Concierge Medicine is just the next iteration of your Neighborhood's Family Practice Doctor!

Well has it not come full circle? When I was a kid we had a Family Practice doc down the street. When you got hurt, were sick you went to see the good doc. At the end of the visit the Doctor’s wife (the lady siting at the desk) would hand you an envelope to give to your mom. That was the bill. Everybody in the neighborhood went to see this Physican, and we all did just fine. We all did fine until big CORPORATE took over medicine, and broke the bond between the local Family Practice Doctor and the neighborhood. This "concierge medicine” is just the second coming of a system that should have never gone away! Thank goodness it has come back!

Forget insurance. These Delaware docs only take fees

Jen Rini, The News Journal11:32 p.m. EST November 15, 2015

Cristy Beckman, who suffers from chronic pain in her spine and osteoarthritis, spent six hours in a doctor's crowded waiting room in severe pain.

That was enough, the Middletown resident decided. It was time to make a drastic change in how she was treated.

At about the same time, Dr. Christina Bovelsky opened Peachtree Family Medicine in downtown Middletown with a unique approach to medicine.

Instead of dealing with traditional insurance, co-pays and deductibles, her patients pay a one-year membership fee that includes an annual physical exam and between two and four office visits. Small procedures such as nebulizer treatments, strep tests and electrocardiograms, are included.

Beckman, 46, became one of Bovelsky's first patients.

"There's an absolute peace of mind that someone is looking after your healthcare," Beckman said. "I don't think there's any way I could do something different."

Bovelsky's patients can pay monthly fees between $65 and $75. Yearly rates for adults vary between $780 and $900, depending on the number of visits a patient wants. Care for children under 18 ranges from $240 to $360. Additional office visits cost $80 each.

Nationally, more health care providers are embracing the direct-pay, or "concierge medicine," model.

A Physicians' Foundation 2014 survey found 7 percent of doctors run a direct-pay practice and another 13 percent plan to transition to some form of direct-pay model.

Most of Bovelsky's patients still have insurance for additional procedures and tests not covered by the doctor's fees, such as vaccines and lab work.

Health care providers say they are transitioning to direct-pay medicine because they are able to spend more time with fewer patients, which allows them to drill down to the cause of a medical issue instead of ordering extra tests. The doctors are also more readily available to patients after hours.

Specialists are also embracing the model.

David Wilderman, a longtime physical therapist, decided to sell his physical therapy practice in Pennsylvania and open a new one in Delaware to help patients, like Beckman, who wanted a more personal approach.

"My belief is everyone should receive high-quality health care," he said. "The optimal goal is for my patients is to avoid medication and surgery."

Even with the extra attention, some fear direct pay and concierge medicine will drive up medical costs for individuals. Insurance representatives say consumers should make sure they completely understand a direct fee plan and the cost of treatments from a physician who is not working within a traditional insurance plan network.

Courtney Jay, a spokeswoman for America’s Health Insurance Plans, a national trade association representing the health insurance industry, said in an email that a doctor can charge more for a specific procedure than he or she is typically reimbursed for by an insurance company, which means the patient will pay more for that procedure.

"The out-of-pocket amount for the patient would vary depending on the patient's specific policy within their plan," she said.

Dr. Nick Biasotto, a family doctor and past president of the Medical Society of Delaware, said many doctors are exploring these new business models because they are seeing more patients daily as practices merge and facing higher medical costs with technological advancements.

And, as doctors age, they tend to want to scale back.

At 65, Biasotto, said he found he couldn't keep the pace. He is beginning to transition to a direct-pay practice after becoming frustrated with seeing 45 patients a day. In his 36 years as a doctor, he's seen 4,000 patients.

"It's time for me to slow down. I don’t want to join the hospital system and crank out patient after patient," he said.

Under the direct-pay system, he might see 500 patients in a year and he'll be able to make house calls. He's heard of about eight other doctors pursuing these models.

But he also had to let some employees go and help some patients who couldn't afford monthly fees transition to new providers.

"That was the hardest part of the whole process ... saying goodbye to patients I've cared for four years," Biasotto said.

A direct-fee model also helps doctors and patients eliminate paperwork such as prior authorizations and filing for reimbursements. Bovelsky said she uses that time saved to focus more on patients.

"The average time a doctor has with a patient is 7 minutes," Bovelsky said. "Here, it is at least 30 to 60 minutes. Sometimes it's 90. When you take the time to sit down, you are going to find the answer to what is going on with them.

