishable physician capacity

More clinical time, less administrative overhead

• Gaps in schedules• No claims to file

• No additional space• Cancelled appointments

• Semi-retired physicians

No additional space

• No front office resources (e.g., receptionist)ys

icia

n tyys

icia

n ty

• Work from home physicians

• Stranded capacity in retail li i

• No nurse or med assistant

• No bad debt expense, and crea

se P

hyC

apac

icr

ease

Phy

Cap

aci

clinics

• Off-hours

p ,paid immediately

• Medical malpractice i id d

Inc

Inc

All material proprietary and confidential. Presented by Teladoc, Inc.5

insurance provided

Page 6: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Employer adoption of telehealth

Workplace telemedicine is a growing trend, and one that is gaining increasing attention.

“Health care delivery and treatment settings continue to evolve, leading to th l ti f lt t t kthe acceleration of alternate network strategies, including high-performance networks, third-party providers and telemedicine. For example, 17% plan to offer telemedicine by 2013, and another 27% are considering it for 2014 and 2015 ”2015.”

Source: Towers Watson, Health Care Changes Ahead Survey Report, October 2012 http://www.towerswatson.com/en/Insights/IC-Types/Survey-Research-Results/2012/10/health-care-changes-ahead-survey-report

All material proprietary and confidential. Presented by Teladoc, Inc.6

1 Health Care Changes Ahead Survey Report, Towers Watson, October, 2012. Link: http://www.towerswatson.com/assets/pdf/8139/TW-HealthCare-Trends-Survey-NA-2012.pdf

Page 7: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Agenda

1 Investment thesis why invest in the Telehealth space?1. Investment thesis - why invest in the Telehealth space?2. Evaluating investment opportunity – why Teladoc?3. Closer look at Teladoc - corporate overview4 Market problem healthcare issues4. Market problem – healthcare issues5. Teladoc solution6. Market opportunity7 C t di d ROI7. Case studies and ROI8. Future vision & strategy

All material proprietary and confidential. Presented by Teladoc, Inc.All material proprietary and confidential. Presented by Teladoc, Inc.

Page 8: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc, the industry leader

Telehealth’s time has come.

Teladoc is the first and largest provider of telehealth medicalTeladoc is the first and largest provider of telehealth medical consultations in the United States. Not only do we have the most experience, we have the results to prove it:

97% 125,000+ 12minMember Satisfaction

,Consultations Annually

0 1 91%

Avg. Consult Duration

0Malpractice Claims

1hourGuaranteed Response Time

91%Patient Issues Resolved

All material proprietary and confidential. Presented by Teladoc, Inc.8

Based on Teladoc reporting and member surveys

Page 9: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc Competitive Advantages

Teladoc’s complete solution differentiates us from pthe competition

The industry’s deepest experience in telehealth, and across the h lth ( l li i l t h l l t )Experience healthcare space (payor, employer, clinical, technology, regulatory)

The industry’s only dedicated in-house clinical quality capability, including provider credentialing, rigorous QA, clinical protocols, and proprietary EBM guidelines tailored to telehealth

Experience

Clinical Qualityproprietary EBM guidelines tailored to telehealth

A highly secure, stable, and scalable platform audited by multiple health plans and employers, delivering 125K consults this yearOperational Excellence

Ability to leverage client clinical resources and Teladoc’s physicians, utilizing flexible rules-based network configurations and routing of consults

Member communications expertise and a full portfolio of collateral &

Platform Flexibility

Member communications expertise and a full portfolio of collateral & strategies to drive consumer engagement and utilization

A demonstrated history of data-validated, statistically significant ROI results delivered for clients

Member Engagement

Proven Results

All material proprietary and confidential. Presented by Teladoc, Inc.9

Page 10: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Who we are

We understand the needs of consumers, employers, health plans, and health systems

