Analyzing the language used by the largest public healthcare companies shines a light on a broader telehealth trend
Some estimates are that $250 billion of current U.S. healthcare spend could potentially be virtualized. Ro believes that telehealth will play an increasingly prominent role in the healthcare system as patients first check to see if they can receive care virtually, before navigating to in-person care if it’s most appropriate. In fact, Ro has gone so far as to predict that in 10 years more healthcare services will be provided online or at home than in all doctor’s offices, hospitals, and pharmacies.
While this belief shapes Ro’s platform and efforts to make high-quality care available where and when patients need it, what do other healthcare companies believe?
I took a look at the language used by some of the largest healthcare organizations to find out; and it seems the legacy healthcare system is finally starting to wake up to this shift.
COVID-19 catalyzed the dramatic expansion of telehealth services in the United States (Brown et. al 2020). In April of 2020, telehealth visits comprised 69% of total ambulatory visits (Epic Health Research Network). However, this figure dropped to 21% by July (Epic Health Research Network), and some argue that despite its rapid adoption during the pandemic, the future of telehealth remains uncertain (Fisk et. al, 2020).
Though industry analysts and prominent stakeholders opine that telehealth-related changes driven by the pandemic will be made permanent, corroborating research is limited. Prior to the pandemic, scholars had long sought to understand and improve upon challenges faced by the U.S. healthcare system around technology adoption and/or transformation at the industry level (Burns and Pauly, 2018, Berwick 1991). Given this historical context, questions regarding the staying power of telehealth beyond the pandemic are warranted despite the flurry of recent activity. The purpose of this analysis was to look for evidence of a systemic shift toward the adoption of telehealth within organizational artifacts of the healthcare system’s most prominent players. Transcripts of these large organizations’ public earnings calls are one example of such artifacts. The purpose of this study was to explore what might be gleaned about telehealth’s staying power by comparing pre and post pandemic call language. We posited, that if such traditionally laggard organizations demonstrated an increased focus on telehealth during their earnings calls, this could represent a shift in the broader healthcare industry.
To understand how large healthcare companies are responding to the proliferation of telehealth as a result of the pandemic, we analyzed qualitative data from the transcripts from public earnings calls for Quarter 4 (Q4) (October-December) of 2019 and 2020. Following every quarter, public companies are required to hold earnings calls where corporate leaders speak on their companies’ recent performance as well as the larger business environment. Transcripts of these calls are publicly available and were sourced from Financial Modeling Prep’s Earning Call Transcript API, a data service that provides full transcripts of company earnings calls. We scraped S&P 500 company data from Wikipedia and filtered per the Global Industry Classification Standard industry taxonomy to determine whether there was any evidence of the adoption of telehealth by specific healthcare industry subsectors. The analysis was performed in python by running a text search for mentions of select words of relevance. The analytical code is included as an appendix here. Data was available for 53 of the 63 healthcare companies in the S&P 500.
Analysis of earnings calls from the fourth quarter of 2019 and 2020 show a pronounced change in language used by these public healthcare companies. Of the 53 company transcripts analyzed, 22 mentioned “telehealth”, “telemedicine”, or other variations of the word “tele” in their Q4 2020 earnings calls, up 57% from the same period in the prior year (similar words were included in 14 Q4 2019 earnings calls) (Figure 1).
For example, UnitedHealth Group Inc., one of the largest healthcare insurance companies, did not have a single mention of telehealth in their Q4 call in 2019, yet in their 2020 call mentioned it 11 times, including in the following contexts:
“What I would say is the good news is that telehealth is a great vehicle for people to access care”
as well as:
“We work with a lot of telehealth providers on different products and capabilities, and I would say how it’s ultimately going to shake out is going to be related to who provides the best outcomes using telehealth, the lowest cost, and ultimately the best patient experience”.
The word “virtual” was also used considerably more in 2020’s Q4 earnings calls than 2019’s. The word was mentioned in just 6 companies’ calls in Q4 of 2019. This number quadrupled to 24 companies in 2020 (Figure 1). In medical technology leader Medtronic’s 2020 Q4 earnings call, “virtual” was mentioned 6 times after not being mentioned a single time in the company’s earnings call from the same period in the previous year. The chart below illustrates this trend by showing how select words spiked in frequency in 2020’s Q4 earnings calls relative to earnings calls held during the same period in 2019.
The increase in telehealth-related language appears even more dramatic when you consider the year-over-year change on a percentage basis (Figure 2).
For contrast, we analyzed usage trends for generic words. Results show that “health” and “medical”, were flat year over year from 2019 to 2020.
An industry-wide shift
Given the diversity of sectors within the healthcare industry, we grouped trends within subsectors to assess whether there was any variation in telehealth-relevant language usage across organization types.
Analysis shows that the trend is consistent no matter the subsector (Figure 3).
This study has some limitations. First, the analysis did not look into the semantics of how the select words were used in the earnings calls, rather just that they were used at all. Given this, this analysis didn’t dive into the topic of analyzing the sentiment of these earnings calls nor if these conversations represented concrete steps or investments in telehealth. Second, earnings calls are public, which might not accurately reflect internal, confidential strategic outlooks held by the organization. Small sample sizes within the subsector analysis preclude generalizability of these trends to all healthcare companies within that subsector. Finally, missing data from some S&P 500 companies in Q4 might bias results.
Limitations notwithstanding, our analysis reveals a remarkable increase in telehealth-related language and discussion in the public-facing earnings call transcripts of the healthcare companies included in the analysis. This shift is especially notable given the timing of the calls analyzed: data from Q4 indicates that the trend of increased attention towards telehealth first experienced earlier in 2020 is holding steady, even as the pandemic’s grip on society begins to wane. While we can’t be certain that these language changes reflect the cementation of telehealth into the strategic plans of these industry giants, it’s clear that they’re more focused on telehealth than they were before the pandemic. As future earnings call transcripts become available for analysis and the dust begins to settle from the pandemic, continuing to analyze the spoken word of corporate leaders, and subsequently policymakers and other industry participants, will offer visibility into how the business world is thinking about telehealth.
Dr. Lauren Broffman (Research Scientist, Ro) contributed to this article
- Brown et. al. The Impact of COVID-19 on Telemedicine Utilization Across Multiple Service Lines in the United States. Sci-hub (2020).
- Telehealth: Fad or the Future. Epic Health Research Network (2020).
- Fisk et. al. Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States. Journal of Medical Internet Research (2020)
- Burns and Pauly. Transformation of the Health Care Industry: Curb Your Enthusiasm? Sci-hub (2018)