Teladoc Health Inc (TDOC) 2019 Q2 法說會逐字稿

Welcome to Teladoc's Second Quarter 2019 Earnings Conference Call and Webcast.

歡迎來到 Teladoc 2019 年第二季度收益電話會議和網絡直播。

(Operator Instructions) It is now my pleasure to turn the floor over to Adam Vandervoort, Chief Legal Officer.

（操作員說明）現在我很高興將發言權交給首席法務官 Adam Vandervoort。

You may begin.

你可以開始了。

Thank you, and good afternoon.

謝謝，下午好。

Today, after the market closed, we issued a press release announcing our second quarter 2019 financial results.

今天，在市場收盤後，我們發布了一份新聞稿，宣布了我們 2019 年第二季度的財務業績。

This press release is available in the Investor Relations section of the teladochealth.com website.

本新聞稿可在 teladochealth.com 網站的投資者關係部分獲取。

On this call to discuss the results are Jason Gorevic, our Chief Executive Officer; and Mala Murthy, our Chief Financial Officer.

我們的首席執行官 Jason Gorevic 參加了這次討論結果的電話會議；和我們的首席財務官 Mala Murthy。

During this call, we will provide our third quarter and full year outlook, and our prepared remarks will be followed by a question-and-answer session.

在這次電話會議中，我們將提供第三季度和全年展望，我們準備好的講話之後將進行問答環節。

Please note that we will be discussing certain non-GAAP financial measures that we believe are important in evaluating Teladoc Health's performance.

請注意，我們將討論我們認為對評估 Teladoc Health 的業績很重要的某些非公認會計準則財務指標。

Details on the relationship between these non-GAAP measures to the most comparable GAAP measures and reconciliations thereof can be found in the press release that is posted on our website.

有關這些非公認會計原則措施與最具可比性的公認會計原則措施之間的關係及其對賬的詳細信息，請參閱我們網站上發布的新聞稿。

Also please note that certain statements made during this call will be forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995.

另請注意，本次電話會議中的某些陳述將是 1995 年《私人證券訴訟改革法案》所定義的前瞻性陳述。

Such forward-looking statements are subject to risks, uncertainties and other factors that could cause the actual results for Teladoc Health to differ materially from those expressed or implied on this call.

此類前瞻性陳述受風險、不確定性和其他因素的影響，可能導致 Teladoc Health 的實際結果與本次電話會議中明示或暗示的結果存在重大差異。

For additional information, please refer to our cautionary statement in our press release and our filings with the SEC, all of which are available on our website.

有關更多信息，請參閱我們在新聞稿中的警告聲明以及我們向 SEC 提交的文件，所有這些都可以在我們的網站上找到。

I now turn the call over to Jason.

我現在把電話轉給傑森。

Thanks, Adam, and thank you, everyone, for joining us this afternoon.

謝謝亞當，謝謝大家今天下午加入我們。

I'm incredibly excited to start off the call today by making 2 highly anticipated introductions.

我非常高興能通過 2 次備受期待的介紹來開始今天的電話會議。

The first is to Mala Murthy, who joined us at the end of June as our Chief Financial Officer.

首先是 Mala Murthy，她於 6 月底加入我們，擔任首席財務官。

Many of you have had a chance to speak with Mala since she came on board.

自從 Mala 加入以來，你們中的許多人都有機會與她交談。

But as a refresher, Mala joined us most recently from American Express and brings with her an accomplished track record of success across a diverse set of leading public companies and industries.

但作為複習者，Mala 最近從美國運通加入我們，並帶來了她在各種領先的上市公司和行業中取得的成功記錄。

I'm pleased to say that she has hit the ground running and is already having an impact with the team.

我很高興地說，她已經開始起步並且已經對團隊產生了影響。

The second introduction is to our new Chief Operating Officer, David Sides.

第二個介紹是我們的新首席運營官 David Sides。

We're very excited to have David come on board as he brings a unique combination of strong technical, commercial and strategic skills that are perfectly suited to our profitable growth trajectory.

我們很高興大衛能夠加入，因為他帶來了強大的技術、商業和戰略技能的獨特組合，非常適合我們的盈利增長軌跡。

As a former CEO with deep health care tech and public company experience, David understands well the broader strategic health care landscape and comes in with a clear view of the exciting opportunities ahead of Teladoc Health.

作為擁有深厚醫療保健技術和上市公司經驗的前任首席執行官，David 非常了解更廣泛的戰略醫療保健前景，並對 Teladoc Health 面臨的令人興奮的機遇有著清晰的認識。

David and his family will be relocating to the New York area later this summer.

大衛和他的家人將在今年夏天晚些時候搬到紐約地區。

Our search process to fill both of these roles was a thorough one, as we held our standards high for both the right functional capabilities, as well as the appropriate mission-oriented cultural fit.

我們尋找這兩個角色的過程是一個徹底的過程，因為我們對正確的功能能力以及適當的以任務為導向的文化契合度都保持了很高的標準。

I know I speak for the entire Teladoc Health team when I say we're very pleased to have both Mala and David join the company, and I look forward to introducing many of you to them in person in the coming months.

當我說我們很高興 Mala 和 David 都加入公司時，我知道我代表整個 Teladoc Health 團隊發言，我期待在未來幾個月內親自向他們介紹你們中的許多人。

Before we dig into the second quarter, I'd be remiss if I didn't take this opportunity to thank Peter McClennen and Gabe Cappucci for their leadership during this transition period.

在我們深入研究第二季度之前，如果我不藉此機會感謝 Peter McClennen 和 Gabe Cappucci 在這個過渡時期的領導，那我就失職了。

Under their stewardship, we operated seamlessly, continuing to deliver for our members, clients and shareholders.

在他們的管理下，我們無縫運作，繼續為我們的會員、客戶和股東提供服務。

Lastly, I'd like to thank Valerie Haertel for her oversight of Investor Relations during this transitional period and wish her well in her future endeavors.

最後，我要感謝 Valerie Haertel 在此過渡期間對投資者關係的監督，並祝愿她在未來的工作中一切順利。

Turning to our results for the second quarter.

轉向我們第二季度的業績。

We saw the momentum from the first quarter continue, with particular strength in revenue and visit volumes, both coming in at the high end of our expectations.

我們看到第一季度的勢頭仍在繼續，收入和訪問量特別強勁，均處於我們預期的高端。

In comparison to Q2 2018, total revenue grew 38% to $130.3 million, including 24% organic growth when you exclude Advance Medical.

與 2018 年第二季度相比，總收入增長 38% 至 1.303 億美元，其中包括 24% 的有機增長（如果不包括 Advance Medical）。

Visit volume of 908,000 visits increased 70% or 46%, excluding Advance Medical.

不包括 Advance Medical 的訪問量為 908,000 次，增長了 70% 或 46%。

U.S. paid membership grew to 26.8 million members, adding 100,000 new members in the quarter and 4.3 million new members when compared to the 22.5 million members in the second quarter of 2018.

美國付費會員增長至 2680 萬，與 2018 年第二季度的 2250 萬會員相比，本季度增加了 10 萬新會員和 430 萬新會員。

This maintains our consistent track record of growing membership 7 of the last 8 quarters.

這保持了我們在過去 8 個季度中有 7 個會員不斷增長的一貫記錄。

And adjusted EBITDA came in within our expected range at $6.3 million.

調整後的 EBITDA 在我們的預期範圍內，為 630 萬美元。

Drilling down a bit deeper into visits, I'm particularly pleased to see utilization increase more than 100 basis points as we continue to realize the benefits of our diversification strategy.

深入研究訪問，我特別高興地看到利用率增加了 100 多個基點，因為我們繼續實現多元化戰略的好處。

We are uniquely able to capitalize on the growing macro consumer adoption tailwinds, both domestically and abroad, with our international populations and associated visits included seeing some of the fastest rates of growth across our total book of business.

我們能夠獨特地利用國內和國外不斷增長的宏觀消費者採用順風，我們的國際人口和相關訪問包括在我們的總業務書中看到一些最快的增長率。

Domestically, I'm pleased to see strong utilization in our pay-for-performance deals and robust growth across all our clinical specialties persisting in Q2.

在國內，我很高興看到我們的按績效付費交易的強勁使用以及我們所有臨床專業的強勁增長在第二季度持續存在。

As an example, behavioral health stands out as one of the strongest drivers of visit growth.

例如，行為健康是訪問增長的最強勁驅動力之一。

During the quarter, we set several single-day high watermarks for our B2B service in terms of number of visits, with members coming to us for an increasing number of conditions.

在本季度，我們的 B2B 服務在訪問次數方面設置了幾個單日高水位線，越來越多的會員來我們這裡尋求條件。

On BetterHelp, in the second quarter, the team continued to improve member retention metrics through the launch of member experience enhancements, which we expect to be sustainable over time.

在 BetterHelp 上，第二季度，該團隊通過推出會員體驗增強功能繼續改善會員保留指標，我們預計隨著時間的推移，這種增強是可持續的。

These outstanding results provide proof that our portfolio of solutions is extremely well positioned to address the massive unmet global need in the mental health arena.

這些出色的結果證明我們的解決方案組合非常適合解決心理健康領域巨大的未滿足的全球需求。

In terms of our selling season, the excellent momentum we continue to see across all dimensions speaks to the long-term benefits of our diversified growth strategy.

就我們的銷售季節而言，我們繼續在各個方面看到的良好勢頭說明了我們多元化增長戰略的長期利益。

Overall, RFP volume continued to accelerate this quarter, remaining well above second quarter of 2018.

總體而言，本季度 RFP 數量繼續加速增長，遠高於 2018 年第二季度。

The team is seeing wins across all our channels and products.

該團隊在我們所有的渠道和產品中都看到了勝利。

We are seeing increasing success in selling multiple products to our clients, and our bookings year-to-date for deals with multiple products continues to accelerate.

我們在向客戶銷售多種產品方面取得了越來越大的成功，今年迄今為止，我們對多種產品交易的預訂繼續加速。

In our employer business, we are seeing robust activity, both with new and existing clients.

在我們的雇主業務中，我們看到新客戶和現有客戶的活動都很活躍。

We have several new Fortune 500 logos in late-stage contracting, many of which are for multiple products.

我們有幾個新的財富 500 強標誌處於後期承包階段，其中許多是針對多種產品的。

This also extends to our existing client base, reflecting a healthy appetite to add a combination of additional products and populations.

這也延伸到我們現有的客戶群，反映了增加額外產品和人口組合的健康意願。

In our health plan business, we are also seeing very strong growth, both in terms of new distribution as well as penetration of existing relationships.

在我們的健康計劃業務中，我們也看到了非常強勁的增長，無論是在新的分銷方面，還是在現有關係的滲透方面。

This area continues to diversify, with wins in new lines of business, populations and geographies, both commercial and government programs.

這一領域繼續多樣化，在新的業務領域、人口和地理區域、商業和政府項目中取得成功。

In this strategic growth channel, we recently expanded our relationship with a major Blues plan and continued to increase penetration into our largest clients' books of business, where our sales velocity is healthy and on track with expectations.

在這一戰略增長渠道中，我們最近擴大了與 Blues 一項重大計劃的關係，並繼續增加對我們最大客戶的業務賬簿的滲透，我們的銷售速度健康且符合預期。

Another exciting development from the second quarter was our announcement in June of our strategic partnership with Vida Health, an early-stage company that provides virtual chronic disease management programs to members of large payer and employer group populations across the U.S. This minority investment is a great example of our stated build, buy or partner strategy, accelerating our path to market with new products through selective deployment of capital.

