Teladoc Health Inc (TDOC) 2019 Q3 法說會逐字稿

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

歡迎來到 Teladoc 2019 年第三季度收益電話會議和網絡直播。

(Operator Instructions)

（操作員說明）

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

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.

謝謝你。

Good afternoon.

下午好。

Today, after the market closed, we issued a press release announcing our third 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 年第三季度的財務業績。

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 fourth quarter and full year outlook, and our prepared remarks will be followed by a question-and-answer session.

在本次電話會議中，我們將提供第四季度和全年展望，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.

此外，請注意，本次電話會議期間的某些陳述將是 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。

After the market closed today, Teladoc Health reported another strong quarter.

今天市場收盤後，Teladoc Health 報告了另一個強勁的季度。

I'm very pleased with our results across the full breadth of our business, delivering at the high end of our expectations, showing progress on several of our strategic initiatives and making strides on our path to profitability.

我對我們在整個業務範圍內的業績感到非常滿意，實現了我們期望的高端，在我們的幾項戰略舉措上取得了進展，並在我們的盈利道路上取得了長足的進步。

With positive momentum coming out of the third quarter and good visibility into the fourth quarter, we're raising our revenue and visit guidance for the full year 2019.

憑藉第三季度的積極勢頭以及對第四季度的良好可見性，我們正在提高 2019 年全年的收入和訪問指導。

While Mala will delve into the specifics of the quarter shortly, I wanted to spend a few minutes highlighting the strong execution that underscores the quarter's momentum and serves as a foundation for long-term growth.

雖然 Mala 將很快深入探討本季度的具體情況，但我想花幾分鐘時間強調強大的執行力，它強調了本季度的發展勢頭並為長期增長奠定了基礎。

In the third quarter, we saw the greatest population expansion in the company's history as more than 17 million people gained access to Teladoc.

在第三季度，我們看到了公司歷史上最大的人口擴張，超過 1700 萬人獲得了 Teladoc 的使用權。

This significant increase was driven by our entrenched distribution footprint across channels, in particular, the accelerated momentum in health plans.

這一顯著增長是由我們在渠道中根深蒂固的分銷足跡推動的，特別是健康計劃的加速勢頭。

The largest population onboarded was UnitedHealthcare's 15 million commercial members.

加入人數最多的是 UnitedHealthcare 的 1500 萬商業會員。

This marks the first and only fully integrated virtual care offering within the UHD experience, as highlighted by their recent press release.

正如他們最近的新聞稿所強調的那樣，這標誌著 UHD 體驗中第一個也是唯一一個完全集成的虛擬護理產品。

The initial launch went very smoothly.

最初的發射非常順利。

Full engagement efforts are progressing on schedule, and we're pleased with the early results.

全面參與的工作正在按計劃進行，我們對早期結果感到滿意。

I'm extremely proud of our team and appreciative of the collaboration from the United team members who, together, brought this deeply integrated solution and seamless consumer experience to life.

我為我們的團隊感到非常自豪，並感謝美聯航團隊成員的合作，他們共同將這種深度集成的解決方案和無縫的消費者體驗變為現實。

On the visits front, we continue to see the acceleration of growth across our total book of business globally, with visits up 45% in the quarter.

在訪問方面，我們繼續看到我們全球業務總量的增長加速，本季度訪問量增長了 45%。

Digging into the favorable growth, we continue to see accelerating adoption across all our clinical specialties.

挖掘有利的增長，我們繼續看到我們所有臨床專業的加速採用。

In fact, we're seeing the strongest visit growth amongst our largest populations with multiple clinical specialties, which experienced a 59% increase in visit volume over the same quarter last year.

事實上，在我們擁有多個臨床專科的最大人群中，我們看到訪問量增長最為強勁，與去年同期相比，訪問量增長了 59%。

As we continue to realize the benefits from our sustained data-driven member engagement capabilities, combined with the breadth of our clinical services, we're uniquely equipped to take advantage of the growing macro consumer adoption tailwinds.

隨著我們繼續從我們持續的數據驅動的會員參與能力中受益，再加上我們廣泛的臨床服務，我們擁有獨特的能力來利用不斷增長的宏觀消費者採用順風。

Mental health continues to be an area where we're seeing accelerated adoption.

心理健康仍然是我們看到加速採用的領域。

In Q3, we were pleased to celebrate our BetterHelp channel, passing the 50 million message milestone, and continued strong utilization growth within our U.S. distribution channels.

在第三季度，我們很高興地慶祝我們的 BetterHelp 渠道突破了 5000 萬條消息的里程碑，並在我們的美國分銷渠道中繼續強勁的利用率增長。

Internationally, we launched the U.K. market's first and only virtual mental health service for navigating complex conditions with AIG Life, followed by this month's announcement of the expansion of our Great-West Life partnership to include the mental health navigator service in Canada.

在國際上，我們與 AIG Life 合作推出了英國市場上第一個也是唯一一個用於導航複雜狀況的虛擬心理健康服務，隨後本月宣布擴大我們的 Great-West Life 合作夥伴關係，將加拿大的心理健康導航服務包括在內。

On the heels of World Mental Health Day, however, it's clear to me that we need to do more.

然而，在世界精神衛生日之後，我很清楚我們需要做更多的事情。

The multinational study we released earlier this month reveals the intense need for greater access to mental health care, which pervades across borders and is growing at an alarming rate, as younger people are demonstrating poorer mental health than previous generations.

我們本月早些時候發布的這項多國研究表明，隨著年輕人的心理健康狀況比前幾代人更差，人們迫切需要更多地獲得心理保健服務，這種保健服務跨越國界並以驚人的速度增長。

This study found that 61% of 18- to 25-year olds report that mental health symptoms have affected their job performance compared to 38% of all age groups.

這項研究發現，61% 的 18 至 25 歲的人報告說心理健康症狀影響了他們的工作表現，而所有年齡組的這一比例為 38%。

This is truly a global challenge, and Teladoc Health's holistic portfolio of mental health offerings is optimally designed to meet the escalating demand.

這確實是一個全球性挑戰，Teladoc Health 的整體心理健康產品組合經過優化設計，可以滿足不斷增長的需求。

Our portfolio spans services for those with needs ranging from texting or having a video visit with a therapist for conditions such as anxiety and depression, to psychiatric treatment and medication management, to those needing a full expert review and navigation of the health care system to get them back on their feet.

我們的產品組合涵蓋的服務範圍從發短信或與治療師進行視頻訪問以應對焦慮和抑鬱等疾病，到精神科治療和藥物管理，再到需要全面專家審查和醫療保健系統導航以獲得他們重新站起來。

The level of conversation amongst buyers and consumers alike has never been higher or with a greater sense of urgency, and I remain confident we will continue to see strong growth for the foreseeable future.