Experienced health care leadership

• Jason Gorevic, CEO

• Kevin Williamson, Marketing/Product

• Jeff Nadler, Chief Technology Officer

• Daniel Trencher, Business Development

• Mike King, Chief Sales Officer

• Henry DePhillips, Chief Medical Officer

• Paul Squire, General Counsel

All material proprietary and confidential. Presented by Teladoc, Inc.10

Page 11: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Agenda

1 Investment thesis why invest in the Telehealth space?1. Investment thesis - why invest in the Telehealth space?2. Evaluating investment opportunity – why Teladoc?3. Closer look at Teladoc - corporate overview4 Market problem healthcare issues4. Market problem – healthcare issues5. Teladoc solution6. Market opportunity7 C t di d ROI7. Case studies and ROI8. Future vision & strategy

All material proprietary and confidential. Presented by Teladoc, Inc.All material proprietary and confidential. Presented by Teladoc, Inc.

Page 12: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc’s Founding Principles

Providing solutions for three of the biggest issues in healthcare:

Timely accessTimely access

Lower costLower cost

Quality care

Employee / consumer satisfaction is one of the

many benefits of Quality care addressing these issues

All material proprietary and confidential. Presented by Teladoc, Inc.12

Page 13: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc – The leader in telehealth

The first and largest provider of telehealth medical

• Leading market since founded in 2003

The first and largest provider of telehealth medical consults in the United States.

• 900+ Employer clients; multiple National, BCBS, and Medicaid MCO Health Plans

• The market’s only fully integrated technology, clinical, and engagement solution

• On-demand, live diagnostic physician consultations 24/7/365 by phone, online video, mobile, and kiosk

• 50 state physician network

Teladoc leads the industry with over

5,000,000 Members• 50 state physician network

• 16-minute average physician call back time• For only $40 / consultation

• Strong financial performance and opportunity

Members, approximately

125,000 ConsultationsStrong financial performance and opportunity

• $35B market opportunity• Recurring subscription based revenues -- 99% retention• Top HC VC investors – Kleiner Perkins, Cardinal, HLM,

Consultations annually, and

97%Customer

All material proprietary and confidential. Presented by Teladoc, Inc.13

p , , ,Trident satisfaction

Page 14: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Market adoption of Teladoc

E ti l G th F l d b R id M k t Ad tiExponential Growth Fueled by Rapid Market Adoption

Members Monthly Consults

5,000,000

6,000,000

Members

10 000

12,000

14,000

Monthly Consults

11,6005.0 M

2 000 000

3,000,000

4,000,000

6,000

8,000

10,000

-

1,000,000

2,000,000

Dec-09 Jun-10 Dec-10 Jun-11 Dec-11 Jun-12 Jan-13-

2,000

4,000

Dec-09 Jun-10 Dec-10 Jun-11 Dec-11 Jun-12 Jan-13Dec 09 Jun 10 Dec 10 Jun 11 Dec 11 Jun 12 Jan 13

Members Monthly Consults

All material proprietary and confidential. Presented by Teladoc, Inc.14

Page 15: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

We serve leading Employers, Health Plans, and Health Systems

All material proprietary and confidential. Presented by Teladoc, Inc.15

Page 16: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Agenda

1 Investment thesis why invest in the Telehealth space?1. Investment thesis - why invest in the Telehealth space?2. Evaluating investment opportunity – why Teladoc?3. Closer look at Teladoc - corporate overview4 Market problem healthcare issues4. Market problem – healthcare issues5. Teladoc solution6. Market opportunity7 C t di d ROI7. Case studies and ROI8. Future vision & strategy

All material proprietary and confidential. Presented by Teladoc, Inc.All material proprietary and confidential. Presented by Teladoc, Inc.

Page 17: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Telehealth and Healthcare Crisis

What are the issues in healthcare today?

National shortage of PCP’s1 Cost shift to consumerg• 78% of physicians believe there is a nation-

wide shortage of PCPs, and 49% of physicians state they will reduce patients or stop practicing.

• Employers are rapidly shifting more cost to members through HDHP plans. Teladoc provides a lower cost alternative for common primary care services.

Coverage expansion2

• National healthcare coverage is expected to result in an increase of approximately 30M

b i t th h lth t

Provider risk arrangements• As providers manage more risk, telehealth is

a great alternative to ER and urgent care members into the healthcare system.