第二季度的另一個令人興奮的發展是我們在 6 月宣布與 Vida Health 建立戰略合作夥伴關係，Vida Health 是一家為美國大型支付者和雇主群體成員提供虛擬慢性病管理計劃的早期公司。這項少數投資是一項巨大的投資我們既定的構建、購買或合作戰略的示例，通過選擇性部署資本加速我們的新產品上市之路。

As we identified Vida as a potential partner and got to know them through this process, it became clear that their multi-condition, coach-led model and overlapping key client base made them the right partner to enable us to deliver on our long-term strategic plan to offer chronic care solutions to our members.

當我們將 Vida 確定為潛在合作夥伴並通過此過程了解他們時，很明顯，他們的多條件、教練主導的模式和重疊的主要客戶群使他們成為合適的合作夥伴，使我們能夠實現我們的長期目標。為我們的會員提供慢性護理解決方案的戰略計劃。

In 2020, we will deliver an integrated virtual care experience across platforms, supporting acute, complex and chronic care needs and addressing the mental health and physical health challenges that often go hand in hand.

2020 年，我們將提供跨平台的集成虛擬護理體驗，支持急性、複雜和慢性護理需求，並解決經常齊頭並進的心理健康和身體健康挑戰。

Before I turn the call over to Mala for a more detailed review of our second quarter financial results, I want to provide an update on some of our strategic investments.

在我將電話轉給 Mala 以更詳細地審查我們第二季度的財務業績之前，我想提供有關我們一些戰略投資的最新信息。

Our expansion into Canada is progressing on schedule, with the product launch in the second quarter and the signing of our first client, a TPA channel partner, that will afford us significant access to the Canadian market.

我們在加拿大的擴張正在按計劃進行，第二季度的產品發布以及我們第一個客戶（TPA 渠道合作夥伴）的簽約，這將使我們能夠進入加拿大市場。

Here in the U.S., our integration work with United and the development of Medicare capabilities are both also progressing on schedule, and I'm optimistic about the revenue impact these initiatives will have in 2020 and beyond.

在美國，我們與美聯航的整合工作以及醫療保險能力的發展也在按計劃進行，我對這些舉措將在 2020 年及以後產生的收入影響持樂觀態度。

Finally, we're encouraged by the recent CVS announcement regarding MinuteClinic virtual visits expansion to 8 additional states as well as the broader HealthHUB expansion.

最後，我們對最近 CVS 關於 MinuteClinic 虛擬訪問擴展到 8 個其他州以及更廣泛的 HealthHUB 擴展的公告感到鼓舞。

We're actively engaging with CVS Health leadership on their enterprise virtual care strategy, including potential applications of our wide range of services, as well as joint development areas in connection with their HealthHUB strategy.

我們正在積極與 CVS Health 領導層就他們的企業虛擬護理戰略進行合作，包括我們廣泛服務的潛在應用，以及與其 HealthHUB 戰略相關的聯合開發領域。

With that, I'll turn the call over to Mala.

有了這個，我會把電話轉給馬拉。

Thank you, Jason, and good afternoon, everyone.

謝謝你，傑森，大家下午好。

I'm thrilled to have joined the Teladoc team and have been impressed with the energy and commitment of the leadership team, as well as the broader Teladoc community.

我很高興加入 Teladoc 團隊，領導團隊以及更廣泛的 Teladoc 社區的精力和承諾給我留下了深刻的印象。

I'm inspired by our mission to transform the way people access and experience health care and our prospects for growth.

我們的使命是改變人們獲得和體驗醫療保健的方式以及我們的增長前景，這讓我深受鼓舞。

I hope that my extensive experience in global financial leadership will add value to Teladoc.

我希望我在全球金融領導方面的豐富經驗能為 Teladoc 增加價值。

I'd like to echo Jason's comments regarding our continued strong execution of our 2019 objective, and I will now review Teladoc Health's second quarter financial performance in more detail.

我想回應 Jason 關於我們繼續強勁執行 2019 年目標的評論，我現在將更詳細地回顧 Teladoc Health 第二季度的財務業績。

Let me start our discussion with revenue.

讓我從收入開始討論。

Total revenue increased 38% to $130.3 million for the second quarter, as compared to a year ago.

與一年前相比，第二季度的總收入增長了 38% 至 1.303 億美元。

On an organic basis, revenue increased by 24% for the second quarter of 2019, consistent with our expectations.

在有機基礎上，2019 年第二季度的收入增長了 24%，符合我們的預期。

Revenue from global subscription access fees of $111.3 million increased 39% compared to a year ago and accounted for 85% of our total revenue in the quarter.

全球訂閱訪問費收入為 1.113 億美元，同比增長 39%，占我們本季度總收入的 85%。

Additionally, U.S. subscription access fee revenue of $85.6 million continues to represent about 3 quarters of global subscription revenue, while international subscription revenue of $25.7 million account for the balance.

此外，8560 萬美元的美國訂閱訪問費收入繼續佔全球訂閱收入的約 3 個季度，而 2570 萬美元的國際訂閱收入佔其餘部分。

Looking at the drivers of subscription access fees, we ended the quarter with 26.8 million U.S. paid members, up 19% compared to a year ago.

從訂閱訪問費的驅動因素來看，我們在本季度末擁有 2680 萬美國付費會員，比一年前增長 19%。

As Jason said in his remarks, this reflects expansion in membership in 7 out of the last 8 quarters.

正如傑森在講話中所說，這反映了過去 8 個季度中有 7 個季度的成員數量增加。

Membership growth in the quarter was lower than expected, as a result of a large expansion population from an existing health plan client that shifted its rollout from the second to the third quarter of 2019.

本季度的會員增長低於預期，原因是現有健康計劃客戶的大量擴張人口將其推出從 2019 年第二季度轉移到了第三季度。

As a reminder, our definition of members includes just U.S. paid members that are associated with a PMPM or paid U.S. membership and does not include visit-fee-only access.

提醒一下，我們對會員的定義僅包括與 PMPM 或付費美國會員相關的美國付費會員，不包括僅訪問費的訪問權限。

We saw the second quarter 2019 PMPM increase to $1.06 from $1 a year ago or $1.05 on a pro forma basis when adjusting for the impact from Advance Medical.

我們看到 2019 年第二季度 PMPM 從一年前的 1 美元增加到 1.06 美元，或者在調整 Advance Medical 的影響後，在備考基礎上增加到 1.05 美元。

On a sequential quarterly basis, the PMPM increased from $1.03.

按季度計算，PMPM 從 1.03 美元上漲。

As we have previously indicated, we typically experience a dampening effect on PMPM when we onboard a large number of new health plan members, as was reflected in our sequential quarterly trending in the first quarter of 2019.

正如我們之前所指出的，當我們加入大量新的健康計劃成員時，我們通常會對 PMPM 產生抑製作用，這反映在我們 2019 年第一季度的連續季度趨勢中。

Visit fee revenue for the quarter increased to $19 million, representing growth of 29% compared to the prior year and constituted the remaining 15% of global revenue.

本季度參觀費收入增至 1900 萬美元，同比增長 29%，佔全球收入的 15%。

As a reminder, our visit fee revenue is driven by our U.S. paid membership visits as well as individuals with visit fee only access.

提醒一下，我們的訪問費收入是由我們的美國付費會員訪問以及僅訪問費訪問的個人驅動的。

U.S. paid membership visits generated $15.1 million in the quarter, a 28% increase over the second quarter of 2018.

本季度美國付費會員訪問產生了 1510 萬美元，比 2018 年第二季度增長 28%。

This line includes revenue from general medical visits as well as other specialty visits primarily comprised of expert medical and commercial behavioral health services.

這條線包括來自一般醫療訪問以及主要由專家醫療和商業行為健康服務組成的其他專業訪問的收入。

The balance of visit fee revenue is primarily comprised of our visit fee only access.

訪問費收入的餘額主要包括我們僅訪問費的訪問。

Looking at the drivers of visit fee revenue, as Jason mentioned, we had an excellent quarter with respect to visit volume with 908,000 visits, an increase of 70% compared to a year ago.

正如 Jason 所說，從訪問費收入的驅動因素來看，我們在訪問量方面表現出色，訪問量達到 908,000 次，與一年前相比增長了 70%。

When adjusting for the impact of Advance Medical, visit volume for the quarter increased by 46% as compared to the prior year.

在調整 Advance Medical 的影響後，本季度的訪問量比去年同期增長了 46%。

Visits from our U.S. paid membership grew 40% to 610,000, which represents an annualized utilization rate of 9.1%, a 105 basis point increase over last year's second quarter.

美國付費會員訪問量增長 40% 至 610,000 人次，年化利用率為 9.1%，比去年第二季度增加 105 個基點。

Approximately 48% of our U.S. paid membership visits, or 291,000, were paid visits, and the other 319,000 were from our visits included members.

在我們的美國付費會員訪問中，大約 48% 或 291,000 次是付費訪問，另外 319,000 次來自我們的訪問，其中包括會員。

International visits totaled 244,000 in the quarter.

本季度國際訪問量總計 244,000 人次。

To round out my discussion of visits, we completed 54,000 visits for individuals with visit fee only access, a growth of 47% over last year's second quarter.

為了完善我對訪問的討論，我們完成了 54,000 次僅訪問費訪問的個人訪問，比去年第二季度增長了 47%。

We had 9.7 million individuals with visit fee only access at the end of the quarter, down slightly from the previous quarter within our existing client base.

在本季度末，我們有 970 萬人只收取訪問費，在我們現有的客戶群中比上一季度略有下降。

Gross margins for the quarter were in line with our expectations at 68% compared to the 70.7% in the second quarter of last year.

本季度的毛利率與我們的預期一致，為 68%，而去年第二季度為 70.7%。

The year-over-year net decline in gross margin percentage primarily reflects product mix shift, including the impact of the May 2018 acquisition of Advance Medical.

毛利率百分比的同比淨下降主要反映了產品組合的轉變，包括 2018 年 5 月收購 Advance Medical 的影響。

As a reminder, our gross margins typically experience a sequential increase in Q2 as a result of seasonality.

提醒一下，由於季節性因素，我們的毛利率通常會在第二季度連續增長。

In terms of gross margin dollars, we generated $88.6 million in the second quarter compared to $66.9 million a year ago, representing a 33% increase.

就毛利率而言，我們在第二季度創造了 8860 萬美元，而去年同期為 6690 萬美元，增長了 33%。

Operating expense in the quarter totaled $110.7 million, an increase of 30% from the $85 million in the second quarter of last year.

本季度運營費用總計 1.107 億美元，比去年第二季度的 8500 萬美元增長 30%。

When noncash charges, such as depreciation and amortization, stock compensation, as well as one-time acquisition-related costs are eliminated, adjusted operating expenses are $82.3 million or 63% of total revenue compared to $64.2 million or 68% of second quarter 2018 revenue.

扣除折舊和攤銷、股票補償以及一次性收購相關成本等非現金費用後，調整後的運營費用為 8230 萬美元，佔總收入的 63%，而 2018 年第二季度收入為 6420 萬美元，佔總收入的 68% .

This 500 basis point improvement in the quarter relative to the prior year reflects our improved operating leverage, including synergies, while maintaining our marketing spend.