買家和消費者之間的對話水平從未如此之高或緊迫感更強，我仍然相信，在可預見的未來，我們將繼續看到強勁的增長。

Continuing on the topic of clinical specialty innovation.

繼續臨床專業創新的話題。

In the third quarter, we launched Teladoc Medical Experts in the U.S. market, onboarding more than 100,000 employees from UPS and Nationwide Insurance.

第三季度，我們在美國市場推出了 Teladoc Medical Experts，為 UPS 和 Nationwide Insurance 的 100,000 多名員工入職。

Leveraging the best-of-breed insights and capabilities from our Advanced Medical and Best Doctors acquisitions into one single experience, the Teladoc Medical Expert service creates a virtual Center of Excellence for individuals grappling with the challenges of complex physical and mental conditions.

Teladoc Medical Expert 服務利用我們從 Advanced Medical 和 Best Doctors 收購中獲得的最佳洞察力和能力，為應對複雜身心條件挑戰的個人創建了一個虛擬卓越中心。

With this unique service, a doctor works with individuals right from the start to get timely answers regarding accurate diagnoses and treatment plans regardless of their geographic location.

借助這項獨特的服務，醫生從一開始就與個人合作，以便及時獲得有關準確診斷和治療計劃的答案，無論其地理位置如何。

The Teladoc physicians are also equipped to help people navigate seamlessly across both the virtual and in-person health care landscape based on their individual needs and preferences, leveraging Teladoc Health's proprietary analytics-driven physician database to make smart referrals into preferred health plan and Center of Excellence networks.

Teladoc 醫生還具備幫助人們根據個人需求和偏好在虛擬和麵對面醫療保健領域無縫導航的能力，利用 Teladoc Health 專有的分析驅動的醫生數據庫，將智能轉診到首選的健康計劃和中心卓越網絡。

Turning to the selling season.

轉向銷售旺季。

We see continued strong momentum, both in terms of net new clients and expansion of existing relationships.

在淨新客戶和現有關係的擴展方面，我們看到了持續的強勁勢頭。

As we close the year and enter 2020, our deal flow, RFPs and pipeline all remain strong across the full breadth of our diversified distribution channels.

隨著我們結束這一年並進入 2020 年，我們的交易流、RFP 和管道在我們多元化的分銷渠道的全部範圍內都保持強勁。

One highlight this quarter is our momentum in the U.K. Our relationship with AIG Life is a great example of successfully leveraging our comprehensive integrated portfolio to realize 3 of our core growth pillars: driving new innovation across the market, selling our integrated suite of services and expanding the population.

本季度的一個亮點是我們在英國的發展勢頭。我們與 AIG Life 的關係是成功利用我們全面的綜合投資組合實現我們的 3 個核心增長支柱的一個很好的例子：推動整個市場的新創新、銷售我們的綜合服務套件和擴大人口。

Foundational to AIG expansion was Teladoc Health's successful registration with the Care Quality Commission, the independent regulator of health and social care in England.

AIG 擴張的基礎是 Teladoc Health 在護理質量委員會（英國健康和社會護理的獨立監管機構）的成功註冊。

I'm proud of our team in the U.K. for earning this important stamp of approval as it paves the way for accelerated growth in this key European market.

我為我們在英國的團隊贏得了這一重要的認可印章而感到自豪，因為它為這個關鍵的歐洲市場的加速增長鋪平了道路。

Turning to Medicare Advantage.

轉向醫療保險優勢。

Client interest continues to grow with both existing and new health plan partners.

客戶對現有和新的健康計劃合作夥伴的興趣持續增長。

We're seeing early evidence of success with several wins, including an agreement with one of our largest and most significant Blues partners for their full Medicare Advantage population as well as with 5 other plans.

我們看到了一些成功的早期證據，包括與我們最大和最重要的 Blues 合作夥伴之一就他們的全部 Medicare Advantage 人口以及其他 5 個計劃達成協議。

The pipeline of additional opportunities remains robust and are optimistic about the revenue impact that this initiative will have over the next 18 to 24 months.

額外機會的管道仍然強勁，並且對該計劃將在未來 18 至 24 個月內產生的收入影響持樂觀態度。

And with that, I'll turn the call over to Mala for a review of the third quarter financial results.

有了這個，我將把電話轉給馬拉，以審查第三季度的財務業績。

Thank you, Jason, and good afternoon, everyone.

謝謝你，傑森，大家下午好。

It's good to be here today to talk about our third quarter results, which reflects the momentum you're seeing across numerous facets of our business and is a continuation of our track record of delivering strong performance and results.

今天很高興來到這裡談論我們的第三季度業績，這反映了您在我們業務的許多方面看到的勢頭，並且是我們提供強勁業績和業績的記錄的延續。

As I go through the discussion of the quarter, it bears reminding that this is the first quarter this year where our growth versus prior year is entirely organic but for the small impact of the M�decinDirect acquisition to our financials.

在我討論本季度時，值得提醒的是，這是今年第一季度，我們的增長與去年相比完全是有機的，但收購 M�decinDirect 對我們的財務影響很小。

Total revenue increased 24% to $138 million for the third quarter as compared to a year ago.

第三季度總收入同比增長 24% 至 1.38 億美元。

As we continue to see a stronger U.S. dollar relative to last year against most major currencies in which we operate, our FX-adjusted revenue growth was approximately 80 basis points above our reported revenue growth.

由於我們繼續看到美元兌去年我們經營的大多數主要貨幣走強，我們的外匯調整後收入增長比我們報告的收入增長高出約 80 個基點。

Now as you know, FX rates tend to fluctuate over time, and we could see FX rates go in the other direction in future quarters.

如您所知，外匯匯率往往會隨著時間的推移而波動，我們可以看到外匯匯率在未來幾個季度朝另一個方向發展。

Let's look at some details of this performance.

讓我們來看看這場演出的一些細節。

I will start with the U.S. paid membership and individuals with visit-fee-only access.

我將從美國付費會員和僅訪問費的個人開始。

As Jason noted in his remarks, U.S. paid membership grew this quarter to 35 million members, up 55% compared to a year ago, as we further scaled our member base by onboarding new clients and expanding existing clients on our platform.

正如 Jason 在講話中指出的那樣，美國付費會員本季度增長至 3500 萬會員，比一年前增長 55%，因為我們通過在我們的平台上招募新客戶和擴大現有客戶進一步擴大了我們的會員基礎。

Membership growth in the quarter included the continued onboarding of a large health plan as well as approximately 1/3 of 15 million members in the commercial population of UnitedHealthcare.

