Telemedicine & telehealth
Telemedicine and telehealth covers the platforms delivering remote clinical care - synchronous video visits, asynchronous messaging consultations, virtual specialist networks, and the DTC prescription channels that grew up alongside them. The category exploded through COVID, with US virtual visit volume rising more than 60x at peak. Most of that volume reverted by 2023, leaving a much smaller core business that is still material in mental health, chronic disease management and a handful of DTC prescription categories. Public-market telehealth equity has been brutal - Teladoc traded above $300 in 2021 and below $10 by 2024; Babylon Health went bankrupt in 2023; Cerebral has been the subject of DOJ investigations over controlled-substance prescribing. The structural survivors are DTC consumer telehealth (Hims & Hers, Ro) and B2B virtual care plumbing.
The sector spans general virtual primary and urgent care, DTC consumer telehealth and prescription, virtual mental health, virtual specialty and chronic disease care, asynchronous and on-demand provider networks, and the B2B telehealth infrastructure used by hospitals and health plans.
Revenue comes from per-visit fees paid by patients or insurers, monthly subscription pricing on DTC consumer telehealth, PMPM contracts with employers and health plans, B2B SaaS sold to hospital and provider systems, and pharmacy revenue from prescribed medications dispensed through owned or partner pharmacies.
Telemedicine & telehealth is part of Digital health.
$123B
Global market size
32
Public companies
Key VC investors
Key strategic buyers
How telemedicine & telehealth companies monetize?
Telemedicine and telehealth companies monetize through DTC subscription and prescription, PMPM employer contracts and pharmacy revenue.
PMPM employer & health plan contracts
Per-member-per-month fees paid by self-insured employers and health plans for access. The historical Teladoc model; the model under most pressure as employer wallets consolidate.
DTC subscription & prescription
Monthly subscription plus per-prescription pricing paid directly by consumers. The Hims & Hers and Ro engine; the structurally strongest model in the category.
Per-visit fee-for-service
Per-visit billing to insurers under fee-for-service codes. Common at general virtual urgent care and specialist consult networks.
Virtual specialist networks
Curated specialist consult networks selling into health plans, employers and self-pay channels. The Doximity and Included Health model.
B2B virtual care infrastructure
Video, scheduling and clinical workflow software sold to hospitals and health systems. Amwell and Caregility lead the white-label side.
Pharmacy revenue
Take rate on prescription fulfilment through owned or partner pharmacies, often the highest-margin line in DTC telehealth. Hims, Ro and Lemonaid all rely on this layer.
Telemedicine & telehealth valuations in May 2026
Public telemedicine & telehealth comps trade at 2.0x EV/Revenue. Median revenue multiple across telemedicine & telehealth M&A deals was 2.3x in the last 12 months. Median revenue multiple across telemedicine & telehealth VC rounds was 12x in the last 12 months.
2.0x
Median EV/Revenue as of May 2026 for public telemedicine & telehealth companies
13x
Max Healthcare Institute is the highest valued public telemedicine & telehealth company based on EV/Revenue (excluding outliers)
2.3x
Median EV/Revenue across telemedicine & telehealth M&A deals in the last 12 months
12x
Median EV/Revenue across telemedicine & telehealth VC rounds in the last 12 months
Telemedicine & telehealth market segments
Telemedicine and telehealth spans DTC consumer telehealth, virtual mental health and B2B virtual care infrastructure.
DTC consumer telehealth
Direct-to-consumer brands offering virtual visits and recurring prescriptions for sexual health, hair, skin, mental health, weight loss and other categories. Key players: Hims & Hers (NYSE: HIMS), Ro, Lemonaid Health (23andMe) and Wisp.
General virtual primary & urgent care
On-demand video visits for routine primary and urgent care, sold mainly through health plans and employer benefits. Key players: Teladoc Health, Amwell, Doctor on Demand (Included Health) and MDLive (Cigna Evernorth).
Virtual mental health
Video and asynchronous mental health visits, often paired with medication management. Subject to ongoing DEA controlled-substance rule changes. Key players: Talkspace (NASDAQ: TALK), BetterHelp (Teladoc), Cerebral and Brightside Health.
Virtual specialty & chronic disease care
Specialty consults and longitudinal chronic disease management delivered virtually - cardiology, dermatology, behavioural health, weight management. Key players: Included Health, Firefly Health, Hello Heart and Vida Health.
B2B virtual care infrastructure
Video, scheduling and clinical workflow platforms sold to hospitals and health plans for white-label virtual care. Key players: Amwell (NYSE: AMWL), Caregility, Bluestream Health (Vocera/Stryker) and Zoom for Healthcare.
