Virtual care as software delivery network
Brendan Keeler, Senior PM at Zus Health, on building infrastructure for digital health
The big shift was that investors stopped treating virtual care like a low margin services business and started treating it like a new kind of care delivery network built on software. Once telehealth usage stayed far above pre pandemic levels, companies like Teladoc and Omada looked less like staffing heavy clinics and more like repeatable systems that use clinicians, care teams, and software together to serve patients across employers, payers, and direct channels.
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Five years earlier, most digital health startups sold software into hospitals. That meant long security reviews, slow integrations, and doctors who could not directly buy tools. Virtual first providers changed the buyer and the workflow by hiring clinicians themselves and delivering care inside their own product.
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The reason this became financeable is that virtual care proved it could persist beyond the COVID spike. Telehealth stabilized at 14% to 17% of visits versus about 1% before the pandemic, which made digital delivery look like a durable care channel rather than a temporary workaround.
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Omada shows what investors liked in the new model. It combined coaches, licensed specialists, and software, then sold multi condition programs through employers, health plans, and PBMs. By March 31, 2025 it had more than 2,000 customers and over 679,000 enrolled members. Teladoc showed the same logic at larger scale by mixing access fees, visit fees, and chronic care revenue.
Going forward, the winners are likely to look less like single point apps and more like specialized digital provider groups with strong distribution and tightly integrated care workflows. The market is moving toward broader virtual clinics that can add conditions, plug into insurance networks, and use infrastructure software to coordinate care without inheriting the full weight of a hospital stack.