Medical cost and Misuse of ER• 85% of Americans who went to the ER said

th ld ’t it t th i l di l

g gvisits.

• Some hospitals are exploring kiosks in ER waiting rooms to manage patient outflow.

they couldn’t wait to see their regular medical provider.3

• •79.7% of adults who visited the ER did so due to the lack of access to other providers.4

1. The Physicians’ Perspective: Medical Practice in 2008. 2. New York Times, “Health Care Reform”, 17 October 2011; 3. American College of Emergency Physicians Emergency Care Poll 20124. “Emergency Room Use Among Adults Aged 18-64: Early Release of Estimates

From the National Health Interview Survey”, Renee M. Gindi, Ph.D.; Robin A. Cohen Ph D ; and Whitney K Kirzinger M P H Division of Health Interview

All material proprietary and confidential. Presented by Teladoc, Inc.17

Cohen, Ph.D.; and Whitney K. Kirzinger, M.P.H., Division of Health Interview Statistics, National Center for Health Statistics, January-June 2011

Page 18: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

The primary care physician supply-demand gap

Th d d i h b f l PCP i i dThe demand in the number of yearly PCP visits due to population increase and expanded coverage will drive the need for more PCPs.

POPULATIONBASELINE AGING ACA EFFECT

280,000

YEARLY PCP VISITS ADDITIONAL PCPs NEEDED

52 000240,000

200 000

52,000Additional PCPsneeded by 2025

"Projecting US Primary Care Physician Workforce Needs: 2010-2025"; Stephen M. Petterson, PhD, Winston R. Liaw, MD, MPH, Robert L. Phillips Jr, MD, MSPH, David L. Rabin, MD, MPH, David S. Meyers and Andrew W. Bazemore, MD,

200,000

160,000

All material proprietary and confidential. Presented by Teladoc, Inc.18

, , a d S eye s a d d e a e o e, ,MPH; November/December 20122010 20252014

Page 19: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

The impact of mandated insurance in Massachusetts

The numbers:

Average wait time to see an internal medicine physician 48 days g p y

Family medicine physicians no longer accepting new patients.

y

53%

Internal medicine physicians no longer accepting new patients.

Increase in number of ER visits

51%

9%

Coverage increase resulting from healthcare reform:Massachusetts: Increased from 90% to 96% = an increase of 6 7%Massachusetts: Increased from 90% to 96% = an increase of 6.7%National: Projected to increase from 86% to 94% = an increase of 9.3%

2011 Patient Access to Health Care Study, A Survey of Massachusetts Physician’s Offices, ,Part of the Massachusetts Medical Society’s 2011 Physician Workforce StudyConducted by Anderson Robbins Research for the Massachusetts Medical Society‘’Severe’ doc shortage seen hiking wait times", Boston Herald, September 15, 2009

All material proprietary and confidential. Presented by Teladoc, Inc.19

g g , , p ,

Page 20: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Misuse of the ER

Recent CDC and ACEP data:

f ER i it th lt f t b i bl tof ER visits were the result of not being able to wait to see person’s regular medical provider.1

of adults from age 18-64 visited an ER in the

85%

20%

Reasons for last ER visit

Doctor’s office not open – 48.0%

past 12 months.2

of adult ER visits were due to lack of access to other providers.2

20%

80%

No other place to go – 46.3%

ER is closest provider – 45.8%

p

of ER visits were not classifiable as immediate, emergent or urgent at triage.3

Most care is at ER – 17.7%

46%

1 American College of Emergency Physicians Emergency Care Poll 20122 “Emergency Room Use Among Adults Aged 18-64: Early Release of Estimates From the National Health Interview Survey”, Renee M. Gindi, Ph.D.; Robin A. Cohen,

All material proprietary and confidential. Presented by Teladoc, Inc.20

Ph.D.; and Whitney K. Kirzinger, M.P.H., Division of Health Interview Statistics, National Center for Health Statistics, January-June 20113 National Hospital Ambulatory Care Survey published by the CDC 2009 Link: http://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2009_ed_web_tables.pdf