本季度與上一年相比提高了 500 個基點，這反映了我們在維持營銷支出的同時提高了運營槓桿率，包括協同效應。

EBITDA was a loss of $12.2 million for the second quarter of 2019, as compared to a loss of $10.1 million for the same period last year.

2019 年第二季度 EBITDA 虧損 1220 萬美元，而去年同期虧損 1010 萬美元。

Adjusted EBITDA increased to a positive $6.3 million for the quarter, which compares favorably to the adjusted EBITDA of $2.7 million from last year's second quarter, reflecting our aforementioned ability to generate improved operating leverage.

本季度調整後 EBITDA 增至正 630 萬美元，與去年第二季度的 270 萬美元調整後 EBITDA 相比是有利的，這反映了我們上述提高運營槓桿的能力。

Concluding my commentary of the income statement.

結束我對損益表的評論。

Our net loss in the quarter was $29.3 million compared to a loss of $25.1 million last year.

我們本季度的淨虧損為 2930 萬美元，而去年的虧損為 2510 萬美元。

On a per-share basis, our net loss was $0.41 for the second quarter of 2019 compared to $0.40 in the prior year.

按每股計算，我們 2019 年第二季度的淨虧損為 0.41 美元，而去年同期為 0.40 美元。

Turning to the balance sheet.

轉向資產負債表。

We ended the quarter with $472.6 million in cash, cash equivalents and short-term investments, as we have maintained our strong liquidity position while continuing to invest strategically in the business during the quarter.

我們以 4.726 億美元的現金、現金等價物和短期投資結束本季度，因為我們在本季度繼續對業務進行戰略性投資的同時保持了強勁的流動性狀況。

Our total debt as of June 30, 2019, was $562.5 million, which consists of our 2 convertible note issuances: the $275 million 3% convertible notes that mature at the end of 2022 and the $287.5 million 1 3/8 percentage notes that mature during 2025.

截至 2019 年 6 月 30 日，我們的總債務為 5.625 億美元，其中包括我們發行的 2 次可轉換票據：在 2022 年底到期的 2.75 億美元 3% 可轉換票據和 2.875 億美元在2025 年。

I'll conclude my commentary with our expectations for the third quarter and the full year.

我將以我們對第三季度和全年的預期來結束我的評論。

For the third quarter of 2019, we expect total revenue to be between $135 million to $138 million, an EBITDA loss to be between $10.5 million to a loss of $12.5 million, adjusted EBITDA to be between positive $7 million to $9 million, total U.S. paid membership to be approximately 28.5 million to 29.5 million and visit fee only access to be available to approximately 10 million individuals.

對於 2019 年第三季度，我們預計總收入將在 1.35 億美元至 1.38 億美元之間，EBITDA 虧損將在 1050 萬美元至 1250 萬美元之間，調整後 EBITDA 將在 700 萬美元至 900 萬美元之間，美國支付總額會員人數約為 2850 萬至 2950 萬，訪問費僅對約 1000 萬人開放。

We expect total visits to be between 800,000 and 900,000 in the quarter and net loss per share to be between a loss of $0.40 and $0.42 per share based on 72.3 million weighted average shares outstanding.

我們預計本季度總訪問量將在 800,000 至 900,000 之間，每股淨虧損將在 7230 萬股加權平均流通股的基礎上每股虧損 0.40 美元至 0.42 美元之間。

For the full year 2019, our updated expectations are as follows: total revenue for the year between $538 million and $545 million, an EBITDA loss between $39 million and $45 million, adjusted EBITDA between positive $27 million and $33 million, total U.S. paid membership of approximately 29 million to 30 million members and visit fee only access to be available to approximately 10 million individuals.

對於 2019 年全年，我們更新後的預期如下：全年總收入在 5.38 億美元至 5.45 億美元之間，EBITDA 虧損在 3900 萬美元至 4500 萬美元之間，調整後 EBITDA 在 2700 萬美元至 3300 萬美元之間，美國付費會員總數大約 2900 萬至 3000 萬會員，並且訪問費僅對大約 1000 萬人開放。

We expect total visits between 3.7 million and 4 million, net loss per share to be between a loss of $1.52 to $1.60 per share, based on 72 million weighted average shares outstanding.

我們預計總訪問量在 370 萬至 400 萬之間，每股淨虧損將在每股虧損 1.52 美元至 1.60 美元之間，基於 7200 萬股加權平均流通股。

And as we have said before, we expect to be operating cash flow positive for the first time in 2019.

正如我們之前所說，我們預計 2019 年的經營現金流將首次為正。

I look forward to getting to know you all over the course of the coming weeks and months.

我期待在接下來的幾周和幾個月內與您結識。

Let me now turn the call back to Jason for his closing remarks.

現在讓我把電話轉回傑森的閉幕詞。

Thank you, Mala.

謝謝你，馬拉。

As we conclude the call, I couldn't be more pleased about our momentum across the full breadth of our business.

當我們結束電話會議時，我對我們在整個業務範圍內的發展勢頭感到非常高興。

Clients globally see increasing value as utilization continues to grow across channels and populations and increasingly embrace the strategic value Teladoc Health's unique offering can provide.

隨著跨渠道和人口的利用率持續增長，全球客戶看到了越來越大的價值，並越來越多地接受 Teladoc Health 獨特產品可以提供的戰略價值。

Looking to the back half of the year, we remain confident in our ability to deliver within our range with this broad-based strength serving to buffer any new learnings as we implement large complex health plan business.

展望下半年，我們仍然相信我們有能力在我們的範圍內提供這種廣泛的優勢，在我們實施大型複雜的健康計劃業務時緩衝任何新的學習。

Earlier this month, we gathered for our annual leadership meeting, and I was struck by the energy and passion amongst our global leadership team.

本月早些時候，我們齊聚一堂參加年度領導會議，我被我們全球領導團隊的活力和熱情所震撼。

Driven by both external macro adoption forces, as well as the increasing strategic nature of their conversations with clients, the feedback from the team was resoundingly reaffirming of our global growth strategies and the quality of our operational execution.

在外部宏觀採用力量的推動下，以及他們與客戶對話的戰略性質日益增強，團隊的反饋有力地重申了我們的全球增長戰略和我們的運營執行質量。

Their hard work and commitment are instrumental in our success and ensuring that we keep our promises.

他們的辛勤工作和承諾有助於我們取得成功並確保我們信守承諾。

As always, thank you for your continued interest in Teladoc Health and our story.

一如既往，感謝您對 Teladoc Health 和我們的故事的持續關注。

And with that, we'll open the call for questions.

有了這個，我們將打開問題的電話。

Operator?

操作員？

(Operator Instructions) Our first question comes from the line of Lisa Gill from JP Morgan.

（操作員說明）我們的第一個問題來自摩根大通的 Lisa Gill。

Jason, it's that time of the year you talk about the selling season.

傑森，這是你談論銷售旺季的一年中的那個時候。

I appreciated the comments you gave on the call, but I'm just wondering if you can put some things into context.

我感謝您在電話會議上發表的評論，但我只是想知道您是否可以將一些事情放在上下文中。

So talking about RFPs being up versus last year, a way to maybe quantify that.

因此，談論 RFP 與去年相比有所上升，這是一種量化的方式。

I know you talked about winning on multiple products and seeing a lot of engagement with existing clients.

我知道您談到了在多種產品上獲勝並看到與現有客戶的大量互動。

Anything else that you can just maybe give us?

您還有什麼可以給我們的嗎？

I know that you don't always like to give us a ton of color around the selling season.

我知道你並不總是喜歡在銷售季節給我們大量的顏色。

But as we think about this going into 2020, if you could just help to maybe frame some of this would be really helpful.

但是當我們考慮到 2020 年的情況時，如果你能幫助構建其中的一些框架，那將非常有幫助。

Sure, Lisa, I'm happy to give a little bit more color.

當然，麗莎，我很高興能給你更多的色彩。

I won't break with tradition, but I'll give you a little bit more.

我不會打破傳統，但我會給你更多一點。

I talked about multiproduct sales and integrated offerings.

我談到了多產品銷售和集成產品。

At this point this year, we're at about 4x the number of multiproduct or the volume of multiproduct bookings that we had last year at this time.

今年這個時候，我們的多產品數量或多產品預訂量大約是去年這個時候的 4 倍。

So I think that really speaks to the attraction of the full scope of our offering.

所以我認為這確實說明了我們產品的全部範圍的吸引力。

Similarly, with respect to RFPs, RFP requests for the full integrated offering of our solutions are up about 75% relative to last year.

同樣，在 RFP 方面，我們解決方案的完整集成產品的 RFP 請求比去年增加了約 75%。

So I think that both of those reinforce the strategy that we've laid out about a comprehensive offering and the commentary we've given over the last few quarters about the market moving in that direction.

因此，我認為這兩者都強化了我們制定的關於全面產品的戰略以及我們在過去幾個季度中就市場朝著這個方向發展的評論。

So hopefully, that gives you a little bit more color on the selling season.

所以希望這能讓你在銷售季節多一點色彩。

I guess the last thing I would say is we're seeing strength across all of our channels, among all of our customers.

我想我要說的最後一件事是，我們在所有渠道、所有客戶中都看到了實力。

So it is true among both large employers and the smaller employer and broker community.

因此，在大型雇主和較小的雇主和經紀人社區中都是如此。

It's also true among health plans.

在健康計劃中也是如此。

It's true among hospitals and health systems, and we're seeing it both domestically and internationally.

在醫院和衛生系統中確實如此，我們在國內和國際上都看到了這一點。

That's helpful.

這很有幫助。

You know I always want more.

你知道我總是想要更多。

And my follow-up would just be around United.

我的後續行動將圍繞曼聯進行。

You talked about it being on schedule.

你談到它正在按計劃進行。

Can you just remind us what you anticipate for 2019?

您能否提醒我們您對 2019 年的預期？

And you said it will also go into 2020.

你說它也將進入 2020 年。

Just want to understand what we're going to see come online in the back half of 2019.

只是想了解我們將在 2019 年下半年看到什麼上線。

Yes.

是的。

So we are deep in implementation and launch planning.

因此，我們正在深入實施和啟動計劃。

The teams are working actively together, both technically, operationally and in terms of marketing and communication.

這些團隊在技術、運營以及營銷和溝通方面都積極合作。

We are -- we will have some impact that we expect in '19.

我們是——我們將在 19 年產生一些我們預期的影響。

The majority of the impact, of course, given the fact that it will launch in the back half of the year will be in 2020.

當然，考慮到它將在今年下半年推出，大部分影響將在 2020 年推出。

But right now, we're all systems go, although we're still not able to sort of size the opportunity for you.

但是現在，我們都是系統，儘管我們仍然無法為您確定機會的大小。

Our next question comes from the line of Jamie Stockton from Wells Fargo.

我們的下一個問題來自富國銀行的 Jamie Stockton。

I guess maybe the first one just to follow up on your comments about the multiple products and the strength there.

我想也許是第一個跟進您對多種產品及其實力的評論的人。

Can you give us some sense of the order?

你能給我們一些秩序感嗎？

Is that second most common thing that people are attaching behavioral?

這是人們重視行為的第二常見的事情嗎？

Is it second opinion?

是第二意見嗎？

If you could give us some color there, that would be great.

如果你能給我們一些顏色，那就太好了。

Yes.

是的。

It's -- right now, we're seeing expert second opinion or expert medical opinion as sort of the #2.

這是 - 現在，我們將專家的第二意見或專家的醫學意見視為#2。

But we're seeing the combined offering of general medical with behavioral health or general medical with behavioral health and expert services as the most rapidly growing set of combinations, so a full integrated offering, so to speak.