"I love what I do and I wanted to spend my time with patients. The way medicine is set up currently ... it really is a revolving door."

Insurance standards often dictate what services specialists, like physical therapists, can provide and how long they can care for patients, Wilderman said. Often patients in physical therapy have between 12 to 24 sessions, but the amount of time spent with a therapist is under a half hour.

"It's not in the patient's best interest," Wilderman explained.

Under his model, patients only will need four to six visits, for about an hour each, though there are no set number of visits a person must have. An initial assessment appointment is $195 with any additional visit costing $165. Patients can try to get their services reimbursed as well, he said.

"This is helping people get better faster...People don't have to lose valuable time away from work and family," Wilderman said. "I don't have to go by the insurance company saying I'm not going to cover that.

"When you tally everything up, it is cheaper in the long run to do what I'm doing as an out-of-network provider."

Smart Phones, Tracking arm bands, online patient portals working for Anerican Healthcare? I don't know!

Okay, so this article is about the British patient living in Britain. I have seen Americans using technology to eat better, track exercise, and review blood and other tests ordered by their physician. Sounds good…right? One problem…these same people are still fat, really do not exercise enough, and really do not care about the test results. I just do not get it!

Is this the end of traditional doctors?

A third of over 65s use technology to manage their health

As Brits continue to avoid a visit to their GP, new research reveals a third of over 65s are using technology to keep tabs on their health and wellbeing

By Saffron Alexander

7:00AM BST 21 Oct 2015

The Telegraph

We're living in the age of digital health according to new research.

In 2014, a study revealed that 65 per cent of people actively avoid going to their GP, with a further two thirds admitting they preferred to research health information online. Now new research has revealed more than half of all Brits use gadgets or technology to manage their health and wellbeing.

Research from Push Doctor, published in the UK Digital Health Report, found that checking medical symptoms, monitoring exercise levels, establishing individual BMI scores, monitoring heart rates and checking blood pressure are the top five most common ways we are now using technology to understand and manage our wellbeing.

Half of all adults now use a gadget or some form of technology to manage their health, with a third of over 65s doing the same.

People are even forgoing a trip to the opticians, now preferring to test their vision with apps. Dispensing optician for Essilor, Andy Hepworth, says while apps can be useful, they should not be a replacement for your regular check-up: "They're a smart way of flagging up when you need to get scheduled.

"Vision loss could be linked to other health conditions, so you should never delay booking in with your optician if you've noticed a significant change in your sight."

The research found that people would firstly Google their symptoms and then ask their partner for advice before visiting their GP, while men were more likely than women to book an appointment if they felt ill.

Last year, the number of health searches in the UK increased by 19 per cent up to an average of 848,820 searches a month.

71 per cent said they felt "positive about using technology this way to better understand their bodies" and believe it helps them to be more aware and in control of their health.

Eren Ozagir, CEO and founder of Push Doctor, said: “We use technology to manage nearly every aspect of our lives - from socialising, to organising our finances and heating of our homes. The adoption of health-tech by the general population remains a natural next step; with more and more people discovering how their health information can be used to guide and control and enhance their everyday lives.

“Sports and fitness trackers, gave way to more advanced health-tech monitoring and interpretation tools, and now we have really applicable digital health tools like blood pressure and glucose applications. Combined usage can provide a view of individual their past and current health state, which can be used by you or your doctor to inform what you do next; what you do day to day to improve your general wellbeing or tackle a range of conditions working with a clinician to interpret and use this data to take action to ultimately improve your short, medium and long term health conditions.”

Medical professionals have begun to take advantage of the rising popularity in tracking your health with technology and are beginning to offer online healthcare services.

5.1 per cent of people said they would even share their symptoms on social media in order to get opinions from their followers. A further 6.3 per cent said they had shared data with their doctor online so they could review it remotely, and almost 10 per cent said they had either participated in an online chat or video consultation with their doctor.

Dr Helen Webberley, who consults patients online through My Web Doctor, says although we can never replace the physical GP, online healthcare could soon be the status quo: "Online healthcare is just about to boom, and people are beginning to trust and use it much more.

"It is surprising these days what can be dealt with remotely. Advice is easy by email or telephone; mobile phone photos are easy to upload for looking at spots and rashes; and more detailed looks at the body can be achieved via real-time video conferencing. Prescriptions can be arranged and sent out in the post to home and work.