Page 21: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Agenda

1 Investment thesis why invest in the Telehealth space?1. Investment thesis - why invest in the Telehealth space?2. Evaluating investment opportunity – why Teladoc?3. Closer look at Teladoc - corporate overview4 Market problem healthcare issues4. Market problem – healthcare issues5. Teladoc solution6. Market opportunity7 C t di d ROI7. Case studies and ROI8. Future vision & strategy

All material proprietary and confidential. Presented by Teladoc, Inc.All material proprietary and confidential. Presented by Teladoc, Inc.

Page 22: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

The complete telehealth solution

Teladoc is a clinical services company that delivers customer value and ROI

ConsumerClinical quality and engagementquality and

health

Teladoc

Integrated technology

Consumer engagement

ROI

Integratedtechnology

ROI

technology solution

Clinical quality

All material proprietary and confidential. Presented by Teladoc, Inc.22

Page 23: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

How does Teladoc work? Imagine this…

An employee has cold-like symptoms but doesn’t have the time to sit in an urgent care

iti I t d th ll T l dwaiting room. Instead they call Teladoc:

St 2 St 3St 1 Step 2.Contact Teladoc

Step 3.Talk with a doctor

The employee simply logs into their account or calls Teladoc, 24/7/365, to request either a telephone or video

A U.S. board-certified physician licensed in the member’s state reviews the Electronic Health Record (EHR) and provides a

Step 1.Medical HistoryThe employee completes their medical history when setting up their Teladoc account to ensure this information is

Step 4.R l th i

Step 5.Settle p

Step 6.Resol tion

request either a telephone or video consultation.

22min avg response time

Health Record (EHR) and provides a consultation, just like an in-person visit.available when they request a consultation.

Resolve the issue Settle up ResolutionThe physician recommends the right treatment for their medical issue. If a prescription is necessary, it is electronically sent to the employee’s pharmacy of choice.

The employee is charged $38 or less, depending on their benefit plan. A claim is sent to the health plan each night for the remaining balance.

Your member’s medical issue gets resolved at fraction of the time and cost.

All material proprietary and confidential. Presented by Teladoc, Inc.23

Page 24: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

What is it commonly used for?

Top 10Diagnoses

PrescriptionManagement

• Sinus Problems• Urinary Tract Infection• Pink Eye

• Electronic prescribing (SureScripts) or by phone,if needed

F f ibi i il t• Bronchitis• Upper Respiratory Infection• Nasal Congestion

• Frequency of prescribing similar to provider practice (about 80%)

• Use of antibiotics limited to short durations; patient education and physician

• Allergies• Flu• Cough

durations; patient education and physician reminders for appropriate use

• No prescribing of DEA-controlled substances, medication for psychiatric g

• Ear Infection illness, or lifestyle drugs (i.e. erectile dysfunction, diet, smoking-cessation).

• Generic drugs are automatically d d

All material proprietary and confidential. Presented by Teladoc, Inc.24

recommended

Page 25: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc’s solution: clinical quality and health

Telehealth as a fully integrated solution.

Clinical quality and health

• National provider network• Proprietary EBM clinical guidelines ConsumerClinical Integrated Consumer Proprietary EBM clinical guidelines• Rigorous Quality Assurance• Regulatory compliance• Credentialing

Consumerengagementquality and

health

Teladoc

Integrated technology engagement

Credentialing

Integrated

ROI

gtechnology

solution

Clinical quality

All material proprietary and confidential. Presented by Teladoc, Inc.25

q y

Page 26: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

The highest quality care

By directly managing our network,our physicians are:

The largest national independent physician

Board-certified Board-certified in internal medicine, family practice, emergency medicine or pediatrics. p p y

network in telehealth

97% Teladoc h i i

g y p

State-licensed State-licensed in their respective states.

