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The unquestioned leader in a virtual care sector that has surged in the Covid-19 era, Teladoc has a relationship with more than one-fifth of the U.S. population. The telemedicine provider’s planned acquisition of diabetes coaching company Livongo is poised to make it even more of a juggernaut: The two companies had a combined market capitalization of nearly $30 billion as of the end of the day on Monday.

But Teladoc’s dominance was not inevitable. In interviews with STAT, Teladoc’s founders, early employees, and industry analysts pointed to the many successful bets the company placed over the years — long before it was clear how best to build a telemedicine business, or whether one could even take off. Among them: the company’s early launch and early IPO, its decision to sell only a deluxe product at a deluxe price, and its focus on complementing — rather than replacing — the existing health care system.


These were pivotal decisions that were not at all obvious at the time, but that, in hindsight, proved to be the right ones. Taken together, those moves turned Teladoc into the first true health tech behemoth in an industry where even the most successful companies don’t usually reach valuations higher than a few billion dollars.

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