"Obviously we can never replace the physical GP, but online healthcare services can still advise on whether you need to see your GP, and within what time-frame, so the next time the receptionist asks if it is urgent for today, you will know whether it is or not. The convenience of being able to access a good doctor from your laptop or mobile phone, at any time of day, and to be able to receive your medication through the post, has got to be the way forward."

Obamacare rate increases in 2015 and 2016 will sweep the GOP into the White House!

Obamacare premiums will cause a firestorm at the polls in 2016! Rate increases will cause so many Americans to drop their Obamacare coverage, and those that have yet to sign-up (There is already low penetration that is well well well lower than the 75% needed) will be priced out of the healthcare market. Many Americans are going to be much worse off than they were prior to Obama breaking the American Healthcare system! Was it perfect? Hell no! But….If the Federal Government would have just bought every uninsured American a solid plan instead of wasting all this money on the Obamacare infrastructure America would not have this huge mess! Just saying!

Forbes/Opinion

JUN 10, 2015 @ 12:57 PM

GUEST POST WRITTEN BY

Robert Laszewski

Mr. Laszewski is the president of Health Policy and Strategy Associates, LLC, a policy consulting firm based in Washington, D.C.

Why Are The 2016 Obamacare Rate Increases So Large?

You might recall that I have said we wouldn’t see the real Obamacare rates until the 2017 prices are published in mid-2016. By then health plans will finally have had a couple of years of credible claim data and two of the three “3 Rs” reinsurance provisions subsidizing the insurance companies will have gone away.

I have also made the argument that after two years the Obamacare enrollment of what it needs for us to be assured that we have a sustainable risk pool—enough healthy people signed up to pay the costs for the sick.

Instead of moderate rate increases for one more year, the big rate increases have begun. They are particularly large among the health insurers with the most enrollment—the carriers with the most data.

Texas Blue Cross stands out. The health plan commented in its federal government rate filings that it covered 730,833 Obamacare individuals in 2014 with premium of $2.1 billion and claims totaling $2.5 billion––for a medical loss ratio of 119%. The plan further commented that, after the “3Rs” reinsurance adjustments, they lost 17% to 20% of premium in 2014–that would be about $400 million. And, they are only asking for a 20% rate increase.

While we won’t see all of the rates in all of the states for a few months, some state regulators have begun to make the 2016 rate actions public:

• CareFirst Blue Cross of Maryland is asking for a 34% rate increase on its PPO plan and a 26.7% rate increase for its HMO. CareFirst has an 80% market share in the Obamacare exchange and only 30% of the eligible Maryland market has signed up on the exchange.

• In Oregon, where less than 35% of the eligible have signed up on the exchange, the biggest insurer with 52% of the market, Moda, has asked for a 25.6% increase. Lifewise, with a 19% market share, has asked for a 38.5% increase.

• Blue Cross Blue Shield of Tennessee, with a 165,000 members making up 70% of the Obamacare exchange is asking for a 36.3% increase. The second biggest player, Humana HUM +1.14%, is asking for a 15.8% increase. Less than 40% of the eligible exchange market signed up in Tennessee.

• Georgia is the second biggest Obamacare market for Humana, having enrolled 254,000 people out of a total market of 479,000, and Georgia “maybe. Its CEO has said about Georgia, “We can’t have one business being subsidized by another business.” Humana is asking for 2016 individual plan rate increases from 14.8% to 19.44%.

• In Iowa, with the lowest enrollment rates in the country, and where its biggest Obamacare insurer went broke last December, Wellmark Blue Cross, which only sells off the exchange, is asking for a 43% increase on its Obamacare compliant policies. Coventry, which has 47,000 Obamacare customers, is asking for an 18% increase for its on-exchange business.

• The Kansas insurance department has not made its rate increases public yet but has said that plans will increase by as much as 38%. Less than 40% of the eligible have so far enrolled.

• Pennsylvania is not encouraging with market leader Highmark asking for increases ranging from 13.5% to 39.65% and the Geisinger HMO asking for increases from 40.6% to 58.4%. Pennsylvania enrolled 50% of the potential exchange market in 2015.

But the rate increases so far are also a mixed bag:

• In Washington State, where only 30% of the market signed up, the biggest player, Primera Blue Cross is asking for a 9.6% increase. But most of the other big plans are withdrawing their old plans and replacing them with new designs: Coordinated Care with 13% share, Lifewise 17% share, and Regence 16% share. When a carrier retools its offerings it is generally a sign of needing to go back to the drawing board. Requested rate changes for other existing plans range from -10.86% to +19.3%.