本季度的會員增長包括一項大型健康計劃的持續加入，以及 UnitedHealthcare 商業人口中約 1500 萬會員的 1/3。

As a reminder, the U.S. paid membership does not include individuals with visit-fee-only access.

提醒一下，美國付費會員不包括僅訪問費的個人。

Our U.S. paid membership has expanded sequentially in 14 of the last 15 quarters and reflects our entrenched distribution across several channels.

在過去的 15 個季度中，有 14 個季度的美國付費會員數量連續增長，這反映了我們在多個渠道中根深蒂固的分佈。

Individuals with visit-fee-only access increased to 19 million at the end of the quarter, up from approximately 10 million from the previous quarter and reflecting approximately 2/3 of the 15 million members in the commercial population of UnitedHealthcare.

在本季度末，僅付費訪問的個人增加到 1900 萬，高於上一季度的約 1000 萬，約佔 UnitedHealthcare 商業人口 1500 萬成員的 2/3。

Turning to visits.

轉向訪問。

We had an excellent quarter with respect to visit volume with 928,000 visits, an increase of 45% compared to a year ago.

就訪問量而言，我們有一個出色的季度，訪問量達到 928,000 次，與一年前相比增長了 45%。

Our press release highlights the details of visit volume during the quarter.

我們的新聞稿重點介紹了本季度訪問量的詳細信息。

Visit volume from paid members in the U.S. grew 42% to 622,000, which represents an annualized utilization rate of 8%, a 17 basis point increase over last year's third quarter.

美國付費會員的訪問量增長 42% 至 622,000 人次，年化利用率為 8%，比去年第三季度增加 17 個基點。

The utilization rate in the quarter expanded even with the substantial increase in the population of U.S. paid members versus last year.

即使美國付費會員人數與去年相比大幅增加，本季度的使用率也有所增加。

Our leadership in the area of mental health drove visit growth of over 50% in the quarter.

我們在心理健康領域的領先地位推動本季度訪問量增長超過 50%。

The final point I'd like to highlight is that the growth in visits from new registrations is accelerating sequentially and year-over-year as we engage with members and drive adoption.

我想強調的最後一點是，隨著我們與會員互動並推動採用，新註冊訪問量的增長正在逐年加速。

Driving our overall revenue growth in the quarter of 24% was revenue from global subscription access fees of $119.1 million, which accounted for 86% of our total revenue in the quarter and increased 23% compared to a year ago.

推動我們在本季度 24% 的整體收入增長的是來自全球訂閱訪問費的收入 1.191 億美元，占我們本季度總收入的 86%，與一年前相比增長了 23%。

Additionally, U.S. subscription access fee revenue of $92.1 million continues to represent about 3/4 of global subscription revenue while international subscription revenue of $27 million accounts for the balance.

此外，美國 9210 萬美元的訂閱訪問費收入繼續佔全球訂閱收入的 3/4 左右，而國際訂閱收入為 2700 萬美元，佔其餘部分。

We saw the PMPM this quarter decrease, as expected, to $0.98 from $1.08 a year ago and from $1.06 last quarter.

正如預期的那樣，我們看到本季度的 PMPM 從一年前的 1.08 美元和上一季度的 1.06 美元降至 0.98 美元。

As we've previously indicated, we typically experience a dampening effect on PMPM when we onboard large new health plan member populations.

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。

Visit fee revenue for the quarter increased to $18.8 million, representing growth of 31% compared to the prior year and constituted the remaining 14% of global revenue.

本季度參觀費收入增至 1880 萬美元，同比增長 31%，佔全球收入的 14%。

U.S. paid membership visits generated $14.1 million in the quarter, a 25% increase over the third quarter of 2018.

本季度美國付費會員訪問產生了 1410 萬美元，比 2018 年第三季度增長 25%。

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。

Visit-fee-only access revenue of $4.3 million comprised the remainder of visit fee revenue and grew 72% in the quarter.

僅訪問費收入為 430 萬美元，佔訪問費收入的其餘部分，在本季度增長了 72%。

Gross margin percentage for the quarter was in line with our expectations at 69% and consistent when compared to the 69.2% in the third quarter of last year.

本季度的毛利率百分比與我們預期的 69% 一致，與去年第三季度的 69.2% 相比保持一致。

The year-over-year consistency in gross margin percentage reflects strength in our diverse product portfolio as well as our disciplined, predictable pricing approach as we continue to gain new clients and members.

毛利率的同比一致性反映了我們多樣化產品組合的實力，以及我們在不斷獲得新客戶和成員時嚴格、可預測的定價方法。

In terms of gross margin dollars, we generated $95.2 million in the third quarter compared to $76.8 million a year ago, representing a 24% increase and in line with the aforementioned revenue increase.

就毛利率而言，我們在第三季度創造了 9520 萬美元，而去年同期為 7680 萬美元，增長了 24%，與上述收入增長一致。

Turning to expenses.

轉向開支。

Operating expense in the quarter totaled $115.1 million, an increase of 24% from the $92.6 million in third quarter of last year.

本季度運營費用總計 1.151 億美元，比去年第三季度的 9260 萬美元增長 24%。

And noncash charges such as depreciation and amortization, stock compensation, as well as onetime acquisition-related costs are eliminated.

折舊和攤銷、股票補償以及一次性購置相關成本等非現金費用也被消除。

Adjusted operating expenses are $86.1 million or 62% of total revenue compared to $70.5 million or 64% of third quarter 2018 revenue.

調整後的運營費用為 8610 萬美元，佔總收入的 62%，而 2018 年第三季度收入為 7050 萬美元，佔總收入的 64%。

The leverage in our adjusted operating expense includes year-over-year increases in advertising and marketing investments to support the onboarding of some of our recently added member populations as well as engagement and acquisition activities.

我們調整後的運營費用的槓桿作用包括廣告和營銷投資的同比增長，以支持我們最近增加的一些會員群體的入職以及參與和收購活動。

Concluding my commentary of the income statement.

結束我對損益表的評論。

Our net loss in the quarter was $20.3 million compared to a loss of $23.3 million last year.

我們本季度的淨虧損為 2030 萬美元，而去年的虧損為 2330 萬美元。

The lower net loss included a onetime noncash tax benefit of approximately $8.1 million or $0.11 per share, reflecting planning associated with our global tax strategy.

較低的淨虧損包括約 810 萬美元或每股 0.11 美元的一次性非現金稅收優惠，反映了與我們的全球稅收戰略相關的計劃。

On a per-share basis, our net loss was $0.28 for the third quarter of 2019 compared to $0.34 in the prior year.

按每股計算，我們 2019 年第三季度的淨虧損為 0.28 美元，而去年同期為 0.34 美元。

Moving to the adjusted EBITDA and EBITDA.