但是，我們看到將普通醫療與行為健康或普通醫療與行為健康和專家服務相結合的組合是增長最快的組合，因此可以說是完全集成的產品。

Behavioral health RFPs are up significantly.

行為健康 RFP 顯著上升。

In fact, we've seen a 200% year-over-year increase in behavioral health RFPs through the first half of the year.

事實上，我們已經看到今年上半年的行為健康 RFP 同比增長了 200%。

So I think the commentary in my prepared remarks about the growth in the adoption of behavioral health is not only about our growth in visit volume, but it's also about the tenor of the market.

因此，我認為我準備好的評論中關於行為健康采用率增長的評論不僅與我們訪問量的增長有關，而且還與市場的基調有關。

We were just at the AHIP Institute, and behavioral health is one of the biggest topics of conversation and areas of focus for the health plans.

我們剛剛在 AHIP 研究所，行為健康是最大的話題之一，也是健康計劃的重點領域。

We're also hearing the same thing from the employers.

我們也從雇主那裡聽到同樣的話。

Okay.

好的。

That's great.

那太棒了。

And then maybe with David coming on board, he's obviously got somewhat of an international background.

然後也許隨著大衛的加入，他顯然有一些國際背景。

You've dropped global multiple times in your commentary.

您在評論中多次刪除 global。

Can you talk about will his focus be disproportionately international?

你能談談他的關注點會不成比例地國際化嗎？

Just any color there would be great.

只要有任何顏色都會很棒。

Yes.

是的。

I wouldn't say disproportionately international.

我不會說不成比例的國際化。

I would say appropriately proportionally international.

我會說適當地按比例國際化。

So certainly, as we were going through the search, it was a significant plus to find someone who had international experience.

因此，當然，當我們進行搜索時，找到具有國際經驗的人是一個重要的優勢。

As you know, Jamie, it's rare to find someone in the U.S. in the health care arena who has global experience.

如您所知，傑米，在美國的醫療保健領域很難找到具有全球經驗的人。

And so David's experience, both domestically and internationally, both technically, operationally and commercially made him a great candidate.

所以大衛在國內和國際上的經驗，無論是技術上、運營上還是商業上，都使他成為了一個很好的候選人。

And we think he'll have an impact, both here in the U.S. and abroad.

我們認為他會在美國和國外產生影響。

Our next question comes from the line of Stephanie Demko from Citi.

我們的下一個問題來自花旗的 Stephanie Demko。

I just want to talk a little bit about the strong behavioral health growth that you guys had talked about before and sort of your thoughts on buy versus build to expand the channel and to further demographics.

我只想談談你們之前談到的強勁的行為健康增長，以及你們對購買與建立以擴大渠道和進一步人口統計的想法。

Yes, Stephanie.

是的，斯蒂芬妮。

Behavioral health has been really strong in both the B2B arena as well as our BetterHelp direct-to-consumer business.

在 B2B 領域以及我們的 BetterHelp 直接面向消費者的業務中，行為健康一直非常強勁。

Both are growing incredibly rapidly.

兩者都在以驚人的速度增長。

And we see both the population growing as well as visit volume and visits per user growing.

我們看到人口增長以及訪問量和每位用戶的訪問量都在增長。

On the behavioral health side, we feel really good about the fact that we're increasing the member tenure and retention.

在行為健康方面，我們對增加會員任期和保留率這一事實感到非常滿意。

We've always talked about 3 major levers or metrics on that business: customer acquisition cost, member tenure or duration and lifetime value.

我們一直在談論該業務的 3 個主要槓桿或指標：客戶獲取成本、成員任期或持續時間和生命週期價值。

And all 3 of those continue to go in the right direction.

所有這三個都繼續朝著正確的方向前進。

With respect to our B2B offering, we're seeing significantly greater adoption among employers and really, I would say, outpaced growth in visit volume.

關於我們的 B2B 產品，我們看到雇主的採用率顯著提高，而且我想說的是，訪問量的增長速度確實超過了。

That's very encouraging.

這是非常令人鼓舞的。

And as you know, the visit pattern for that population tends to be multiple visits, as opposed to episodic, like our general medical visits are.

如您所知，該人群的就診模式往往是多次就診，而不是像我們一般的醫療就診那樣是間歇性的。

With respect to build versus buy, we feel like we have a very strong offering there.

關於構建與購買，我們覺得我們在那裡提供了非常強大的產品。

If we were to go out and find a partner there or a strategic asset, it would probably be feature-oriented as opposed to going after a new demographic because I think we have a good set of capabilities to go after the sort of target demographic at this point.

如果我們要出去在那裡尋找合作夥伴或戰略資產，它可能會以功能為導向，而不是追求新的人群，因為我認為我們有一套很好的能力來追求那種目標人群這點。

So could we see the BetterHelp asset maybe evolving a little bit from more of a Gen Z product to a broader offering?

那麼，我們能否看到 BetterHelp 資產可能會從更多的 Z 世代產品演變為更廣泛的產品？

Yes.

是的。

I mean we're seeing the population who engages with BetterHelp expand pretty consistently.

我的意思是，我們看到參與 BetterHelp 的人數持續增長。

So if you look at the distribution of the demographics, it has expanded from what it was a year or 2 or 3 ago as the BetterHelp team has continued to seek new channels for customer acquisition.

因此，如果您查看人口統計數據的分佈，隨著 BetterHelp 團隊繼續尋找新的客戶獲取渠道，它已經從一年或 2 或 3 年前擴大了。

That's it for health.

就是為了健康。

Just one quick housekeeping one.

只需一個快速的家政服務。

Could you kind of give us an update on the BetterHelp growth trajectory for the quarter?

您能給我們提供有關本季度 BetterHelp 增長軌蹟的最新信息嗎？

So we don't generally break out BetterHelp by itself.

因此，我們通常不會單獨拆分 BetterHelp。

What we've said historically was that our -- or at the beginning of the year, we said we expect our behavioral health business to grow by more than 50% this year, and we are very much on target to do that.

我們在歷史上所說的是，我們 - 或在今年年初，我們表示我們預計我們的行為健康業務今年將增長 50% 以上，我們非常有可能實現這一目標。

Our next question comes from the line of Sean Wieland from Piper Jaffray.

我們的下一個問題來自 Piper Jaffray 的 Sean Wieland。

On your visit fee only business, it looks like the membership was a bit lighter, but the visits were quite a bit stronger.

在您只收取訪問費的業務上，看起來會員資格要輕一些，但訪問量要強一些。

And just wanted -- I know it's not hugely impactful to the total revenue, but just wanted to see if you can call out anything there.

只是想 - 我知道這對總收入影響不大，但只是想看看你是否可以在那裡調出任何東西。

Yes.

是的。

I'll start and if Mala has anything I missed, she can add some color.

我會開始，如果 Mala 有什麼我錯過的，她可以添加一些顏色。

In that segment, there are big populations and so we see natural expansion and contraction in those populations with hiring, with membership, et cetera.

在該細分市場中，人口眾多，因此我們看到這些人口在招聘、會員資格等方面自然擴張和收縮。

Obviously, the size of the membership doesn't have any impact on our revenue because there's no subscription fee associated with it.

顯然，會員規模對我們的收入沒有任何影響，因為沒有與之相關的訂閱費。

I think you point out a good thing, Sean, which is membership or population has decreased and visits volume has increased pretty significantly.

我認為你指出了一件好事，肖恩，會員或人口減少了，訪問量顯著增加。

I think that, that is attributed to where we roll out our engagement sciences, like with the Aetna fully insured population, we're increasing utilization, so to speak.

我認為，這歸因於我們推出參與科學的地方，比如 Aetna 完全投保的人群，可以說，我們正在提高利用率。

And where we act more like a consultant to our clients, like in the FEP population, we're seeing significant growth in visit volume there.

在我們對客戶更像是顧問的地方，比如在 FEP 人群中，我們看到那裡的訪問量顯著增長。

Those have also gone hand-in-hand with expansion of the services that we offer, meaning rollout of behavioral health and dermatology, along with general medical.

這些也與我們提供的服務的擴展齊頭並進，這意味著推出行為健康和皮膚病學以及普通醫療。

So we think all of that is very positive.

所以我們認為所有這些都是非常積極的。

And as we said, we're a little less sensitive to the population.

正如我們所說，我們對人口不太敏感。

Mala, I don't know...

馬拉，我不知道...

Yes.

是的。

I think you've captured the highlights.

我想你已經抓住了亮點。

It's a small part of our overall visit volume, as you saw in our prepared remarks.

正如您在我們準備好的評論中看到的那樣，這只是我們整體訪問量的一小部分。

The members -- the individual base is there's some natural attrition in it, nothing more than that.

成員——個人基礎有一些自然損耗，僅此而已。

And I would say we are really pleased with the momentum on that overall.

我想說我們對整體上的勢頭感到非常滿意。

All right.

好的。

And then in the behavioral business, you mentioned improved member retention metrics.

然後在行為業務中，您提到了改進的會員保留指標。

Can you maybe put any numbers around that, specifically in behavioral?

你能不能在這方面加上任何數字，特別是在行為方面？

And then any commentary in general around member retention across the broader business.

然後是關於更廣泛業務中的會員保留的一般評論。

No.

不。

I mean I was really speaking about the BetterHelp business.

我的意思是我真的在談論 BetterHelp 業務。

I'm not going to quantify the improvement that we've seen.

我不會量化我們所看到的改進。

But we consistently do test and control populations in order to figure out what member features and member experience components drive better member retention.

但我們始終對人群進行測試和控制，以確定哪些會員功能和會員體驗組件可以提高會員保留率。

And we have found some things that have been very successful and expanded those to the full population.

我們發現了一些非常成功的東西，並將其擴展到了所有人群。

Member retention isn't really the same kind of metric for our broader population.

對於我們更廣泛的人群來說，會員保留並不是真正的同類指標。

I guess maybe what I would say, Sean, is we're seeing consistent visit patterns to what we saw last year.

我想也許我會說，肖恩，我們看到的訪問模式與去年的一致。

So in the first quarter, we were about 50-50 for general medical visits in terms of new users versus returning existing registrants; and in the second quarter, about 60-40, where it's 60% of the visits are coming from repeat users and 40% from new users.

因此，在第一季度，就新用戶與返回的現有註冊人而言，我們進行一般醫療訪問的人數約為 50-50；在第二季度，大約 60-40 次，其中 60% 的訪問來自重複用戶，40% 來自新用戶。

That's almost identical to what we saw last year.

這與我們去年看到的幾乎相同。

I think the good news there is that we're both seeing adoption and repeat utilization from our existing members, but we're also bringing in a substantial number of new users and that creates that sort of flywheel that builds on itself.

我認為好消息是我們既看到了現有成員的採用和重複使用，但我們也帶來了大量新用戶，這創造了一種基於自身的飛輪。

Our next question comes from the line of Ryan Daniels from William Blair.

我們的下一個問題來自 William Blair 的 Ryan Daniels。

Jason, one for you.

傑森，給你一個。

You talked about the volume of multiproduct bookings, I think, up about 4x year-over-year.

你談到了多產品預訂量，我認為，同比增長約 4 倍。

And I'm hoping to get a little bit more clarity on what that means from an average contract size.

我希望從平均合同規模中更清楚地了解這意味著什麼。

I know that will clearly vary based on who the contract's with and the size of perhaps the employer group.