Experienced Experienced, with an average of 15 years of practice.

physician satisfaction rate

Primary Source Verified

Verified through the National Practitioner Data Bank (NPDB) and the American Medical Association (AMA) Board certification, work history, peer reference, State licenses monthly state sanction reports DEA license

U.S. residents U.S. residents, living and working in the United States.

licenses, monthly state sanction reports, DEA license, criminal and civil background.

Credentialed Teladoc is the first and only telehealth company in the US to have a provider credentialing process that is certified by NCQA.

All material proprietary and confidential. Presented by Teladoc, Inc.26

Page 27: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc quality management

Telehealth processes and systems in place to ensure quality consultations.

• Physicians review a multi-phase patient checklist prior to consultation

• Over 110 proprietary Evidence Based Medicine clinical guidelines specifically designed for telehealth embedded with hyperlinkedspecifically designed for telehealth embedded with hyperlinked references

• Patients are educated using CDC “Get Smart” program about overuse of antibiotics and when they should not be prescribed (e.g., cold, flu), and physicians are reminded using the CMA Foundation AWARE

Teladoc pursues excellence

through quality

and physicians are reminded using the CMA Foundation AWARE

• 15% of all consults are randomly reviewed. QA reviews determined by evidence-based medicine

• Bi-directional exchange of clinical and administrative data available through quality assurance and improvement.

Bi directional exchange of clinical and administrative data available

• Prescriptions are sent electronically to the patient’s pharmacy

All material proprietary and confidential. Presented by Teladoc, Inc.27

Page 28: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc Resolution Rate

For nearly three years, Teladoc member survey results have shown a 91% resolution rate:

91% 9%91%PATIENT MEDICAL

ISSUES RESOLVED

9%UNRESOLVED:

4% referred4% referred2% out of scope for telehealth2% seeking meds only1% sent to the ER

All material proprietary and confidential. Presented by Teladoc, Inc.28

Page 29: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc’s solution: integrated technology platform

Telehealth as a fully integrated solution.

Integrated technology platform

• Clinical/administrative data exchange• Scheduling, Routing, Queuing engine

Cli i lg g g g

• Flexible Network Structures• EHR• SLAs

Consumerengagement

Clinical quality and

health

Teladoc

Integrated technology

Consumer engagement

• Reporting ROI

Integratedtechnology

solution

Clinical lit

All material proprietary and confidential. Presented by Teladoc, Inc.29

quality

Page 30: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Modern telehealth technology platform

Multiple Points of Access to Quality Care

Ph MobilePhone Mobile

KioskKiosk

All material proprietary and confidential. Presented by Teladoc, Inc.30

Video

Page 31: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

An integrated technology platform

T l d i hi hl t t d d t ti it fTeladoc is highly automated and supports continuity of care.

• Systems and operational flexibility to handle different network models• Systems and operational flexibility to handle different network models (including use of partner providers as primary)

• Transfer Continuity of Care Record (CCR or CCD) to PCPs or other providers, with ability for deeper EHR integration

• Advanced system for on-demand consultation scheduling, routing and queuing

• High degree of automation, standardization, and real-time processes: real time eligibility, benefits checking, claims submission

• e-prescribing through Surescripts

• Ability to integrate care alerts and messaging

• Platform fully vetted by national health plans and Fortune 100 clients; scalable to handle millions of additional members

All material proprietary and confidential. Presented by Teladoc, Inc.31

Page 32: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc’s solution: consumer engagement

Telehealth must be a fully integrated solution.

Consumer engagement

• Drive utilization and savings• Portfolio of communication strategies

Consumerengagement

Clinical quality and

healthg• Proprietary predictive model• Consultative approach• Direct to consumer experience

health

TeladocIntegrated technology

Consumer engagement

p

Integratedtechnology

solution

ROI

solution

Clinical lit

All material proprietary and confidential. Presented by Teladoc, Inc.32

quality

Page 33: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Consumer Engagement

Teladoc supports clients with targeted messaging and aTeladoc supports clients with targeted messaging, and a consultative approach to drive utilization – and ROI that speaks to a client’s membership.