轉向調整後的 EBITDA 和 EBITDA。

Adjusted EBITDA increased to a positive $9 million for the quarter, which compares favorably to the adjusted EBITDA of $6.3 million from last year's third quarter, reflecting our revenue growth, gross margin performance and ability to generate improved operating leverage.

本季度調整後的 EBITDA 增至正 900 萬美元，與去年第三季度的 630 萬美元的調整後 EBITDA 相比是有利的，這反映了我們的收入增長、毛利率表現和提高經營槓桿的能力。

EBITDA was a loss of $10.3 million for the third quarter of 2019 as compared to a loss of $6 million for the same period last year.

2019 年第三季度 EBITDA 虧損 1030 萬美元，而去年同期虧損 600 萬美元。

Turning to the balance sheet.

轉向資產負債表。

We ended the quarter with $490.9 million in cash, cash equivalents and short-term investments.

我們在本季度結束時擁有 4.909 億美元的現金、現金等價物和短期投資。

Sequentially, our cash balances have improved by roughly $18 million, which is largely reflective of our year-to-date positive cash flows from operations of over $10 million and reinforces our confidence to deliver positive cash flow for the full year.

隨後，我們的現金餘額增加了大約 1800 萬美元，這在很大程度上反映了我們年初至今超過 1000 萬美元的經營活動產生的正現金流，並增強了我們全年實現正現金流的信心。

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

截至 2019 年 9 月 30 日，我們的總債務為 5.625 億美元，其中包括我們的 2 次可轉換票據發行：2.75 億美元 3% 可轉換票據於 2022 年底到期，2.875 億美元 1 3/8 百分比票據於 2022 年到期2025 年。

In terms of our expectations for the full year and the fourth quarter, here is the guidance for the full year 2019.

就我們對全年和第四季度的預期而言，這裡是對 2019 年全年的指導。

We are increasing revenue guidance to be between $546 million and $550 million.

我們將收入指導提高到 5.46 億美元至 5.5 億美元之間。

The increase in guidance is a reflection of our strong performance throughout the year, both on subscription and visit revenue as well as better visibility into the ramp of recently onboarded member population.

指引的增加反映了我們全年在訂閱和訪問收入方面的強勁表現，以及更好地了解最近加入的會員人數的增長。

We are tightening the guidance for EBITDA and adjusted EBITDA as follows: an EBITDA loss between $45 million and $41 million, adjusted EBITDA between positive $28 million and positive $32 million.

我們正在收緊對 EBITDA 和調整後 EBITDA 的指導，具體如下：EBITDA 虧損在 4500 萬美元至 4100 萬美元之間，調整後 EBITDA 在正 2800 萬美元至正 3200 萬美元之間。

We expect total U.S. paid membership of approximately 35 million members and visit-fee-only access to be available to approximately 19 million individuals.

我們預計美國的付費會員總數約為 3500 萬，大約 1900 萬個人可以使用僅付費訪問。

We expect total visits between 3.9 million and 4.1 million visits.

我們預計總訪問量在 390 萬到 410 萬之間。

Net loss per share to be between a negative $1.49 to negative $1.43 per share based on 71.9 million weighted average shares outstanding.

根據 7,190 萬股加權平均流通股，每股淨虧損介於負 1.49 美元至負 1.43 美元之間。

And as we've said before, we expect to continue to be operating cash flow positive and have achieved that as of September 30, 2019.

正如我們之前所說，我們預計將繼續保持正運營現金流，並在 2019 年 9 月 30 日實現這一目標。

For the fourth quarter of 2019, we expect total revenue to be between $149 million to $153 million, an EBITDA loss to be between negative $9 million to negative $5 million, adjusted EBITDA to be between positive $11.5 million to positive $15.5 million, total U.S. paid membership to be approximately 35 million and visit-fee-only access to be available to approximately 19 million individuals.

對於 2019 年第四季度，我們預計總收入將在 1.49 億美元至 1.53 億美元之間，EBITDA 損失將在負 900 萬美元至負 500 萬美元之間，調整後 EBITDA 將在正 1150 萬美元至正 1550 萬美元之間，美國支付總額會員人數約為 3500 萬，大約 1900 萬個人可以使用僅付費訪問。

We expect total visits to be between 1 million and 1.2 million and net loss per share to be between negative $0.37 and negative $0.31 per share based on 72.5 million weighted average shares outstanding.

我們預計總訪問量將在 100 萬至 120 萬之間，基於 7250 萬股加權平均流通股，每股淨虧損將在負 0.37 美元至負 0.31 美元之間。

In concluding my remarks, I am pleased with our financial results, and I'm confident in our future ability to deliver consistent revenue growth performance as we scale while we continue to strategically invest in the business to enable our longer-term success.

在結束我的發言時，我對我們的財務業績感到滿意，並且我對我們未來能夠在我們擴大規模的同時實現持續的收入增長表現充滿信心，同時我們繼續對業務進行戰略投資以實現我們的長期成功。

One final point which relates to our Investor Relations team here at Teladoc Health.

最後一點與 Teladoc Health 的投資者關係團隊有關。

I'd like to welcome our new Vice President of Investor Relations, Patrick Feeley.

我要歡迎我們新任投資者關係副總裁 Patrick Feeley。

Patrick has a highly successful track record as an equity research analyst focused on health care services, with stints at various banks, most recently at Barclays.

作為專注於醫療保健服務的股票研究分析師，Patrick 有著非常成功的業績記錄，曾在多家銀行任職，最近在巴克萊銀行任職。

He will start his role at Teladoc Health on November 4. I know I speak for the entire Teladoc Health team when I say we are very pleased to have Patrick join the company, and I look forward to his leadership and contributions to our growth.

他將於 11 月 4 日開始在 Teladoc Health 任職。當我說我們很高興 Patrick 加入公司時，我知道我代表整個 Teladoc Health 團隊發言，我期待他的領導和對我們發展的貢獻。

With that, let me turn the call back to Jason for his closing remarks.

有了這個，讓我把電話轉回傑森的閉幕詞。

Thanks, Mala.

謝謝，馬拉。

I'm pleased with our momentum across the full breadth of our business, and I'm deeply appreciative of the hard work and commitment from our team members who underpin our success.

我對我們在整個業務領域的發展勢頭感到滿意，我對支持我們成功的團隊成員的辛勤工作和承諾深表感謝。

I'm also pleased with how we have evolved our leadership team structure to support the growth, scale and diversification of our business going forward.

我也很高興我們如何發展我們的領導團隊結構，以支持我們未來業務的增長、規模和多元化。

With this new structure in place, Peter McClennen has decided to transition out of the company at the turn of the year.