• In Connecticut, where 45% of the market signed up, the biggest insurer on the exchange, Anthem WLP +% with a 33% share, has asked for a 6.7% increase and the second biggest carrier, Connecticare, has asked for a 2% increase for its on exchange plans. Other increases range from +5.2% to +33%.

• In Michigan, where 45% of the market signed up, the biggest Blue plan with 65% market share is asking for a 9.7% increase on one of its plans and an 11.3% increase on the other. Other increases range from -12.6% to +42.2%.

• In Vermont, the state with the highest market penetration for the Obamacare exchange with 75% signing up, the dominant Blues plan is asking for increases averaging 8.3% and ranging from +4.7% to +14.3%.

There will be lots more big rate increases coming. For two months we’ve been hearing warnings out in the market that this is going to be widespread. It is also important to note that none of these insurers knew what increases their competitors were going to submit when they prepared their rate actions. What would some of these smaller players have done if they had known in advance the big players with the most data and experience were giving such large increases?

Some might argue these increases are not such a big deal because those being subsidized by the government have their out-of-pocket premiums capped as a percentage of their incomes no matter what the insurance costs. That these people apparently think this bigger price will be paid by the health insurance subsidy fairy aside, it will be important to remember that deductibles and co-pays also rise in relation to costs. When the new plans become public expect to see bigger deductibles and co-pays as well for 2016. The average individual baseline Silver Plan deductible was almost $3,000 last year.

Like last year, others will argue that these rate increases still have to be approved in some of the states. But unlike last year, the carriers now have hard data to show the insurance regulators. Some states will bring political pressure to bear on these increases. But a 35% increase is not suddenly going to become a 5% increase. There is obviously an overall claim cost problem here and regulation can sometimes push it off but it can’t make it go away.

Others will point out that people only have to switch plans to keep their costs in line since there are some carriers asking for a lot less. That’s right. But the fact that it is the big market share players that are often asking for the big increases says something important about where these cheaper plans will be next year. The big guys know something.

You just can’t look at this data and come away with a conclusion other than the big cost increases driven by too few people signing up has started. And it has started a year earlier than most of us expected.

Why are rates all over the place? There are a number of reasons.

The number of people signing up for Obamacare has varied considerably by state and is far below the level of penetration the industry typically needs to create a sustainable risk pool

State sign-ups have varied with Vermont signing up 75% of the exchange eligible and Iowa only signing up 20%––insurers typically want to see 75% sign-up. Will the third open enrollment next year turn things around? This year’s results were not encouraging with the states having the best first year enrollment stalling out in 2015––California, Washington and New York.

If this pattern of one good year of state enrollment followed by a flat enrollment continues, it is hard to see how Obamacare can reach a sustainable enrollment level.

Many, but not all, carriers are worried that the Obama administration is not going to follow through on its promises to pay off most of a carrier’s losses through the “3Rs” reinsurance program and decided not to wait another year before hiking the rates

In December’s budget deal, the Congress insisted that the third element of the program—the risk corridors—be revenue neutral after the administration last year promised it would not be capped. S&P recently reported that, “The ACA risk corridor will not receive adequate monies from insurers with profitable exchange business to pay insurers that have unprofitable exchange business.”

And in 2016, the second element of the “3Rs,” the claim reinsurance element, will see the point over which the government helps pay the claim rise from a $45,000 claim to a $90,000 claim.

Then there is the permanent and revenue neutral risk adjustor element of the program. Health insurers with the worst claims experience end up getting subsidized by the ones with the best experience. The problem is that the government won’t do this calculation on the last year’s business until after the health plans have to submit the next year’s rates making next year’s rate calculation dicey at best.

This is not an exact science

Over the years, it has been common to see one insurance company in the same market dramatically price its business differently than another. Some have more data, some are more patient, some are willing to underprice to grab more market share, some have more experience in this market niche, and some just screw it up. Over time, a few years, they all eventually get to about the same place but with lots of variation along the way.

Health plans are still dealing with incomplete data. Really, they are looking at just one year of claims experience (early 2014 to early 2015) for a brand new book of business in which the enrollment has not been stable.