Physician network platforms
Physician-facing networks combining communication, referrals and telehealth. Key players: Doximity (NYSE: DOCS), Sermo, Figure 1 and Medscape (WebMD).
International telehealth platforms
European and global virtual care companies, generally with stronger payer integration than US DTC. Key players: KRY/Livi (Sweden), Babylon Health (defunct 2023), Push Doctor and Doctorlib.
Fractional CFO, financial modelling and deal advice for telemedicine & telehealth companies
See how Flow helps telemedicine & telehealth founders.
We speak founders' language and have great operational understanding of telemedicine & telehealth businesses.
Book an intro call - we'll look under the hood and recommend concrete next steps.
Fractional CFO
For founders who want to improve their FP&A functions, build an investor-ready financial model, and prepare for the next VC round.
Capital raising
For bootstrapped and already-VC-backed entrepreneurs who are looking to raise late stage venture or growth capital.
M&A
For category-leading technology companies who are exploring exit alternatives with either financial or strategic acquirers.
Key telemedicine & telehealth KPIs to track
Members or subscribers, visits per quarter, ARPU per visit and CAC payback are the metrics investors track in telemedicine and telehealth.
| KPI | Definition |
|---|---|
| Members or subscribers | Covered or subscribed lives. DTC and PMPM businesses report this differently - Hims subscribers (annualised paying customers) vs Teladoc covered lives. |
| Visits per quarter | Synchronous or asynchronous visits delivered. The activity metric for general virtual urgent care and B2B platforms. |
| ARPU / revenue per visit | Average revenue per active subscriber or per visit. The subscription-attach ARPU is the watched figure at Hims and Ro. |
| Net revenue retention | Existing-customer revenue 12 months later. Strong DTC telehealth shows 110%+ NRR through upsell into new prescription categories. |
| PMPM | Per-member-per-month price for B2B contracts. Decision-relevant when comparing Teladoc, Amwell and Included Health employer contracts. |
| Gross margin | DTC telehealth gross margin sits at 70-80% on the service side; the pharmacy side has compressed materially as Hims and Ro fulfil more of their own prescriptions. |
| CAC payback | Time to recover customer acquisition cost. Material at DTC players given heavy paid marketing spend; the unit-economics input separating sustainable from unprofitable players. |
| Prescription volume | Annual prescriptions filled through the platform's pharmacy partners. The activity metric that maps DTC telehealth scale to commercial impact for pharma. |
Main telemedicine & telehealth players globally
The most active telemedicine and telehealth companies and category leaders globally.
| Company | HQ | Overview |
|---|---|---|
Hims & Hers Health hims.com |  San Francisco | DTC telehealth platform across men's and women's sexual, hair, skin, mental health and weight categories (NYSE: HIMS). One of the few digital health public stories well above its IPO price; rolled out compounded GLP-1 offering in 2024. |
Teladoc Health teladochealth.com | Purchase | Largest publicly traded virtual care platform (NYSE: TDOC). Includes BetterHelp (consumer mental health) and Livongo (chronic care). Multiple write-downs since the 2021 peak; new CEO Chuck Divita in mid-2024. |
Amwell amwell.com | Boston | B2B virtual care infrastructure (NYSE: AMWL) sold to hospital systems and health plans. Anchored by the Converge platform; serves large clients including CVS Health and the Veterans Health Administration. |
Doximity doximity.com | San Francisco | Largest US physician professional network and telehealth platform (NYSE: DOCS). Roughly 80% of US physicians on the platform; high-margin advertising, recruiting and telehealth subscriptions. |
Ro ro.co | New York | DTC telehealth platform across men's health, women's health (Modern Fertility), weight management and dermatology. Last valued at $7B in 2022; private and reportedly profit-focused since 2023 cost-out programs. |
Talkspace talkspace.com | New York | Listed virtual mental health platform (NASDAQ: TALK) covering DTC and payer-reimbursed therapy. Made the strategic pivot from DTC to insurance reimbursement in 2022-23 and returned to profitability. |
Cerebral cerebral.com | San Francisco | Virtual mental health platform that grew rapidly during COVID. Faced DOJ scrutiny over controlled-substance prescribing in 2022; reorganised, sharply reduced staffing, and is now operating at smaller scale under new leadership. |
Lemonaid Health lemonaidhealth.com | San Francisco | Virtual care and telepharmacy platform acquired by 23andMe in 2021 for $400M. Continued under 23andMe ownership through the 2025 bankruptcy and Regeneron acquisition. |
Included Health includedhealth.com | San Francisco | Virtual primary care, specialist consults, navigation and behavioural health sold to self-insured employers and health plans. Formed in 2021 from the Grand Rounds + Doctor on Demand merger; majority backed by Carlyle. |
KRY/Livi livi.co.uk |  Stockholm | Largest European telehealth platform, operating in the UK, France, Germany and Nordics. Backed by Index Ventures and Accel; majority-funded by national health-service contracts rather than DTC consumer subscriptions. |
Board pack needs work?