有了這個新結構，Peter McClennen 決定在年底離開公司。

Having joined Teladoc Health as the CEO of Best Doctors, over the past 2.5 years, Peter has played a pivotal role in shaping the integration of our offerings, teams and go-to-market strategies.

在過去的 2.5 年裡，作為 Best Doctors 的首席執行官加入 Teladoc Health，Peter 在塑造我們的產品、團隊和上市戰略的整合方面發揮了關鍵作用。

I'd like to thank Peter personally and on behalf of the entire Teladoc Health team for his contributions to the business and his passion for the mission.

我要代表整個 Teladoc Health 團隊親自感謝 Peter，感謝他對業務的貢獻和對使命的熱情。

I often speak about our many strategic differentiators: scale of global distribution, membership engagement, clinical quality and our network effect.

我經常談到我們的許多戰略差異化因素：全球分銷規模、會員參與度、臨床質量和我們的網絡效應。

We see these come to life as our clients increasingly embrace the growing strategic and economic value that Teladoc Health's unique offering can provide.

隨著我們的客戶越來越多地接受 Teladoc Health 獨特的產品可以提供的不斷增長的戰略和經濟價值，我們看到這些都成為現實。

It's gratifying to know that consumers also know the difference, ranking Teladoc highest in overall satisfaction as well as first in customer service, according to the first-ever J.D. Power Telehealth Satisfaction study, which was released earlier this week.

根據本週早些時候發布的首次 J.D. Power Telehealth Satisfaction 研究，消費者也知道其中的區別，Teladoc 在整體滿意度和客戶服務方面排名最高，這令人欣慰。

Looking to the fourth quarter and the full year.

展望第四季度和全年。

We remain confident in our ability to deliver on our improved expectations as we lean on the broad-based strength of the business.

由於我們依靠業務的廣泛實力，我們仍然有能力實現我們改善的預期。

We're also turning our attention to specific plans for the coming year.

我們還將注意力轉向來年的具體計劃。

We look forward to meeting with you at our 2020 Investor Day, which we are planning to host in March.

我們期待在計劃於 3 月舉辦的 2020 年投資者日與您見面。

As always, thank you all for your continued interest in the Teladoc Health story.

一如既往，感謝大家對 Teladoc Health 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) Your first question comes from Lisa Gill with JPMorgan.

（操作員說明）您的第一個問題來自摩根大通的 Lisa Gill。

Jason, you know I have to ask this question, and I know you talked a little bit about the selling season saying that both deal and RFPs were strong, but can you just give us a little more color around 2 things?

傑森，你知道我必須問這個問題，而且我知道你談到了銷售季節，說交易和 RFP 都很強勁，但你能不能給我們多一點關於兩件事的色彩？

One, you talked about expanding relationships.

一，你談到了擴大關係。

Can you just give us any numbers around where people are expanding?

你能告訴我們人們在哪裡擴張的任何數字嗎？

What they're adding to the relationship?

他們在關係中增加了什麼？

Is it that it's health plans, and they're adding more lives?

是健康計劃，他們正在增加更多的生命嗎？

Is it employer/customers that are adding more clinical services across the platform, I guess, for either of the customer base?

我猜，是雇主/客戶在平台上為任何一個客戶群添加更多臨床服務嗎？

And then as you think about that RFP activity as being strong, how do we think about that year-over-year as we go into 2020?

然後，當您認為 RFP 活動很強大時，我們如何看待進入 2020 年的同比情況？

No surprise, Lisa.

毫不奇怪，麗莎。

I'd be disappointed if you didn't ask.

如果你不問，我會很失望。

Yes, so there's no question the selling season has been incredibly strong, and it's been -- that has been the case across multiple of our selling channels.

是的，所以毫無疑問，銷售旺季非常強勁，而且我們的多個銷售渠道都是如此。

In particular, we've had a great year in the health plan space.

特別是，我們在健康計劃領域度過了美好的一年。

International growth has been good.

國際增長一直很好。

Our hospital and health system client base continues to grow at a very rapid rate.

我們的醫院和衛生系統客戶群繼續以非常快的速度增長。

And I think I can give you a little bit more insight.

我想我可以給你更多的見解。

As we look at RFP volume, it's probably up about 25% year-to-date over last year.

當我們查看 RFP 數量時，今年迄今可能比去年增長了約 25%。

Our bookings are up probably 30% over last year.

我們的預訂量可能比去年增加了 30%。

Deal size is up, so both in terms of average deal size as well as median deal size, which, of course, the median takes out the outliers on the large side.

交易規模增加了，因此無論是平均交易規模還是交易規模中位數，當然，中位數都會排除較大的異常值。

And very importantly, and I think you -- this is part of your question, our multiproduct growth has been a strong contributor to our bookings.

非常重要的是，我認為你 - 這是你問題的一部分，我們的多產品增長一直是我們預訂的重要貢獻者。

So when I talk about multiproduct, that means we're selling multiple products into a new client or we're selling additional products into an existing client.

因此，當我談到多產品時，這意味著我們正在向新客戶銷售多種產品，或者我們正在向現有客戶銷售其他產品。

And multiproduct bookings have represented about half of our bookings year-to-date worldwide.

今年迄今為止，多產品預訂占我們全球預訂的一半左右。

So I think that's really a testament to the breadth of our product portfolio and our strategy of increasing our clinical services to become a holistic virtual care solution for our clients.

因此，我認為這確實證明了我們產品組合的廣度以及我們增加臨床服務以成為客戶的整體虛擬護理解決方案的戰略。

Yes.

是的。

And as we think about the multiproduct booking that you just talked about, about half of them this year.

當我們考慮你剛才談到的多產品預訂時，今年大約有一半。

Just kind of to put that in perspective versus last year, I mean, we're -- as Mala said, this is the first quarter where virtually everything is organic.

與去年相比，我的意思是，我們是 - 正如馬拉所說，這是第一季度幾乎所有東西都是有機的。

So you've had the product offering out there, and now this is kind of the second year of having that full product offering.

所以你已經提供了產品，現在這是提供完整產品的第二年。

How do we compare that year-over-year as far as what people are buying into?

我們如何比較人們購買的產品？

Yes.

是的。

It's up significantly relative to last year as a percentage of our bookings.

與去年相比，它占我們預訂量的百分比顯著上升。

So as I said, it's about half of our bookings this year are multiproduct sales, and that's up significantly as a proportion of our bookings at this time last year.

所以正如我所說，今年我們大約有一半的預訂是多產品銷售，而這在去年這個時候占我們預訂的比例顯著上升。

Okay.

好的。

Great.