What has concerned many actuaries is how the market penetration for Obamacare slowed considerably in year two in the states with the best first year enrollment results. And, almost all of the states recorded a second year growth rate of 10% to 20%. A 20% growth rate might sound good, but to hit the original Obamacare enrollment targets in this first three-year ramp-up, we needed to see enrollment almost double. Obamacare enrollment just plain looks to be stalling out just about everywhere below satisfactory levels and that is a very bad omen for insurer bottom line results.

These rates assume the King v. Burwell Supreme Court challenge to the premium subsidies in the states using the federally run exchange will be unsuccessful

If the Court eliminates the subsidies in at least 34 states, the health plans will submit new and much higher rates in those states.

Body implants to monitor a patient's health! Lower insurance and health costs!

Wanna lower health insurance rates? Charge unhealthy (Obese, smokers, alcoholics, sedentary, yada yada yada) more than you would charge those that are making the effort (with results) to take care of themselves! That’s all I am gonna say about that!

Will Body Monitoring Implants Be The Future of Healthcare?

Adam Ozimek, CONTRIBUTOR    Forbes Business     MAR 8, 2013 @ 6:00 AM 

A classic problem with insurance markets is that the insurer can’t monitor everyone’s behavior, which creates the moral hazard problem: individuals take on too much risk because they don’t have to pay the full cost. But insurance will only make people behave more risky if the insurer can’t charge them for it. Car insurance companies look to be at long last investigating ways to minimize this information problem by incentivizing drivers to put devices on their cars to partly measure how risky of drivers they are. With health care costs rising and increasingly subsidized by the government, it begs the question of whether such monitoring will become necessary for healthcare in the future?

Future technologies will certainly make this easier. Already we are seeing more and more of the “quantified self”, as new products allow us monitor our bodies and amass data about our behaviors. You can track the number of steps you take in a day, your heart rate, how many calories you’re burning, how you’re sleeping. But future technologies are pointing in an even more exhaustive, and some would say intrusive, self-monitoring direction. Research is being done on biomonitoring implants that will keep track of how your body is doing from the inside. Wired reports on how the U.S. government is funding some of this research:

In a new call for research, Darpa is asking for proposals to devise prototype implantable biosensors. Once inserted under a soldier’s skin, Darpa wants the sensors to provide real-time, accurate measurements of “DoD-relevant biomarkers” including stress hormones, like cortisol, and compounds that signal inflammation, like histamine.

Implantable sensors are only the latest of several Pentagon-backed ventures to track a soldier’s health. Darpa’s already looked into tracking “nutritional biomarkers” to evaluate troops’ diets….

With devices like these a health insurance company could offer you discounts for keeping your stress level low, eating healthy, getting more sleep, and generally engaging in behaviors that make you healthier and thus cheaper to insure. Markets will be providing feedback to us that will put a price on our vices. This not only provides us with incentives but information, as our insurers quantify and remind us of the benefits of healthy behavior in dollar terms. Importantly, unlike many paternalistic prohibitions and regulations people will be free to ignore these price signals. Furthermore, if consumers find the nudges undesirable enough then some health insurance companies won’t require them and consumers will be able to choose to avoid them altogether.

In some sense though, regulations are moving us away from this direction. The adjusted community rating part of Obamacare says that insurance companies can only adjust your insurance premium based on your age, where you live, and whether you smoke. There is an understandable motivation for this too: we want insurance to incentivize healthy behaviors, but a lot of health issues are things we are born with. To many it is clearly unfair that someone should have to pay more for healthcare because of how they did in the genetic lottery. However, the exception for smoking shows that people clearly see unhealthy behaviors as something fair to charge people for.  Yet we have an outright ban on health considerations in part because health outcomes are easier to measure than health behaviors ex post, and so any attempts to punish unhealthy behavior risks punishing unfortunate genetics. But if future technologies make reliably measuring unhealthy behaviors easier than this will be less of a problem.

While Obamacare limits how rates can be set, it does appear that discounts for wellness and prevention programs of some form will be allowed. It’s unclear whether or not this would include discounts for healthy behavior as reported by implantable biosensors. But if healthcare costs continue growing and technological innovation in this area improves the economic pressure will be on lawmakers to allow this, insurance companies to promote it, and individuals to abide by it. Obviously this will strike many today as extremely invasive, but if healthcare costs take up enough of our income then I predict the invasiveness will seem less and less consequential.

Telemedicine....lower caost of Medicine. Making care easier for everyone.