我知道這顯然會根據與誰簽訂合同以及雇主群體的規模而有所不同。

But just in general, what's the average uptick in the sales amount for the larger contracts or multiproduct contracts?

但總的來說，較大合同或多產品合同的銷售額平均增長多少？

So Ryan, it's a good question.

所以瑞安，這是一個很好的問題。

I think what you're getting at is it going to drive up our average PMPM if we're selling multiple products into that population?

我認為如果我們向該人群銷售多種產品，它會提高我們的平均 PMPM 嗎？

Is that right?

那正確嗎？

Yes.

是的。

That's a fair way to look at it.

這是一個公平的看待它的方式。

Yes.

是的。

So the answer is it will, but it depends.

所以答案是它會，但這取決於。

But the magnitude is it depends on what the product combination is, right?

但是量級取決於產品組合是什麼，對吧？

So average deal size, in and of itself, is overall up as we look at our for -- as are pipeline and bookings.

因此，當我們查看我們的目標時，平均交易規模本身總體上是上升的——管道和預訂也是如此。

So average deal size is up versus last year.

因此，平均交易規模與去年相比有所上升。

Average PMPM, we see as being in line to up.

平均 PMPM，我們認為是一致的。

And the magnitude of it being up is really dependent on which product combination you're talking about, right?

它上升的幅度實際上取決於您正在談論的產品組合，對嗎？

So behavioral health has a smaller incremental PMPM than Expert Medical Services, for example.

因此，例如，行為健康的 PMPM 增量比專家醫療服務要小。

Okay.

好的。

Okay.

好的。

That's helpful color.

這是有用的顏色。

And then as my follow-up, just any update on Virtual First.

然後作為我的後續，Virtual First 的任何更新。

I mean you kind of talked about that a little bit or alluded to it in some of your contents or prepared comments, but just curious how that's rolling out and what demand for that specific solution looks like going forward?

我的意思是你在一些內容或準備好的評論中談到了一點或暗示了這一點，但只是好奇這是如何推出的，以及對該特定解決方案的未來需求是什麼樣的？

Yes, Ryan.

是的，瑞恩。

Virtual First is very exciting.

Virtual First 非常令人興奮。

We're having high-level discussions with big plans and employers across the country who are trying to figure out what a virtual primary care strategy looks like, what a Virtual First strategy looks like, what a virtual-centric plan design looks like, how they incorporate sort of bricks and clicks, how they take advantage of our capabilities in sort of a virtual Center of Excellence model.

我們正在與全國各地的大型計劃和雇主進行高層討論，他們試圖弄清楚虛擬初級保健戰略是什麼樣的，虛擬優先戰略是什麼樣的，以虛擬為中心的計劃設計是什麼樣的，如何他們結合了一些積木和點擊，他們如何利用我們在虛擬卓越中心模型中的能力。

And the whiteboard sessions are starting to solidify into real plans around plan designs, implementations and rollouts.

白板會議開始固化為圍繞計劃設計、實施和推出的實際計劃。

So we feel good about it.

所以我們對此感覺良好。

I'm not going to size what that's going to look like for 2020.

我不會估計 2020 年的情況。

I think it will be a ramp over the next several years.

我認為這將是未來幾年的一個斜坡。

But I do think that there will be some meaningful proofs of concepts over the 2020 plan year.

但我確實認為在 2020 年計劃年度會有一些有意義的概念證明。

Our next question comes from the line of Richard Close from Canaccord Genuity.

我們的下一個問題來自 Canaccord Genuity 的 Richard Close。

Congratulations, and welcome, Mala.

恭喜，歡迎，馬拉。

Jason, I was wondering if you could talk a little bit about the growth in Best Doctors in Advance Medical or Advance Medical.

傑森，我想知道你能否談談 Advance Medical 或 Advance Medical 的最佳醫生的增長。

It's been about a year now.

現在已經快一年了。

Both those growth rates were obviously below the core growth.

這兩個增長率都明顯低於核心增長率。

You talked about second opinion having a high attachment rate, it sounds like, in this multiproduct.

您談到了在這個多產品中具有高附加率的第二意見。

But can you talk about directionally, have you been able to accelerate the growth in both those businesses?

但是你能有方向地談談，你是否能夠加速這兩個業務的增長？

Yes.

是的。

Richard, thanks for the question.

理查德，謝謝你的問題。

When we look at the Best Doctors business, I don't even think about it as a Best Doctors' business anymore.

當我們審視最佳醫生業務時，我什至不再將其視為最佳醫生業務。

We're fully integrated in terms of our go-to-market strategy, our operations and our selling and RFP process.

我們在進入市場戰略、運營以及銷售和 RFP 流程方面完全整合。

And so I don't really pull those apart anymore.

所以我不再把它們分開了。

We feel good about the growth of our expert second opinion business.

我們對專家第二意見業務的增長感到滿意。

But just as an example with Best Doctors, that's what took us into the Canadian market, which gave us the platform on which to roll out Canadian telemedicine and then -- because it's with similar clients.

但就像 Best Doctors 的例子一樣，這就是我們進入加拿大市場的原因，它為我們提供了推出加拿大遠程醫療的平台，然後——因為它有類似的客戶。

So we're selling that, it's -- cross-selling that into existing legacy Best Doctors' clients who were demanding it.

所以我們正在銷售它，它是 - 將它交叉銷售給需要它的現有傳統 Best Doctors 客戶。

So there are, I would say, revenue synergies both ways on that business.

因此，我想說，該業務的收入協同效應是雙向的。

And then if you look at the Advance Medical business, that has revenue synergies on the legacy Best Doctors' business because we've been out in -- especially the U.K., but also in other parts of Europe, selling the full set of Advance Medical capabilities into the legacy Best Doctors' clients.

然後，如果您查看 Advance Medical 業務，它對傳統的 Best Doctors 業務具有收入協同效應，因為我們已經進入 - 特別是英國，但也在歐洲其他地區，銷售全套 Advance Medical能力融入傳統 Best Doctors 的客戶。

So I would say qualitatively, we're very pleased with the growth across the legacy set of clients and capabilities, but we see it as a full portfolio rather than individual pieces.

所以我會定性地說，我們對傳統客戶和能力的增長感到非常滿意，但我們將其視為一個完整的產品組合，而不是單個部分。

Okay.

好的。

That's helpful.

這很有幫助。

With respect to Vida Health, I was wondering if you could just dive into that a little bit deeper, how you see that rolling out.

關於 Vida Health，我想知道您是否可以更深入地了解它，您如何看待它的推出。

I don't know if you want to share economics or anything like that, but just exactly how is the combination or integration going to work?

我不知道你是否想分享經濟學或類似的東西，但究竟組合或整合將如何運作？

And how should we just think about that?

我們應該怎麼想呢？

Yes.

是的。

We're really excited about Vida.

我們對 Vida 感到非常興奮。

We've talked for a long time about going after the chronic care market, offering remote or virtual chronic care services as part of our full portfolio of services so that we can really take care of the end-to-end continuum of care.

長期以來，我們一直在談論追求慢性護理市場，提供遠程或虛擬慢性護理服務作為我們完整服務組合的一部分，以便我們能夠真正照顧到端到端的連續護理。

And Vida really is a strong platform to do that.

Vida 確實是一個強大的平台。

I've said multiple times that I'm less interested in single-condition point solutions and more interested in platforms that are multi-condition to go after the chronic care market and Vida really presents that.

我多次說過，我對單一條件點解決方案不太感興趣，而對追求慢性護理市場的多條件平台更感興趣，而 Vida 確實展示了這一點。

They're early stage still, and so we felt like it was the right strategy to go with a minority investment and a commercial relationship.

它們仍處於早期階段，因此我們認為這是進行少數股權投資和商業關係的正確策略。

We expect to do the integration over the remainder of this year and the beginning of next year, so that we can go to market with a seamless partnership.

我們預計將在今年餘下時間和明年年初進行整合，以便我們能夠以無縫的合作夥伴關係進入市場。

And we expect to see the fruits of that in 2020.

我們希望在 2020 年看到成果。

I will point out, this is another example of us being very consistent with our partnership strategy and our buy strategy.

我要指出，這是我們與我們的合作夥伴戰略和購買戰略非常一致的另一個例子。

We've said it before that there are certain areas that we are focused on, and Vida is a great example of sort of being consistent to that.

我們之前已經說過，我們專注於某些領域，而 Vida 就是一個很好的例子。

Our next question comes from the line of Matthew Gillmor from Baird.

我們的下一個問題來自 Baird 的 Matthew Gillmor。

Following up on some of the selling season comments.

跟進一些銷售季節的評論。

Jason, you've mentioned the big increase with RFPs that included the full integration.

Jason，您提到了包含完整集成的 RFP 的大幅增長。

Does that limit the number of telehealth vendors that are qualified to respond to those RFPs, so you'd expect your win rate to improve over time?

這是否會限制有資格響應這些 RFP 的遠程醫療供應商的數量，因此您希望您的獲勝率會隨著時間的推移而提高？

Or are there enough vendors with integrated offerings at this point where that competitive set looks about the same on these RFPs?

或者，此時是否有足夠多的供應商提供集成產品，而這些 RFP 上的競爭集看起來大致相同？

The answer is yes.

答案是肯定的。

It certainly works in our favor.

它當然對我們有利。

We're seeing better win rates, I think, as we indicated, bigger deal size and I think bigger deal size comes along with what we talked about with several Fortune 500 companies coming to us.

我們看到了更好的贏率，我認為，正如我們所指出的，更大的交易規模，我認為更大的交易規模伴隨著我們與幾家財富 500 強公司來找我們的談話。

The more sophisticated, the more strategic and the broader their view of virtual care, the more likely they are to select us as really the only player who can offer that full set of capabilities.

他們對虛擬護理的看法越複雜、戰略性越強、視野越廣，他們就越有可能選擇我們作為真正唯一能夠提供全套功能的參與者。

So it definitely plays in our favor.

所以它肯定對我們有利。

Got it.

知道了。

And then on the membership metric and sort of how that ties into the revenue guide, I think Mala had mentioned there was a payer that was pushed from 2Q into 3Q that explains sort of the sequencing of the membership.

然後關於會員指標以及它與收入指南的關係，我認為 Mala 提到有一個付款人從第二季度推到第三季度，這解釋了會員資格的排序。

So maybe just help us understand kind of what drove that.

所以也許只是幫助我們了解是什麼推動了這一點。

I assume that was a client issue.

我認為這是一個客戶問題。

And then it didn't seem to impact the revenue at all, so just kind of give us a sense for sort of why that didn't impact the revenue, if there's something that offset it.

然後它似乎根本沒有影響收入，所以只是讓我們了解一下為什麼這不會影響收入，如果有什麼東西可以抵消它。

Yes.

是的。

So frequently, when we roll out these very large payers, number one, they don't roll out all at once.

如此頻繁地，當我們推出這些非常大的付款人時，第一，他們不會一次全部推出。

They usually roll out in stages.

它們通常分階段推出。

And number two, the bigger they are, the more likely there is for a little bit of shifting in the launch dates.

第二，它們越大，發布日期就越有可能發生一點變化。

It did impact our membership, but as you point out, it really didn't impact our revenue.

它確實影響了我們的會員資格，但正如您所指出的，它確實沒有影響我們的收入。

In fact, we were at the high end of the range.

事實上，我們處於該範圍的高端。

I think that really speaks to the diversification of our revenue model, the different customer channels and the strength that we're seeing across all of those channels.