偉大的。

And then just my last question, and I know it's early to think about 2020, but when we were together in September, you talked about your confidence in the longer-term revenue growth of this company being between 20% and 30%.

然後是我的最後一個問題，我知道現在考慮 2020 年還為時過早，但是當我們在 9 月份聚在一起時，你談到了你對這家公司的長期收入增長在 20% 到 30% 之間的信心。

Is that still a number that you feel confident based on what you've seen to date for new business wins as well as expansion going into 2020?

根據您迄今為止所看到的新業務勝利以及進入 2020 年的擴張，這仍然是一個您有信心的數字嗎？

Absolutely.

絕對地。

I still feel very good about 20% to 30% for the foreseeable future as our top line growth.

在可預見的未來，20% 到 30% 作為我們的收入增長，我仍然感覺非常好。

Mala, I don't know if there's anything you want to add to that.

馬拉，我不知道你有什麼要補充的。

I'd say, I'd echo that.

我會說，我會附和。

I'd also remind you, the base is getting bigger every year.

我還要提醒你，基數每年都在變大。

We feel pretty confident about the initiatives we have in place.

我們對我們現有的舉措充滿信心。

You've seen the unprecedented membership expansion that we had this year.

你已經看到了我們今年前所未有的會員擴展。

Obviously, we will work to activate that, and that will have an impact on not just 2020 but our growth beyond that.

顯然，我們將努力激活它，這不僅會影響 2020 年，還會影響我們的增長。

So I would say, Lisa, we have all of the right initiatives and the right plans to invest to drive that growth.

所以我想說，麗莎，我們有所有正確的舉措和正確的投資計劃來推動這種增長。

Your next question comes from Jamie Stockton with Wells Fargo.

您的下一個問題來自富國銀行的 Jamie Stockton。

I guess, maybe the first one, just on the sales and marketing spend.

我想，也許是第一個，只是關於銷售和營銷支出。

I think maybe Mala mentioned that you guys obviously onboarded a lot of lives at United and you had another big, I think, health plan that you onboarded during the quarter, if I remember correctly from your comments last quarter.

我想也許馬拉提到你們顯然在曼聯加入了很多生命，如果我從你上個季度的評論中沒記錯的話，我認為你在本季度加入了另一個大的健康計劃。

Specifically with United, should we think about this big spend this quarter as being kind of the expense of getting those lives on board?

特別是對於曼聯，我們是否應該將本季度的這筆巨額支出視為讓這些人參與其中的代價？

Or will there probably be another kind of round of incremental spending that hits in Q1, more kind of in line with the normal benefit cycle for those individuals?

還是可能會在第一季度出現另一輪增量支出，更符合這些人的正常福利週期？

Yes.

是的。

Jamie, great question.

傑米，好問題。

I'd say it's both.

我會說兩者兼而有之。

I'd say, we -- as you can see from our financial results, we did invest in marketing spend this quarter.

我想說，我們——正如你從我們的財務業績中看到的那樣，我們確實在本季度投資了營銷支出。

I'd say for a couple of reasons.

我會說有幾個原因。

One is, as you noted, we have a huge membership expansion.

一個是，正如你所指出的，我們有一個巨大的成員擴展。

We did invest ahead of that so that we can put the right plans in place to activate those members.

我們確實在此之前進行了投資，以便我們可以製定正確的計劃來激活這些成員。

And we continue to invest efficiently in driving customer acquisition, so I would say that's the second.

我們繼續有效地投資於推動客戶獲取，所以我會說這是第二個。

And the third I would say is we are leaning into the cold and flu season that is upon us.

第三個我想說的是，我們正處於即將到來的感冒和流感季節。

I would say, though, you should expect to see additional marketing spend as we go into next year as we will continue to activate the new members.

不過，我想說的是，隨著我們將繼續激活新成員，您應該會在明年看到額外的營銷支出。

Okay.

好的。

That's great.

那太棒了。

And then maybe just one more.

然後也許只是一個。

It's got a lot of attention on the call last quarter, but from a timing standpoint, I think it might be more relevant now, the Aetna renewal.

上個季度的電話會議引起了很多關注，但從時間的角度來看，我認為現在可能更相關，即 Aetna 的更新。

Just any color on what's going on there or how that relationship sits would be great.

任何關於那裡發生的事情或這種關係如何坐下來的顏色都會很棒。

I would say no change to my comments from last quarter.

我會說我上個季度的評論沒有改變。

I feel very, very good about our relationship with Aetna and both sides of the house there, Aetna and CVS.

我對我們與 Aetna 以及兩家公司 Aetna 和 CVS 的關係感覺非常非常好。

CVS continues to roll out to more states.

CVS 繼續向更多州推出。

We're now at 39 states plus the District of Columbia with the CVS video visits rollout and very strong relationships with my expectation for continued product expansion with the Aetna population.

我們現在在 39 個州和哥倫比亞特區推出了 CVS 視頻訪問服務，並且與我對 Aetna 人口持續產品擴展的期望有著非常牢固的關係。

So I continue to expect Aetna to be a strong and great client for many years to come.

因此，我繼續期待 Aetna 在未來很多年成為一個強大而偉大的客戶。

Your next question comes from Stephanie Demko with Citi.

您的下一個問題來自花旗銀行的 Stephanie Demko。

Patrick, welcome to the team.

帕特里克，歡迎加入團隊。

So when I think about the levers to accelerate your revenue, utilization is always my biggest question mark.

因此，當我考慮提高收入的槓桿時，利用率始終是我最大的問號。

And with that in mind, I saw a very healthy jump in your advertising expense this quarter.

考慮到這一點，我看到本季度您的廣告費用出現了非常健康的增長。

Could you tell me a bit more about the drivers and any advertising measures we could be seeing soon coming out of Teladoc?

你能告訴我更多關於驅動程序和我們很快會從 Teladoc 看到的任何廣告措施嗎？

Yes.

是的。

So thanks for the question, Stephanie.

所以謝謝你的問題，斯蒂芬妮。

I think advertising spend falls into 2 main buckets for us.

我認為廣告支出對我們來說分為兩大類。

One is driving utilization, as you indicate.

正如您所指出的，一個是提高利用率。

And of course, as we onboard large populations, we spend to activate that population, drive utilization, drive first registrations and then utilization and visits.

當然，當我們加入大量人口時，我們會花錢激活這些人口，推動利用率，推動首次註冊，然後是利用率和訪問量。

That increases as we onboard large populations, and I think you see that reflected in the quarter.

隨著我們加入大量人口，這種情況會增加，我認為您會在本季度看到這一點。

The other part of it is in our direct-to-consumer business, where we're spending against customer acquisition.