Proven Communication Capabilities:• Dedicated, experienced utilization marketing team• Welcome kit to each household• Two marketing campaigns per year (e.g., seasonal,

behavior change, pediatrics)• Co-branded with organization’s logo • Multiple distribution formats

Industry Leading Expertise:• Proprietary predictive model to optimize messaging and

distribution of communications across large populations• Consultative support on plan design (e.g., copays,

incentives) to maximize ROI• Best practices and targeted market research

All material proprietary and confidential. Presented by Teladoc, Inc.33

p g

Page 34: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Agenda

1 Investment thesis why invest in the Telehealth space?1. Investment thesis - why invest in the Telehealth space?2. Evaluating investment opportunity – why Teladoc?3. Closer look at Teladoc - corporate overview4 Market problem healthcare issues4. Market problem – healthcare issues5. Teladoc solution6. Market opportunity7 C t di d ROI7. Case studies and ROI8. Future vision & strategy

All material proprietary and confidential. Presented by Teladoc, Inc.All material proprietary and confidential. Presented by Teladoc, Inc.

Page 35: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Value Proposition by Customer

• Reducing Costs

Value PropositionWho pays for service…

Payors / Employers • Access to Care• Differentiation / Innovation• Productivity (Employers)

Patients / Consumers

y ( p y )

• Convenience / Access• Lower Cost Care• Quality

• Providing Access

Providers / HospitalsProviding Access

• Managing Risk• Patient Acquisition• Revenue

All material proprietary and confidential. Presented by Teladoc, Inc.35

• Revenue

Page 36: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc’s Distribution Strategy

DTCPartnerships

DTCPartnershipsPartnershipsPartnerships

• 91M ASO lives, or 59% of

Large, efficient channels to access lives

EmployerEmployer,

total Commercial lives

• Top 4 national HP’s control 104M total lives (AET/CI/UNH/WLP)

Health PlanHealth Plan• BCBS Plans (ex-WLP)

control 90M lives

• Medicaid MCO’s have 30Mlives, with 30% growth from

ProviderProvider

ACA expansion

All material proprietary and confidential. Presented by Teladoc, Inc.36

Page 37: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Multiple leverage points for growth

• New Clients and Channel partners – e.g., have Highmark and Blue Shield CA, but BCBS ex-WellPoint has 65M+ lives

• Increasing penetration of existing clients – e.g., have 1M of 18M Aetna lives, and 140K f 35M U it d li140K of 35M United lives

• Increasing share of wallet $ per member – e.g., Behavioral Health, Kiosks• New segments – e.g., Retail, ACO’s, Small Group

Case Study:• Launched originally in 2011 with TX and FL Fully Insured, then g y y ,

added AK in 2012 – 760K total members• Implemented ASO channel arrangement in 2012, generating

260K employee lives through 1/1/13• Looking at expansion to new states for FI in 2013Looking at expansion to new states for FI in 2013• Partnering on sales to hospitals for ACO’s• Pursuing new opportunities in behavioral health, health kiosks,

student health

All material proprietary and confidential. Presented by Teladoc, Inc.37

Page 38: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Customer Penetration Opportunity within Existing HP’s

Potential Growth Opportunity Within Aetna, Highmark, BSCA and United Medicaid

($ in Millions)($ )

$7.6

Current Revenue

$84.4Total Potential Revenue

* Total members for each of Highmark Aetna BS CA and United (Medicaid only) multiplied by expected average PMPM revenue yield

All material proprietary and confidential. Presented by Teladoc, Inc.38

Total members for each of Highmark, Aetna, BS CA, and United (Medicaid only), multiplied by expected average PMPM revenue yield, less current revenues

Page 39: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Utilization Marketing – Increasing member use of service

• Dedicated utilization marketingDedicated utilization marketing team

• Communications strategies, plans, and execution to support clients

• Co-branded welcome kits, seasonal emails, posters, etc.