我認為這確實說明了我們收入模式的多樣化、不同的客戶渠道以及我們在所有這些渠道中看到的實力。

We had this situation last year with respect to the TRICARE business, and we didn't miss a beat with respect to hitting our numbers.

去年我們在 TRICARE 業務方面遇到了這種情況，我們在達到我們的數字方面沒有錯過任何一個節拍。

Again, we saw this -- a little bit it's a shift of 1 quarter, so it's not a massive shift.

再一次，我們看到了這一點——這是一個四分之一的轉變，所以這不是一個巨大的轉變。

But I think it really does speak to the strength of our broad-based set of solutions and the diversification of our business.

但我認為這確實說明了我們基礎廣泛的解決方案集的實力和我們業務的多元化。

Yes.

是的。

The thing I'll add to what Jason said is we have talked a little bit about how not all of our contracts start in 1/1 as they used to, right?

我要補充一下 Jason 所說的內容是，我們已經談了一點關於我們的所有合同不是像過去那樣以 1/1 開始的，對吧？

So you will see sort of the onboarding of clients' revenue through the year.

因此，您將看到全年客戶收入的增加。

And that's -- as we exit the year into 2020, that should give us some wind in our sales.

那就是——隨著我們進入 2020 年，這應該會給我們的銷售帶來一些影響。

Our next question comes from the line of Donald Hooker from KeyBanc.

我們的下一個問題來自 KeyBanc 的 Donald Hooker。

Great.

偉大的。

So maybe just a few last items.

所以也許只是最後幾項。

Obviously, a lot of questions have been asked.

顯然，已經問了很多問題。

I mean maybe just an update on TRICARE and maybe the pending Aetna renewal.

我的意思是也許只是關於 TRICARE 的更新，也許還有待定的 Aetna 續約。

Kind of any kind of confidence or anything incremental that give us some confidence around that?

任何一種信心或任何增量，讓我們對此有信心？

Yes.

是的。

So with respect to Aetna, as I've said before, we have a great relationship, I would say an improving relationship and increasingly strategic relationship with both the Aetna side of the house and the CVS side of the house.

因此，就 Aetna 而言，正如我之前所說，我們的關係很好，我想說的是與 Aetna 公司和 CVS 公司的關係正在改善和戰略關係日益增強。

And increasingly, we're having strategic discussions where everybody is in the room together.

而且，我們越來越多地進行戰略討論，每個人都在房間裡。

So I have every expectation that we will be partners with Aetna and CVS for years to come.

因此，我完全期望我們將在未來幾年成為 Aetna 和 CVS 的合作夥伴。

With respect to the TRICARE business, really, no significant change in terms of when.

關於 TRICARE 業務，真的，在時間方面沒有重大變化。

The expansion is there.

擴展就在那裡。

It's -- I think we've executed well on the pilot.

這是——我認為我們在試播集上執行得很好。

And now it's out of our hands in terms of if and when that rolls out larger.

現在，就是否以及何時擴大規模而言，它不在我們的掌控之中。

My expectation is that it will, but I certainly can't control that buyer.

我的期望是它會，但我當然無法控制那個買家。

Super.

極好的。

And maybe just one last one, the other area, I guess, maybe unless I missed it, I don't think it was touched on.

也許只是最後一個，另一個領域，我猜，也許除非我錯過它，否則我認為它沒有被觸及。

But the provider, the hospital, the direct-to-hospital business had been a big grower in prior years.

但供應商、醫院、直接到醫院的業務在前幾年一直是一個大增長者。

Has that started to sort of stabilize out?

已經開始穩定下來了嗎？

Has that market been penetrated?

這個市場被滲透了嗎？

Where do you see that going from here?

你從這裡看到什麼？

No.

不。

It really -- it didn't make it into the prepared remarks only because we're time-limited at some point, and we've had so much strength in all the various channels of our business.

真的 - 它沒有出現在準備好的評論中，只是因為我們在某個時間點有時間限制，而且我們在業務的所有各個渠道都擁有如此強大的實力。

We talked about a fair amount last quarter with the Cincinnati Children's rollout.

我們在上個季度談到了辛辛那提兒童展的相當數量。

No, it's growing really well.

不，它長得很好。

We continue to see strong success there.

我們繼續在那裡看到巨大的成功。

We see hospitals continuing to embrace virtual care across the clinical service lines of their business, and we see excellent opportunity there.

我們看到醫院繼續在其業務的臨床服務領域採用虛擬護理，我們看到了絕佳的機會。

I think bringing on David with his background among the providers and working for a large portion of his career at Cerner, I think it's just another way that we reinforce our strength in that market.

我認為讓 David 具有他在供應商中的背景並在 Cerner 的大部分職業生涯中工作，我認為這只是我們加強我們在該市場的實力的另一種方式。

Our next question comes from the line of Mohan Naidu from Oppenheimer.

我們的下一個問題來自奧本海默的 Mohan Naidu。

Jason, one on your investments and product road map.

Jason，您的投資和產品路線圖之一。

Are you looking at any potentially AI-driven solution, say, for triage or maybe enhanced interaction that members have with your platform that could overall improve your offering?

您是否正在尋找任何可能由 AI 驅動的解決方案，例如，用於分類或增強成員與您的平台的交互，從而全面改善您的產品？

Yes, Mohan.

是的，莫漢。

We rolled out our virtual assistant, the Teladoc Health virtual assistant last year, and that's continued to expand.

我們去年推出了我們的虛擬助手 Teladoc Health 虛擬助手，並且還在繼續擴大。

That's an essentially an AI-driven natural language processing tool that enables a consumer to interact and get guided to the right line of care from us or the right service line from us.

這本質上是一種由人工智能驅動的自然語言處理工具，它使消費者能夠進行交互並被引導到我們提供的正確護理線或我們提供的正確服務線。

That's particularly important, where we have integrated offerings with multiple clinical service lines, so that the consumer doesn't need to know where they are selecting, but rather they just have to answer some questions and get automatically directed in that way.

這一點尤為重要，我們將產品與多個臨床服務線集成在一起，這樣消費者就不需要知道他們在哪裡選擇，而只需回答一些問題並以這種方式自動獲得指導。

We continue to look at the AI diagnostic tools.

我們繼續關注人工智能診斷工具。

We obviously work with IBM Watson on our Oncology Insights program.

我們顯然在我們的 Oncology Insights 計劃上與 IBM Watson 合作。

We see AI today as a tool to assist the physician, I would call it augmented intelligence rather than artificial intelligence, so augmenting the physician's diagnostic capabilities and resources, but not replacing the physician at this point.

我們今天將 AI 視為輔助醫生的工具，我將其稱為增強智能而不是人工智能，因此增強了醫生的診斷能力和資源，但目前還沒有取代醫生。

Most of the things that we've looked at and we pay a lot of attention to the market, we think are still too probabilistic, not definitive enough and not user-friendly enough.

我們看過的大部分東西，我們非常關注市場，我們認為仍然過於概率，不夠明確，不夠用戶友好。

And that's been most of the feedback in the market thus far.

這是迄今為止市場上的大部分反饋。

But certainly, we keep our ear to the market and make sure that we see just about everything out there in case we come across something that we believe has legs.

但可以肯定的是，我們會密切關注市場，並確保我們看到幾乎所有的東西，以防我們遇到我們認為有腿的東西。

Maybe one quick follow-up on the UnitedHealth implementations.

也許是對 UnitedHealth 實施的快速跟進。

Do you have lives in your guidance, I guess, the membership in the membership guidance that you're expecting in second half?

我猜你的指導中有生命嗎，你期望在下半年獲得會員指導的成員資格？

So we do not have United included in our membership guidance.

因此，我們的會員指南中沒有包含美聯航。

Obviously, we are incredibly respectful of United in terms of their rollout and their communication, and so we didn't want to get ahead of our skis and include that in the membership guidance.

顯然，我們非常尊重曼聯的推出和溝通，因此我們不想超越我們的滑雪板並將其包含在會員指南中。

But just to be clear, we do have the revenues and the cost for the rest of the financials in our overall guidance.

但需要明確的是，我們的總體指導中確實包含其他財務的收入和成本。

Our next question comes from the line of Allen Lutz from Bank of America.

我們的下一個問題來自美國銀行的 Allen Lutz。

Jason, you mentioned behavioral health RFPs were up about 200% year-over-year.

Jason，您提到行為健康 RFP 同比增長約 200%。

How does that compare with the RFP volume growth last year?

這與去年的 RFP 數量增長相比如何？

And then is your win rate improving year-over-year?

然後你的贏率是否逐年提高？

It's a good question.

這是個好問題。

I don't have the year-over-year from '17 to '18 for behavioral health RFP volume, so I'd have to circle back with you on that one.

我沒有從 17 年到 18 年的行為健康 RFP 量的同比數據，所以我不得不在那個問題上與你討論。

It's certainly something we have the data, I just don't have it in front of me.

這當然是我們有數據的東西，我只是沒有它在我面前。

It was certainly up last year relative to the year before, I just don't have the magnitude.

相對於前一年，去年肯定是上升了，我只是沒有那麼大。

And then the win rate, I would say, across the board, our win rate is improving.

然後是贏率，我想說，全面來說，我們的贏率正在提高。

As I said, it's one of those things where you look for areas of strength and areas where maybe we could be doing better.

正如我所說，這是您尋找優勢領域和可能我們可以做得更好的領域之一。

And in fact, across all of our major customer channels, we're seeing improvements year-over-year.

事實上，在我們所有的主要客戶渠道中，我們都看到了逐年改善。

We're seeing strong, both RFP volume, and strong win rates.

我們看到了強大的 RFP 數量和強勁的獲勝率。

Great.

偉大的。

And as you think about the partnership with CVS, can you talk about what the marketing strategy is for that?

當您考慮與 CVS 的合作夥伴關係時，您能談談為此制定的營銷策略嗎？

And can you talk about how the telemedicine offering could be integrated with MinuteClinic, basically, what the go-to-market strategy is for that?

您能否談談遠程醫療產品如何與 MinuteClinic 集成，基本上，市場推廣策略是什麼？

Yes.

是的。

The -- we're pleased, as I said in my prepared remarks, to see really the first time that CVS has publicly promoted the virtual care service.

正如我在準備好的講話中所說，我們很高興看到 CVS 第一次公開推廣虛擬護理服務。

And they did that with a press release, and then there were some articles written about it.

他們通過新聞稿做到了這一點，然後寫了一些關於它的文章。

They have not really yet begun the significant marketing, direct-to-consumer marketing of the virtual visits.

他們還沒有真正開始虛擬訪問的重要營銷、直接面向消費者的營銷。

And I don't really have a time line for when they're going to do that.

我真的沒有時間線來說明他們何時會這樣做。

The way that the deal is structured, they are responsible for the marketing and communications around that program, specifically it's branded -- it's private labeled for them.

交易的結構方式，他們負責圍繞該計劃的營銷和溝通，特別是它的品牌 - 它是他們的私人標籤。

And obviously, that means they're in control of the marketing and promotion.

顯然，這意味著他們控制著營銷和促銷。

With respect to the integration with the MinuteClinics, I think it's going to evolve over time.

關於與 MinuteClinics 的集成，我認為它會隨著時間的推移而發展。

So the early structure uses our physicians.

所以早期的結構使用我們的醫生。

The relationship contemplates using their nurse practitioners on our platform in addition to our physicians.