另一部分是在我們的直接面向消費者的業務中，我們在該業務中用於獲取客戶。

We continue to get more efficient on both of those.

我們繼續在這兩個方面提高效率。

So we are relentless about measuring the yield that we get out of the spend on both of those channels.

因此，我們不遺餘力地衡量我們從這兩個渠道的支出中獲得的收益。

And we continue to see improvement in the yield that we get out of those.

我們繼續看到我們從中獲得的收益有所提高。

So reducing our customer acquisition costs on the direct-to-consumer side, increasing our yield of visits per dollar spent on the utilization side.

因此，降低了我們在直接面向消費者方面的客戶獲取成本，提高了我們在利用率方面花費的每美元的訪問量。

Yes.

是的。

And Stephanie, let me add a little bit of color.

還有斯蒂芬妮，讓我添加一點顏色。

Jason talked about the direct-to-consumer.

傑森談到了直接面向消費者。

We are always looking at our channel mix.

我們一直在關注我們的渠道組合。

We are looking at where we spend our marketing spend across the different channels in different times of the year because, as you probably know, different channels costs differently.

我們正在研究一年中不同時間跨不同渠道的營銷支出，因為您可能知道，不同渠道的成本不同。

So we are continuously sort of tweaking, changing and managing our channel mix.

因此，我們不斷地調整、改變和管理我們的渠道組合。

And then the second thing I would say is to the point that Jason talked about activating the members, we do measure and have metrics internally, where we are looking at our cost of acquisitions, cost for visits, et cetera.

然後我要說的第二件事是傑森談到激活會員，我們確實在內部衡量並製定了指標，我們正在查看我們的收購成本，訪問成本等等。

So we are measuring through the year on how we are doing against those.

因此，我們全年都在衡量我們在這些方面的表現。

And is there any way to quantify kind of how you are looking in the direct-to-consumer market?

有什麼方法可以量化您在直接面向消費者的市場中的看法？

If there are advertising channels you've exited or would not use going forward given the ROI?

如果考慮到投資回報率，您是否已經退出或不會使用的廣告渠道？

Yes.

是的。

Stephanie, we're constantly rebalancing the mix, depending on the campaigns that we have in the market, the yield that we get out of each one of the channels.

Stephanie，我們不斷地重新平衡組合，這取決於我們在市場上的活動，我們從每個渠道中獲得的收益。

So it may ebb and flow among various channels.

因此，它可能在各個渠道之間起起落落。

Sometimes, we light up new channels, and we find that they're particularly productive for us.

有時，我們打開新渠道，發現它們對我們特別有成效。

And we certainly have some of those.

我們當然有其中的一些。

But those are all pretty closely guarded components of how we manage the business.

但這些都是我們如何管理業務的非常嚴格的組成部分。

All right.

好的。

And one quick modeling one.

和一個快速建模一個。

When you guys bought Advanced Medical, there was a lot of signaling that the gross margins would be coming down in a pretty meaningful manner.

當你們購買 Advanced Medical 時，有很多跡象表明毛利率將以非常有意義的方式下降。

We haven't really seen that as much.

我們還沒有真正看到那麼多。

Is there anything to call out that you've been able to improve upon that model?

有什麼可以指出您已經能夠改進該模型的嗎？

Yes.

是的。

We're consistently working, and we have been since the acquisition, on improving the gross margins of the Advanced Medical business.

自收購以來，我們一直致力於提高先進醫療業務的毛利率。

We've seen progress on that, and we still see significant opportunity.

我們已經看到了這方面的進展，我們仍然看到了巨大的機會。

And I think you see that very well in the strong gross margins that we've been able to post this quarter and the past several quarters.

而且我認為您在我們本季度和過去幾個季度能夠發布的強勁毛利率中看到了這一點。

So the gross margin continues to fluctuate a little bit with seasonality.

因此，毛利率會隨著季節性因素繼續波動。

You should continue to expect that, but we're proud of what we've done so far, and we still see significant opportunity going forward.

你應該繼續期待這一點，但我們為迄今為止所做的事情感到自豪，我們仍然看到了巨大的機遇。

Is it safe to say that this is no longer a 65% margin mix that we were originally guided to?

可以肯定地說這不再是我們最初被引導的 65% 的利潤率組合嗎？

Well, I think we're not saying that we're never going to get to the mid-60s, which is where we sort of guided over the longer term.

好吧，我認為我們並不是說我們永遠不會到 60 年代中期，這是我們長期指導的地方。

We're just moderating the glide path to that.

我們只是在調整滑行路徑。

Your next question comes from Richard Close with Canaccord Genuity.

您的下一個問題來自與 Canaccord Genuity 的 Richard Close。

International-related questions here.

國際相關問題在這裡。

So on the paid visits revenue internationally, it declined 30%.

因此，在國際付費訪問收入方面，它下降了 30%。

I'm just curious what happened there.

我只是好奇那裡發生了什麼。

Was that just the FX maybe you were talking about?

那可能只是您在談論的FX嗎？

And then, I guess, bigger picture, how do you see the global opportunity developing?

然後，我想，從更大的角度來看，你如何看待全球機遇的發展？

You obviously highlighted some things here with AIG.

您顯然在這裡與 AIG 強調了一些事情。

I know last year on the third quarter call, I think you talked about AXA, Global Care.

我知道去年在第三季度的電話會議上，我想你談到了 AXA，Global Care。

I'm just curious how the international or global opportunity is playing out.

我只是好奇國際或全球機會如何發揮作用。

Yes.

是的。

So Richard, let me address the first question.

那麼理查德，讓我來談談第一個問題。

As you can see from the numbers, you're right, it is declining 30%.

從數字中可以看出，你是對的，它正在下降 30%。

It is literally the result of one particular client in Canada, where the case rate has gone down, and we are working very actively with the client to solve it.

這實際上是加拿大一位特定客戶的結果，那裡的案件率已經下降，我們正在與客戶非常積極地合作解決這個問題。

It's off of a very small base.

它的基礎非常小。

So as you can tell, it is not really overly impacting our overall growth.

如您所知，它並沒有真正過度影響我們的整體增長。

And then, Jason, the second question?

然後，傑森，第二個問題？

Yes.

是的。

I'm really excited, Richard, about the global opportunity.

理查德，我對全球機遇感到非常興奮。

I think AIG is the perfect example of what we're likely to see across our international markets, where we bring the full breadth of our clinical capabilities in order to increase the set of services we bring, the revenue and the population that we serve.

我認為 AIG 是我們可能在國際市場上看到的一個完美例子，我們在這些市場中發揮我們的全部臨床能力，以增加我們帶來的服務、收入和我們所服務的人口。

And we're running that play in multiple markets.