'bout time! Not only does telemedicine help patients, but it also lowers cost. Also...there an increase in the physicians quality of life (Can see patients from home)!

 

Big telehealth firm to go public as remote doctor visits gain traction

Jayne O'Donnell and Benjamin F Mitchell, USA TODAY10:55 p.m. EDT June 30, 2015

One of the largest companies in the telemedicine field is going public Wednesday in a move that signals how important remote doctor visits are becoming to the future of health care and efforts to reduce costs.

Shares in Teladoc, a growing but sometimes controversial player in the field, are priced at $19. Teladoc expects to raise gross proceeds of $180 million by selling 9.5 million shares, which includes 15% made available to the underwriters.

The expected proceeds exceed earlier estimates of about $130 million. Teladoc raised the share price from an estimated $15-17 and added more shares due to the positive reception during the investor road show.

"There was very strong reception by the investment community to the market opportunity, Teladoc's leadership position, our historical performance and our future opportunity," CEO Jason Gorevic told USA TODAY late Tuesday.

Teladoc's 700 board-certified doctors deal directly with consumers on the phone, which sets the company apart from much of the rest of telemedicine, which more often involves a physician with a sick patient who video conferences with another doctor who is often a specialist.

The company won a legal fight recently when a federal judge ruled that a Texas Medical Board regulation that prohibited doctors from diagnosing patients over the phone who they hadn't seen in person or on video was probably anti-competitive. The board was blocked from enforcing it until an antitrust suit Teladoc filed against the board was decided.

Teladoc started in 2002, and Gorevic, a former president of Empire Blue Cross Blue Shield, joined as CEO in 2009.

"I've been looking throughout my career for an opportunity to do something that could really improve quality of care, reduce the cost of care and was a win, win, win for the payers, whether the employers or the health plans, the consumer and the doctor and I finally found one," Gorevic says.

Even the telemedicine industry is conflicted about the best way to do this. Industry experts at an American Telemedicine Association conference in May debated the risks and benefits of over-the-phone consultations, saying that although it is possible to effectively and ethically treat mild conditions this way, some illnesses can't be safely treated over the phone or in a video call. Panelists noted 10% of prescriptions for pediatric sinus infections occur over the phone, and it's up to the industry to keep that number from growing since these children should be seen in person.

A RAND Corp. study commissioned by the California Healthcare Foundation found Teladoc physicians prescribed antibiotics at the same rate as doctors did during office visits.

Several studies show video is "by far preferred as the primary medium in telemedicine," says medical technology analyst Roeen Roashan.

"There is a comfort and level of intimacy that allows both physician and patient to end the session satisfied," he says. But phone consultations have "existed for many years and still play a big role today."

Though some mainstream family care doctors bristle at what they see as a risky practice, companies including PepsiCo, Bank of America and some major insurers use Teladoc as a way to cut soaring health care costs and make doctors more accessible. About 11 million of their employees and clients are Teladoc members.

Another Teladoc client, Rent-a-Center, saves an average of $754 per employee every time they do a phone consultation with a doctor, according to a Teladoc-commissioned study co-authored by Harvard Medical School associate professor and physician Niteesh Choudhry and Stanford School of Medicine professor and physician Arnold Milstein.

The biggest savings reflect what it would have cost if employees went to the emergency room instead. The authors acknowledge something Roashan points out: The savings from telephone consultations are partially offset by the number of times patients need in-office visits after the calls.

Gorevic boasts that his company does more than 500,000 of the 800,000 phone and video consultations a year that involve just one doctor and a patient. That's dwarfed by the 10 million video consultations a year that involve doctors consulting with each other about a patient, which Roashan says could double by 2018.

He's not convinced that's a good thing.

"A 15-minute video call is not the same as good health care," says Roashan, who is with IHS Technology. "There's no patient engagement, it's just a transaction."

Gorevic says his doctors offer patients the option of talking via Facetime or sending pictures or videos for doctors to see. All patients fill out medical histories before they are seen, which is typically within 10 minutes.

Teladoc was sued in early June by competitor American Well, which alleged Teladoc's technology infringed on an American Well patent. The suit seeks an injunction against Teladoc continuing to do business. Teladoc petitioned the U.S. Patent and Trademark Office in March to invalidate some of American Well's patents. Both cases are pending.

"The investment community recognizes Teladoc's opportunity to change the health care landscape," Gorevic says.