除了我們的醫生外，這種關係還考慮在我們的平台上使用他們的執業護士。

So there's really a seamless workforce that uses their resources and our resources over time.

因此，隨著時間的推移，確實有一支無縫的勞動力隊伍可以使用他們的資源和我們的資源。

I think the bigger opportunity comes down the road, and Troy Brennan talked about this at our Investor Day, when they can virtually bring in our specialists into maybe the evolved health hubs rather than the traditional MinuteClinics in order to treat the chronically ill and supplement the nurse practitioners that they have on-site, so that they can take advantage of a remote workforce without necessarily having to staff them on site in those health hubs.

我認為更大的機會即將到來，特洛伊·布倫南 (Troy Brennan) 在我們的投資者日談到了這一點，當時他們實際上可以將我們的專家帶入進化的健康中心，而不是傳統的 MinuteClinics，以治療慢性病並補充他們在現場擁有執業護士，這樣他們就可以利用遠程勞動力，而不必在這些健康中心現場配備他們。

So we're really excited about that opportunity, as well as thinking bigger about what can be done in a bricks-and-clicks environment between the CVS physical locations and the Aetna-insured population.

因此，我們對這個機會感到非常興奮，並且更加思考在 CVS 物理位置和 Aetna 保險人群之間的實體環境中可以做些什麼。

Our next question comes from the line of Matt Hewitt from Craig-Hallum Capital.

我們的下一個問題來自 Craig-Hallum Capital 的 Matt Hewitt。

Most of mine have been asked, but I'll maybe hit you with this one.

我的大部分人都被問過了，但我可能會用這個來打擊你。

And I realize that you've been focused on driving top line growth and expanding into new markets, both from a solution standpoint and geographically.

而且我意識到，無論是從解決方案的角度還是在地理上，您一直專注於推動收入增長和開拓新市場。

But I noticed some -- a little bit more commentary about profitability this quarter.

但我注意到了一些——關於本季度盈利能力的更多評論。

And I'm wondering if maybe Mala and David, some of their experiences and skill sets will allow you to maybe find incremental leverage as they come on board and kind of get more engaged with the overarching platform.

我想知道 Mala 和 David，他們的一些經驗和技能組合是否可以讓您在他們加入時找到增量影響力，並更多地參與總體平台。

So let me start with sort of the bigger picture, and then Mala can give a little bit more commentary on our path to profitability.

因此，讓我從更大的圖景開始，然後 Mala 可以對我們的盈利之路發表更多評論。

I would say, first and foremost, we still believe that there is a massive opportunity in front of us.

我想說，首先，我們仍然相信擺在我們面前的是巨大的機會。

We have a virtually unlimited market opportunity, and we're, by far, the leader.

我們擁有幾乎無限的市場機會，而且到目前為止，我們處於領先地位。

And so we're going to continue to focus, first, on growth and expanding the role and presence of virtual care in the health care system.

因此，我們將首先繼續關注增長和擴大虛擬護理在醫療保健系統中的作用和存在。

Having said that, we also have consistently made progress with respect to the financial performance of the company: first, focusing on getting to adjusted EBITDA positive; second, getting to cash flow positive.

話雖如此，我們在公司的財務業績方面也不斷取得進展：首先，專注於調整後的 EBITDA 為正；第二，現金流為正。

And we are and our board is very focused on making continued financial progress in terms of the bottom line and expense side of the business.

我們和我們的董事會非常專注於在業務的底線和費用方面取得持續的財務進展。

Maybe Mala, you want to give a little more color?

也許瑪拉，你想多給點顏色嗎？

Yes.

是的。

So what I would say is, listen, we are on the path and focused on getting to and delivering strong adjusted EBITDA.

所以我想說的是，聽著，我們正在前進，專注於實現並提供強勁的調整後 EBITDA。

This quarter was a nice progress on that relative to the last quarter.

與上一季度相比，本季度取得了不錯的進展。

And as we have said, we expect to be cash flow positive this year.

正如我們所說，我們預計今年的現金流為正。

We are pretty focused on that as well.

我們也非常關注這一點。

And I would say the way to get there, if I were to think of the levers, it's about making the right investments with efficiency in driving the top line and the revenue growth globally, making sure that we are managing the growth margins appropriately as a portfolio.

我會說實現目標的方法，如果我要考慮槓桿，它是關於有效地進行正確的投資，以推動全球收入和收入增長，確保我們以適當的方式管理增長利潤率文件夾。

And the third thing I would say is we have demonstrated the record, and we will continue to focus on how we can get at operating leverage.

我要說的第三件事是我們已經證明了記錄，我們將繼續關注如何獲得運營槓桿。

So it's the balancing of all of those levers: revenue growth, margins, investments and how we can get at the expense leverage, in my view, which will drive the adjusted EBITDA and the cash flow that we are really focused on.

因此，這是所有這些槓桿的平衡：收入增長、利潤率、投資以及我們如何利用費用槓桿，在我看來，這將推動調整後的 EBITDA 和我們真正關注的現金流。

Our next question comes from the line of Stan Berenshteyn from SunTrust.

我們的下一個問題來自 SunTrust 的 Stan Berenshteyn。

Maybe just a quick question on Rite Aid and Amwell.

也許只是一個關於 Rite Aid 和 Amwell 的快速問題。

They recently announced a partnership, I guess, similar to the one you have with CVS.

我猜他們最近宣布了一項合作夥伴關係，類似於您與 CVS 的合作夥伴關係。

I was just curious if you could comment on whether you participated in RFP for that and if you had any comments on how that offering compares to your partnership with CVS?

我只是想知道您是否可以評論一下您是否為此參與了 RFP，以及您是否對該產品與您與 CVS 的合作夥伴關係有何評論？

Yes.

是的。

So Stan, I read something, yesterday maybe, about a Rite Aid and InTouch Health partnership, but I haven't read about anything with Amwell.

所以斯坦，我昨天讀到了一些關於 Rite Aid 和 InTouch Health 合作的東西，但我還沒有讀到關於 Amwell 的任何東西。

So I can't speak to a...

所以我不能和一個...

(inaudible)

（聽不清）

Oh, it was InTouch.

哦，是 InTouch。

Okay.

好的。

So I won't say what we've competed in and not competed in.

所以我不會說我們參加過什麼比賽，沒有參加過什麼比賽。

My understanding is that, that's a -- more of a physical location and kiosk strategy.

我的理解是，這更像是一種物理位置和信息亭策略。

And so we were not involved in that process.

所以我們沒有參與這個過程。

Our next question comes from the line of Steve Halper from Cantor Fitzgerald.

我們的下一個問題來自 Cantor Fitzgerald 的 Steve Halper。

I just wanted to ask some -- for some commentary around your Medicare.

我只是想問一些——關於你的醫療保險的一些評論。

Obviously, big opportunity.

顯然，機會很大。

The plans presumably put all their benefit packages together.

這些計劃大概將他們所有的福利組合在一起。

How did you fare during that process with the plans?

在計劃的那個過程中，你的表現如何？

And what's the outlook for 2020 contribution?

2020 年的貢獻前景如何？

Yes, Steve.

是的，史蒂夫。

We continue to work with the plans.

我們繼續與計劃合作。

A lot of the plans put play solders in their bids.

很多計劃都在競標中發揮作用。

We're continuing to work with them.

我們將繼續與他們合作。

And what we've said is we think that we'll be able to give commentary when we report in October as, by that point, we will be sort of the decisions will generally have been made.

我們所說的是，我們認為我們將能夠在 10 月份報告時發表評論，因為到那時，我們將在某種程度上做出決定。

I won't say they'll all be made, but generally have been made for the January 1, 2020 rollout.

我不會說它們都會製作完成，但通常是為 2020 年 1 月 1 日推出而製作的。

In the meantime, we continue to have productive discussions and bids with our -- both our existing clients in the health plan space as well as new clients who we're going after in the Medicare Advantage space.

與此同時，我們繼續與我們的現有客戶進行富有成效的討論和投標——我們在健康計劃領域的現有客戶以及我們在 Medicare Advantage 領域追求的新客戶。

So I feel good about it.

所以我對此感覺很好。

I've also said consistently that I don't think this is going to be a big bang, where all 20 million members come online for virtual care January 1, 2020.

我還一直表示，我認為這不會是一次大爆炸，2020 年 1 月 1 日，所有 2000 萬會員都會在線進行虛擬護理。

That never really happens.

這從來沒有真正發生過。

So I think it will be a multiyear-phased rollout across the MA population.

所以我認為這將是一個在 MA 人群中分階段推出的多年期。

Our next question comes from the line of Daniel Grosslight from SVB Leerink.

我們的下一個問題來自 SVB Leerink 的 Daniel Grosslight。

I was just curious, as you see more plans adopting telehealth, are you seeing them really incorporating more shared savings into their pricing models?

我只是好奇，當您看到更多采用遠程醫療的計劃時，您是否看到他們真的將更多的共享儲蓄納入其定價模型？

Or is it your typical PMPM plus visit fee?

還是您的典型 PMPM 加上參觀費？

Yes.

是的。

I wouldn't say that we're seeing a preponderance of shared savings at this point.

我不會說我們在這一點上看到了共享儲蓄的優勢。

I think there's a possibility that we see more of that as we move toward the Virtual First environment or a virtual primary care environment, where we're playing a materially different role.

我認為，隨著我們向 Virtual First 環境或虛擬初級保健環境邁進，我們可能會看到更多這樣的情況，我們在其中扮演著截然不同的角色。

But at this point, we only have a few, what I would call, pay-for-performance contracts.

但在這一點上，我們只有幾個，我稱之為按績效付費的合同。

We tend to perform incredibly well in those.

我們往往在這些方面表現得非常好。

So actually, I like those contracts, but we don't have a ton of them.

所以實際上，我喜歡這些合同，但我們沒有很多。

Our next question comes from the line of David Windley from Jefferies.

我們的下一個問題來自 Jefferies 的 David Windley。

It might be a version of the prior question, but I was just thinking about visits per paid member and the opportunity to increase that and capture -- essentially turn nonusers into users of virtual.

這可能是前一個問題的一個版本，但我只是在考慮每個付費會員的訪問量以及增加和捕獲的機會——本質上是把非用戶變成虛擬用戶。

And I think the restructuring of your Aetna compensation was intended to drive some of that.

我認為你們的 Aetna 薪酬重組旨在推動其中的一部分。

I wondered if that has been successful, if you can provide any metrics that would compare how that visit per member or metric might look in a structure like that versus the more traditional PMPM structure?

我想知道這是否成功，您是否可以提供任何指標來比較每個成員的訪問或指標在類似結構與更傳統的 PMPM 結構中的外觀？

Yes.

是的。

Our Aetna contract has performed very well.

我們的 Aetna 合同表現非常好。

It was at our expectations or maybe slightly above last year, which is really the first year of the restructured contract.

這符合我們的預期，或者可能略高於去年，這實際上是重組合同的第一年。

And this year, it's up again.

而今年，它又來了。

I would say more generally speaking, our utilization rates for the second quarter is up about 105 basis points over last year.

我會說更一般地說，我們第二季度的利用率比去年增加了約 105 個基點。

And so that really speaks -- we define visits over population as utilization rate.

所以這確實說明了 - 我們將訪問量定義為利用率。

And so when you annualize our second quarter results, we were up about 105 basis points over the second quarter annualized last year.

因此，當您對我們的第二季度業績進行年化計算時，我們比去年的第二季度年化結果增長了約 105 個基點。

So I think that's probably the best way to measure visits per user.