• Proprietary predictive model to p y poptimize and target communications

• Consulting on plan design, i tiincentives

All material proprietary and confidential. Presented by Teladoc, Inc.39

Page 40: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Agenda

1 Investment thesis why invest in the Telehealth space?1. Investment thesis - why invest in the Telehealth space?2. Evaluating investment opportunity – why Teladoc?3. Closer look at Teladoc - corporate overview4 Market problem healthcare issues4. Market problem – healthcare issues5. Teladoc solution6. Market opportunity7 C t di d ROI7. Case studies and ROI8. Future vision & strategy

All material proprietary and confidential. Presented by Teladoc, Inc.All material proprietary and confidential. Presented by Teladoc, Inc.

Page 41: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

What you can save

A benefit of telehealth is redirecting ER and UC utilization to an affordable alternative.

Based on Teladoc reporting. Actual savings may vary based on geography. Productivity savings

All material proprietary and confidential. Presented by Teladoc, Inc.41

y g g p y y gbased on U.S. Dept. of Labor data.

Page 42: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Rent-A-Center case study

RAC implemented Teladoc Jan 1, 2011 to provide telehealth services to their 12,300+ employees and th i d d t h h l t d h lth

Why they chose telehealth

their dependents who have elected healthcare coverage

Why they chose telehealth• Convenience• Affordabilityy• Reduce ER utilization

Plan designg• “Consult Bank” concept• Part of benefit plan design

All material proprietary and confidential. Presented by Teladoc, Inc.42

Page 43: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Rent-A-Center case study: communication strategy

Teladoc is mentioned in multiple communication channels, including member ID cards, employee benefit book, wellness and benefit communications, open enrollment, posters,and benefit communications, open enrollment, posters, postcard campaigns, and seasonal messaging.

All material proprietary and confidential. Presented by Teladoc, Inc.43

Page 44: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Rent-A-Center case study: 24-month utilization

Utilization is strongly influenced by seasonality. Communication campaigns help increase

f th i d iawareness, use of the service and savings.

All material proprietary and confidential. Presented by Teladoc, Inc.44

Page 45: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Rent-A-Center case study: 24-month consult redirection

If their employees hadn’t gone to Teladoc, where would they have gone?*

When an employee is unable to see their primary care physician, they may turn to an expensive alternative to get the care they need.

All material proprietary and confidential. Presented by Teladoc, Inc.45

* Teladoc reporting

Page 46: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Rent-A-Center case study: 24-month savings

What would it have cost?*

By covering the cost of the consult, RAC has provided Teladoc to their employees as an affordable health care option for non-emergency care, helping reduce unnecessary ER/urgent care visits. And best of all, employees can use Teladoc from anywhere, even while at work.

All material proprietary and confidential. Presented by Teladoc, Inc.46

* Rent-A-Center reporting. Productivity savings based on average number of hours lost per visit at Rent-A-Center’s average hourly salary per hour.** Represents gross savings and does not consider the fees associated with the service.

Page 47: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

All material proprietary and confidential. Presented by Teladoc, Inc.

Page 48: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

ROI Case Study: A Large Health Plan Client

A large client partnered with Teladoc and their health insurer to offer our telehealth service to

P i l t d ER

their 350,000 members

• Primary goal to reduce unnecessary ER utilization

• 58 000 ER visits annually (~1/3 of visits were58,000 ER visits annually ( 1/3 of visits were redirectable)

• Average redirected ER visit cost of $1,600 • Telehealth service launched in April 2012

All material proprietary and confidential. Presented by Teladoc, Inc.48

Page 49: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Driving utilization for members who have the greatest need

A dedicated focus on active and regularA dedicated focus on active and regular communication:

T l d di d i l ll t• Teladoc discussed in yearly open enrollment meetings.

• Presentations before open enrollment meetingsmeetings.

• Teladoc included in member benefit guide, monthly emails and bi-monthly newsletters.

• Posters placed in offices.p• Welcome kits mailed to eligible employees,

including instructions to set up their account and membership cards.