Investor-grade reporting from a fractional CFO who's sat on both sides of the table.
Key telemedicine & telehealth market trends
GLP-1s reshaping DTC telehealth, DEA controlled-substance rules and pharmacy vertical integration are reshaping telemedicine and telehealth right now.
GLP-1s reshaping DTC telehealth
Hims & Hers, Ro and Eden launched compounded semaglutide offerings through 2024 and pulled in hundreds of millions in revenue. The FDA's October 2024 decision ending the shortage status for semaglutide reset which players can continue compounding; Hims's response (continuing in personalised compounded form) is the most-watched commercial outcome of the year.
DEA controlled-substance telehealth rules
The DEA's ongoing rulemaking on remote prescribing of controlled substances (most recently extended through end-2025) is the binding constraint on virtual ADHD and addiction treatment economics. Cerebral, Done, Wisdo and Bicycle Health have all reorganised around this regulatory framework.
Babylon Health collapse and B2B telehealth retrenchment
Babylon Health filed for administration in August 2023, ending a $4.2B SPAC story. The unwinding closed the chapter on a wave of B2B platform telehealth bets and reset valuations for B2B providers like Amwell and 98point6.
Pharmacy vertical integration in DTC telehealth
Hims & Hers acquired MedisourceRx in 2023 and Ro built compounding capacity through 2024; both moves restructure the gross-margin profile of DTC telehealth. Pharmacy-owned models now run 20+ points of gross-margin advantage over partner-fulfilled.
Employer telehealth wallet consolidation
Self-insured employers have aggressively consolidated point solutions through Transcarent, Included Health and Quantum Health since 2023. Standalone telehealth vendors are being bundled or dropped, and PMPM pricing has compressed.
Ambient and AI scribe integration
Virtual care platforms have integrated ambient AI scribes (Abridge, Suki, DAX) and triage agents into the live visit workflow through 2024-25. The result is shorter visits and lower clinician cost; Teladoc, Included Health and Amwell all shipped material AI features in 2024-25.
Similar verticals to telemedicine & telehealth
Explore niches like digital therapeutics, EHR & practice management, fitness & wellness and health data & analytics.
Explore other sectors
We know tech inside & out.
We live and breath tech - true understanding of how startups operate is fundamental at what we do.
Recent insights across telemedicine & telehealth and beyond
Talk to us
Schedule a call to get a health check on your business and see how we could help.
Fractional CFO
- Fractional CFO for Software
- Fractional CFO for AI & ML
- Fractional CFO for Fintech
- Fractional CFO for Consumer internet
- Fractional CFO for Digital media
- Fractional CFO for E-commerce & marketplaces
- Fractional CFO for Consumer products
- Fractional CFO for Mobility
- Fractional CFO for Digital health
- Fractional CFO for Industrial technology
- Fractional CFO for Digital infrastructure
- Fractional CFO for IT services
Stages
Countries
- UK Fractional CFO
- Ireland Fractional CFO
- France Fractional CFO
- Germany Fractional CFO
- Spain Fractional CFO
- Portugal Fractional CFO
- Italy Fractional CFO
- Netherlands Fractional CFO
- Belgium Fractional CFO
- Switzerland Fractional CFO
- Austria Fractional CFO
- Denmark Fractional CFO
- Sweden Fractional CFO
- Norway Fractional CFO
- Finland Fractional CFO
- Poland Fractional CFO
- Estonia Fractional CFO
- US Fractional CFO
- Canada Fractional CFO
- Mexico Fractional CFO
- Brazil Fractional CFO
- UAE Fractional CFO
- Australia Fractional CFO
Cities
- London Fractional CFO
- Dublin Fractional CFO
- Paris Fractional CFO
- Berlin Fractional CFO
- Madrid Fractional CFO
- Lisbon Fractional CFO
- Milan Fractional CFO
- Amsterdam Fractional CFO
- Brussels Fractional CFO
- Zurich Fractional CFO
- Vienna Fractional CFO
- Copenhagen Fractional CFO
- Stockholm Fractional CFO
- Oslo Fractional CFO
- Helsinki Fractional CFO
- Warsaw Fractional CFO
- Tallinn Fractional CFO
- New York Fractional CFO
- Toronto Fractional CFO
- Mexico City Fractional CFO
- São Paulo Fractional CFO
- Dubai Fractional CFO
- Sydney Fractional CFO