所以我認為這可能是衡量每位用戶訪問量的最佳方式。

And we see consistently improving results there.

我們看到那裡的結果不斷改善。

You might recall that in the first quarter, we were only up about 10 basis points, as we were up against a tough comparable in the flu season, and we also had just onboarded over 3 million new members in the health plan space.

您可能還記得，在第一季度，我們只上漲了大約 10 個基點，因為我們在流感季節遇到了艱難的可比性，而且我們剛剛在健康計劃領域加入了超過 300 萬新成員。

So it's nice to see that expand to 105 basis points in the second quarter.

所以很高興看到第二季度擴大到 105 個基點。

I'm sorry, Jason, so that's an overall statement, not a net-net specific statement, correct?

對不起，傑森，這是一個整體的聲明，而不是網絡特定的聲明，對嗎？

That's correct, yes.

沒錯，是的。

That's about our whole book of U.S. paid members.

這就是我們整本書的美國付費會員。

Yes.

是的。

And would you expect that utilization rate -- I mean I guess going back to -- does a more highly visit-incented maybe shared savings, if that's the right phrase, structure drive faster utilization increases than a traditional model?

您是否會期望利用率——我的意思是我想回到——是否有更高的訪問激勵可能共享節省，如果這是正確的短語，結構驅動比傳統模型更快的利用率增長？

We've performed -- I'm not going to give specific Aetna utilization rates.

我們已經完成了——我不會給出具體的 Aetna 利用率。

What I would say is that we've seen very strong results in our pay-for-performance contracts.

我想說的是，我們已經在按績效付費的合同中看到了非常強勁的結果。

And generally speaking, those have grown their utilization rates faster than our general book of business.

一般來說，這些公司的利用率比我們的一般業務增長得更快。

So certainly, when we are -- when we have greater incentive to drive utilization and we can spend against that using our engagement sciences, we tend to drive better results.

因此，當然，當我們有更大的動力來推動利用率並且我們可以使用我們的參與科學來與之抗衡時，我們往往會獲得更好的結果。

So I think the answer to your question is yes, but I would look at it as our whole pay-for-performance block of business rather than a single client.

所以我認為你的問題的答案是肯定的，但我會將其視為我們整個按績效付費的業務塊，而不是單個客戶。

Our next question comes from the line of Charles Rhyee from Cowen.

我們的下一個問題來自 Cowen 的 Charles Rhyee。

I guess can I ask about the guidance here for the full year, particularly as we think about adjusted EBITDA, when we think about the third quarter range, is that fair to think that we're -- given where the revenue number is set for the guidance, are we -- is that right to think where is the onboarding cost as we've had the sort of mid-year starts on some customers, particularly maybe the one that we talked about earlier -- that was talked about earlier that was delayed, that was pushed out into 3Q?

我想我可以在這裡詢問全年的指導，特別是當我們考慮調整後的 EBITDA 時，當我們考慮第三季度的範圍時，認為我們是公平的 - 考慮到收入數字的設定指導意見，我們是否有權思考入職成本在哪裡，因為我們已經在一些客戶身上進行了年中開始，尤其是我們之前談到的那個 - 之前談到過被推遲了，被推到了第三季度？

And just to confirm, has that client been onboarded?

只是為了確認一下，該客戶是否已入職？

So the way I would think about it is if you look at our adjusted EBITDA for the quarter in Q2 and you look at the ramp that we have in revenue for the back half of the year and you see what it is in Q3 and Q4, I would look at those 2 together and you will understand how we have got to the guidance we have gotten to for Q3 and also for the full year.

所以我的想法是，如果你看看我們在第二季度調整後的 EBITDA，你看看我們在今年下半年的收入增長，你會看到第三季度和第四季度的情況，我會一起看這兩個，你會明白我們是如何獲得第三季度和全年的指導的。

So then the pickup in the fourth quarter is really that -- so I mean, it's right to think that we are having onboarded costs that are rolling off as we collect more in the fourth quarter.

因此，第四季度的回升確實是這樣 - 所以我的意思是，隨著我們在第四季度收集的更多，我們的入職成本正在下降是正確的。

But when we think about the -- is it more in the gross margin, in the COGS, would you say?

但是當我們考慮 - 更多的是毛利率，COGS，你會說嗎？

Or is it more in some of the other OpEx lines as we're modeling out?

還是在我們建模的其他一些運營支出線中更多？

How is the best way we should think about that?

我們應該如何思考這個問題的最佳方式是什麼？

Yes.

是的。

So the onboarding cost, I would think generally is in our advertising and marketing.

所以入職成本，我認為一般是在我們的廣告和營銷中。

That's where we would generally have a lot of our onboarding cost, and that has been factored into our guidance as we've thought about the EBITDA for the rest of the year.

這就是我們通常會有很多入職成本的地方，並且在我們考慮今年剩餘時間的 EBITDA 時，這已被納入我們的指導。

And so what I would say to you is, think of the revenue ramp that we have in the back half.

所以我要對你說的是，想想我們在後半部分的收入增長。

Our gross margin expectations are similar to what we have said before.

我們的毛利率預期與我們之前所說的相似。

And then think about how that flows through into the EBITDA guidance for Q3 and Q4.

然後想想這如何流入第三季度和第四季度的 EBITDA 指導。

I don't want to get more specific than that.

我不想說得更具體。

That's helpful.

這很有幫助。

And Jason, just one last question for you.

還有傑森，最後一個問題要問你。

You talked earlier in your comments about more interest in sort of visit-included-type contracts.

您之前在評論中談到了對包含訪問類型的合同的更多興趣。

Any -- is there maybe not in the total book, but as you think about the selling season currently, is that more than half?

任何 - 總書中可能沒有，但是當您考慮當前的銷售季節時，是否超過一半？

Or is that maybe kind of like how much of new businesses are clients looking at that kind of model versus the more PMPM-plus visit?

或者這可能有點像客戶關注這種模式的新業務有多少，而不是更多的 PMPM-plus 訪問？

It's customer channel-specific.

它是特定於客戶渠道的。

So at the smaller end of our market, we see visits included.

因此，在我們市場的較小端，我們看到訪問包括在內。

In the international markets, we see visits included.

在國際市場，我們看到包括訪問在內。

Health plans don't really want to go visits included nor do very large employers.

健康計劃真的不想去拜訪，大型雇主也不想。

So -- and then mostly on a DTC basis, it's visits included.

所以 - 然後主要是在 DTC 的基礎上，它包括訪問。

So it's very much channel-specific.

所以它非常特定於渠道。

And we're not seeing so much change in the characteristics of those different customer channels.

而且我們沒有看到這些不同客戶渠道的特徵發生太大變化。

Our next question comes from the line of Jailendra Singh from Crédit Suisse.

我們的下一個問題來自瑞士信貸的 Jailendra Singh。

Quick clarification on United contract.

快速澄清曼聯合同。

You did say that the revenue from that contract is included in your guidance for second half.

您確實說過該合同的收入包含在您對下半年的指導中。

Do you expect that contract to hit the annual run rate in second half?

您是否預計該合同將在下半年達到年度運行率？

Or is it more of a ramp, which continues through 2020?

或者它更像是一個斜坡，一直持續到 2020 年？

So I would view that as a ramp.

所以我認為這是一個坡道。

We're going to -- we expect to start and launch that this year.

我們將 - 我們希望在今年開始並推出它。

But as with any new client, especially in the health plan space, utilization and revenue grow over time.

但與任何新客戶一樣，尤其是在健康計劃領域，利用率和收入會隨著時間的推移而增長。

And so I would expect that to ramp.

所以我希望這會增加。

So I wouldn't call our fourth quarter run rate a full annualized expectation.

因此，我不會將我們的第四季度運行率稱為完整的年化預期。

Okay.

好的。

And then I also want to better understand your long-term pricing expectations.

然後我還想更好地了解您的長期定價預期。

At your last Investor Day, you talked about a target of $0.05 to $0.10 expansion on your pricing.

在您的最後一個投資者日，您談到了將您的定價擴展為 0.05 美元至 0.10 美元的目標。

Clearly, you also mentioned that signing up these new members, new clients, they have negative impact on pricing, but then you see positive benefit from upselling and cross-selling your services.

顯然，您還提到註冊這些新成員、新客戶，他們會對定價產生負面影響，但隨後您會看到追加銷售和交叉銷售服務的積極好處。

Help us understand, has it been -- has there been any change in your long-term pricing expectations, based on what you're seen this year or from last few quarters?

幫助我們了解，根據您今年或過去幾個季度的情況，您的長期定價預期是否有任何變化？

No.

不。

No real change in our outlook.

我們的前景沒有真正的變化。

And I think our step-up of $0.03 sequentially is a good example of that, where you did see a dampening in the first quarter, but then in the second quarter, where we added 100,000 members to our total U.S. paid membership, you saw the sequential step-up of $0.03.

我認為我們連續增加 0.03 美元就是一個很好的例子，第一季度你確實看到了下降，但是在第二季度，我們在美國付費會員總數中增加了 100,000 名會員，你看到了0.03 美元的連續升幅。

And then you'll continue to see a little bit of dampening when we onboard significantly large populations.

然後，當我們登上大量人口時，您將繼續看到一點點抑制。

But I think also we gave some numbers in the first quarter, where if you subtract that large population of health plan members, you would see exactly that same trend.

但我認為我們在第一季度也給出了一些數字，如果你減去大量的健康計劃成員，你會看到完全相同的趨勢。

So absent significant mix changes, which we love if they come in and in very large clients, you should expect to see that similar trajectory.

因此，如果沒有顯著的混合變化，如果它們進入並在非常大的客戶中，我們會喜歡這種變化，你應該期望看到類似的軌跡。

Okay.

好的。

And last thing just one follow-up.

最後一件事只是一個後續行動。

There was discussion around Advance Medical impact.

圍繞 Advance Medical 的影響進行了討論。

I mean should we expect any impact from that in -- on your organic growth trends' expectations for second half of 2019, depending on how Advance Medical is doing because that will be in your organic growth numbers for second half.

我的意思是，我們是否應該預期這會對您對 2019 年下半年的有機增長趨勢的預期產生任何影響，這取決於 Advance Medical 的表現，因為這將在您下半年的有機增長數字中。

Yes.

是的。

Jailendra, what I would say to you is we are really pleased with the momentum and the progress on Advance Medical.

Jailendra，我要對你說的是，我們對 Advance Medical 的勢頭和進展感到非常滿意。

And I would say still think of us from an organic growth perspective overall in the 20% to 30% that we have talked about before.

我想說，仍然從我們之前談到的 20% 到 30% 的整體有機增長的角度來考慮我們。

So no change to that outlook.

因此，這種前景沒有改變。

And there are no further questions at this time.

目前沒有進一步的問題。

I will turn the call back over to Jason Gorevic for any closing remarks.

我會將電話轉回給 Jason Gorevic 以獲取任何結束語。

Thanks so much, everybody, for tuning into the call and the great questions.

非常感謝大家收聽電話和重要的問題。

Welcome to the new team members, David and Mala.

歡迎加入新團隊成員 David 和 Mala。

And we're really excited about the performance in the second quarter and even more excited about the future looking forward.

我們對第二季度的表現感到非常興奮，對未來的展望更加興奮。

So with that, I think we'll end the call.

因此，我想我們將結束通話。

And this concludes today's conference call.

今天的電話會議到此結束。

You may now disconnect.

您現在可以斷開連接。