• Seasonal communication targeting current members with past ER usage for non-emergent issues, or likelihood to use ER for non-emergent issues

All material proprietary and confidential. Presented by Teladoc, Inc.49

non-emergent issues

Page 50: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Health Plan Client case study: 9-month consult redirection

If their employees hadn’t gone to Teladoc, where would they have gone?*

When a member is unable to see their primary care physician, they may turn to an expensive alternative to get the care they need.

All material proprietary and confidential. Presented by Teladoc, Inc.50

* Teladoc reporting

Page 51: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Health Plan Client case study: redirection savings

What would it have cost?*

By covering the cost of the consult, our client has provided Teladoc to their members as an affordable health care option for non emergency care helping reduceas an affordable health care option for non-emergency care, helping reduce unnecessary ER/urgent care visits. * Represents gross savings and does not consider the fees associated with the service.

All material proprietary and confidential. Presented by Teladoc, Inc.51

Page 52: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Agenda

1 Investment thesis why invest in the Telehealth space?1. Investment thesis - why invest in the Telehealth space?2. Evaluating investment opportunity – why Teladoc?3. Closer look at Teladoc - corporate overview4 Market problem healthcare issues4. Market problem – healthcare issues5. Teladoc solution6. Market opportunity7 C t di d ROI7. Case studies and ROI8. Future vision & strategy

All material proprietary and confidential. Presented by Teladoc, Inc.All material proprietary and confidential. Presented by Teladoc, Inc.

Page 53: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc’s Vision

We will revolutionize Timely accesshow consumers use the healthcare system

Timely access

by delivering remote access to affordable,

Lower cost

high quality care --when, where, and how Quality care

each patient chooses

All material proprietary and confidential. Presented by Teladoc, Inc.53

Page 54: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc Evolution

Teladoc has continued to evolve and grow off of our coreTeladoc has continued to evolve and grow off of our core service and membership base

Employer Health Plan Provider Retail

• Administrative integration (eligibility, claims, etc.)

• Clinical data exchange

• PCP / patient relationship

• Custom multi-tiered networks

• Core technology platform

• Clinical quality (QA, EBM guidelines, credentialing)

• Direct to Consumer marketing

• Health system co-branded partnerships

exchange

• Plan design flexibility and automation

• Scalability, security testing and upgrades

• Provider availability scheduling

• EHR integration

• Clinical protocol flexibility

credentialing)

• National provider network

• Member utilization marketing

• Patient acquisition

• Referral capture

• Health kiosk partnership

flexibility• Reporting & ROI

• Regulatory expertise

All material proprietary and confidential. Presented by Teladoc, Inc.54

Page 55: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Teladoc Strategy

Transform Care Access

N N G t P t ti f I Di t t

Exponentially Expand Footprint / Penetration

Transform Care Access

New Accounts

New Channels

Greater Penetration of Existing Health Plans

Increase Utilization

Direct to Consumer

Expand Expand Scope of

Cl M k t L d i

Health Kiosk Access

Smartphone Apps

Behavioral Health

Dermatology

pSpecialtiesTelehealth Products &

Services

Clear Market Leader in Telehealth

Smartphone Apps

Connected Biometric Devices

At Home Testing

gy

Diabetes

Second Opinion

Travel Med

Expand Clinical Use CasesHome Care Post Discharge Wellness / Screening Chronic Care

All material proprietary and confidential. Presented by Teladoc, Inc.55

Page 56: Teladoc – Innovation and Investment Opportunity and ... · The first and largest provider of telehealth medical • Leading market since founded in 2003 The first and largest provider

Contact us:Name Teladoc, Inc.Jason Gorevic(203) [email protected]

,4100 Spring Valley, Ste 515Dallas, TX 75244www.Teladoc.comjg @

© 2012 Teladoc, Inc. All rights reserved. Teladoc and the Teladoc logo are registered trademarks of Teladoc, Inc. and may not be used without written permission.

Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states Teladoc does not prescribe DEA controlled substances non therapeutic drugs and certain other drugs which may be harmful because

All material proprietary and confidential. Presented by Teladoc, Inc.

not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. Teladoc phone consultations are available 24 hours, 7 days a week while video consultations are available during the hours of 7am to 9pm, 7 days a week.