With interest rates and inflation near record lows, recession concerns subsiding, and the upcoming election providing an incentive for the Trump administration to tamp down worries over trade, it's no mystery why major market benchmarks are hitting new records. Investors looking over the growth stock landscape are seeing high valuations, but there are opportunities in stocks that are riding strong trends that promise to continue for years.
One such stock is Teladoc Health (NYSE:TDOC). The company is the largest global supplier of virtual healthcare services, linking patients with doctors and other medical experts over the internet, a low-cost and convenient method of delivering healthcare that expanding rapidly around the world. Here are seven reasons why the telehealth stock is a great pick for 2020 and beyond.
1. Leadership in an exponentially growing market
Teladoc has an attribute that's something of a holy grail for growth stock investors: a dominant position in a market with explosive growth. The global telehealth market is expected to expand at an 23% annual rate over the next few years, reaching $267 billion by 2026. That's a tremendous tailwind for the global leader in the space, driven by societal needs to lower healthcare costs and improve access in rural communities.
The company's recent results bear this out. Revenue grew 24% to $138 million in the third quarter on a 45% increase in total visits. On the conference call, CEO Jason Gorevic said he's confident of 20% to 30% top-line growth for the foreseeable future.
2. Membership growth
Fueling the company's revenue growth is expansion of the number of members using Teladoc's service. U.S. members paying regular subscription fees grew 55% to 35 million and users who access the service by paying a per-visit fee more than doubled to 19 million in the third quarter.
Teladoc grows its membership primarily by signing up clients -- employers, hospitals and health systems, and health plan providers -- who offer the services to their employees and customers. Last quarter was the largest jump in patient population in the company's history, thanks mostly to 15 million new members recently onboarded from United Healthcare. The giant health plan unit of UnitedHealth Group launched an app in October that offers Teladoc's 24/7 telemedicine services to its 27 million plan participants.
3. Expanding usage
Not only is Teladoc adding new members at a rapid rate, but its existing members are also using the services more all the time. In the first nine months of 2019, the utilization rate was 9.27%, up from 8.86% in the same period in 2018. Teladoc gets help driving usage from its employer clients, who promote the service to their employees in order to control healthcare costs, but the growing utilization rate also indicates that patients are satisfied with the approach.
Expanding utilization by a growing membership is resulting in exponential growth of visits. By the end of this year, the total number of visits since 2014 will hit about 10 million, up from 5.9 million at the end of 2018 and 3.3 million the year before that.
4. Growing momentum in mental health
Teladoc utilizes 50,000 medical experts across 450 specialties and continues to add new services, such as nutritional counseling, which was announced earlier this month. But mental health is the clinical specialty that stands out as one of the biggest drivers of visit growth.
The company expects revenue from mental health services to grow over 50% this year to about $90 million, and it thinks the demand in this area is huge. And mental health use has an outsized effect on financials because those patients are highly likely to return for multiple visits. Eighty percent of Teladoc's mental health visits are from repeat users.
5. International opportunity
Subscription fees from customers outside the U.S. account for a bit under a quarter of the total, but they're growing rapidly (up 57% year to date), and Teladoc executives are excited about the opportunities. Even in European countries that have nationalized healthcare systems, there are competing private insurers, and many of those have been quick to adopt Teladoc's full suite of services in order to differentiate themselves. The company delivers care in 30 languages to patients in 130 countries.
6. High recurring revenue
Teladoc's business has some protection from downturns, not only because healthcare tends not to be subject to economic cycles, but also because most of the company's revenue comes from subscriptions. Subscription fees in 2019 accounted for 85% of the total and have grown 36%, compared with 29% growth of visit fee revenue. Even if the economy falters in 2020, Teladoc should continue to grow.
7. Cash for acquisitions
Teladoc isn't yet profitable, but it turned operating cash flow positive last quarter and has been using its balance sheet for acquisitions, especially to boost international expansion. Last year, the company bought virtual care provider Advance Medical to boost its footprint in Europe, Asia, and Latin America. Earlier this year, it bought MedicinDirect, a telemedicine provider in France. Teladoc has $490 million in cash, so expect it to continue generating growth by making small acquisitions in 2020.
Teladoc's strengths haven't gone unnoticed by the investment community. The share price has risen 55% in 2019 and the stock sells for just over 10 times revenue. The company is still losing money as it invests in expansion, so if market sentiment turns against risk in 2020, this stock will get slammed like it did late in 2018. But patient investors can buy it now -- when it's still 11% below its all-time high -- and have some confidence that growth in the business over many years to come will eventually be rewarded.