我們正在多個市場上運行這種遊戲。

I think AIG is the first of what I expect to be many to come.

我認為 AIG 是我期望的許多人中的第一個。

Your next question comes from Matthew Gillmor with Baird.

您的下一個問題來自 Matthew Gillmor 和 Baird。

I wanted to hit on the revenue guidance for 2019.

我想談談 2019 年的收入指引。

It looks like 3Q came in about $1 million or $2 million above Street, and you raised the full year '19 revenue by more like $5 million to $6 million.

看起來第三季度的收入比 Street 高出大約 100 萬美元或 200 萬美元，而你將 19 年全年的收入提高了 500 萬至 600 萬美元。

So I wanted to understand sort of what drove that increase and how that carries into 2020.

所以我想了解是什麼推動了這種增長，以及這種增長如何延續到 2020 年。

Was that sort of membership with new or existing clients or something else?

是新客戶或現有客戶的那種會員資格還是其他什麼？

Yes.

是的。

So the way to think about that is I'd characterize it in sort of 3 different ways.

所以考慮這個問題的方法是我會用 3 種不同的方式來描述它。

The first is, as you saw, we essentially delivered at the high end of our guidance for Q3, and so we are reflecting the flow-through of that to the full year.

首先，如您所見，我們基本上交付了第三季度指導的高端，因此我們正在反映全年的流動情況。

And then the second thing I would say is, as Jason referenced in his remarks, we are seeing great momentum across many facets of the business.

然後我要說的第二件事是，正如傑森在他的講話中提到的那樣，我們在業務的許多方面都看到了巨大的發展勢頭。

And he particularly highlighted mental health.

他特別強調了心理健康。

We are calling it mental health.

我們稱之為心理健康。

We have called it behavioral health in the past on past calls.

我們過去在過去的電話中稱其為行為健康。

So we are reflecting the momentum of that part of the business.

因此，我們正在反映這部分業務的發展勢頭。

And then I would say more broadly, we are seeing -- as you can see from our momentum, we are seeing really strong momentum on visits.

然後我會更廣泛地說，我們看到 - 正如你從我們的勢頭中看到的那樣，我們看到訪問的勢頭非常強勁。

So we are essentially factoring all of those into the guidance take-up this time.

因此，我們這次基本上將所有這些因素都納入了指導意見。

And Matt, I guess, I would just add that the third quarter results reflected some mid-quarter adds.

馬特，我想，我只想補充一點，第三季度的業績反映了一些季度中期的增長。

We were pretty public about the launch of United on September 1. So we only got 1 month of that in the third quarter, but obviously, we get a full 3 months of it in the fourth.

我們對 9 月 1 日聯合航空公司的推出非常公開。所以我們在第三季度只得到了 1 個月，但很明顯，我們在第四季度得到了整整 3 個月的時間。

So the run rate coming out of September is bigger than the average over the quarter.

因此，9 月份的運行率高於本季度的平均水平。

Yes.

是的。

Got it.

知道了。

That's helpful.

這很有幫助。

And then, Jason, I did want to get an update on Medicare Advantage.

然後，傑森，我確實想獲得有關 Medicare Advantage 的最新信息。

It sounds like the momentum there is really good.

聽起來那裡的勢頭非常好。

Can you share with us how that market's developed?

你能和我們分享一下這個市場是如何發展的嗎？

Are they contracting in a similar way to the traditional business?

他們是否以與傳統業務類似的方式簽訂合同？

And how are Medicare Advantage plans, these initial ones that are using telehealth looking to use it for their members?

Medicare Advantage 計劃如何，這些使用遠程醫療的初始計劃希望將其用於其成員？

Yes.

是的。

Very similar structure to our commercial membership.

與我們的商業會員非常相似的結構。

We're seeing PMPMs plus visit fees.

我們看到 PMPM 加上參觀費。

We've already rolled out some MA populations over the course of this year as we've expanded with some of our large clients.

隨著我們與一些大客戶的擴展，我們已經在今年推出了一些 MA 人群。

And as I pointed out, we have 6 already under contract and a robust pipeline still to come.

正如我所指出的，我們已經有 6 個合同簽訂了，還有一個強大的管道仍然存在。

So I would expect that market to develop.

所以我預計這個市場會發展。

As I've always said, I expect that to be sort of a 3-year development for that to fully flow through the entire MA population.

正如我一直說的那樣，我希望這將是一個 3 年的發展，以便完全流向整個 MA 人群。

Health plans never uniformly move en masse the first year that something is available.

健康計劃從不會在有東西可用的第一年統一移動。

And to be honest, we're still seeing some of the MA plans who are processing the new rules and figuring out exactly how they're going to put it into their plans.

老實說，我們仍然看到一些 MA 計劃正在處理新規則並弄清楚他們將如何將其納入他們的計劃中。

So we're actively engaged with our clients and prospects around how to do that.

因此，我們正在積極與我們的客戶和潛在客戶就如何做到這一點進行溝通。

In some cases, we're sort of educating them on the rules because we can be specialists in that part of the rule.

在某些情況下，我們會在某種程度上對他們進行規則教育，因為我們可以成為規則那部分的專家。

Your next question comes from Sam Weiland (sic) [Sean Weiland] with Piper Jaffray.

您的下一個問題來自 Sam Weiland (sic) [Sean Weiland] 和 Piper Jaffray。

It's Sean.

是肖恩。

I think your -- the growth in members is probably masking an underlying growth trend in utilization, and I was wondering if you could speak to that and help us understand what the true growth of utilization is maybe in terms of the members that were paid members of last year this time.

我認為您的 - 會員的增長可能掩蓋了使用率的潛在增長趨勢，我想知道您是否可以談談並幫助我們了解使用率的真正增長可能是付費會員去年的這個時候。

What does that growth in utilization look like?

利用率的增長是什麼樣的？

Yes.

是的。

So the way I would think about it, Sean, is we talked about us being at an 8% utilization rate for the quarter.

因此，肖恩，我的想法是，我們談到本季度的利用率為 8%。

If we were to "normalize it," if you will, for the extra population that we added on, it's -- think of it about 50 basis points higher approximately for the quarter.

如果我們要“正常化”，如果你願意的話，對於我們增加的額外人口，它是 - 想想本季度大約高出 50 個基點。

So that 50 basis points, that's not an annualized 50 basis points?

那麼50個基點，這不是年化的50個基點嗎？

That's for the quarter?

是這個季度的嗎？

No.

不。

Sorry.

對不起。

It's -- think of it on an annualized basis to be 50 basis points higher...

它是——按年計算要高出 50 個基點……

Within the quarter?

季度內？

Within the quarter.

季度內。

Within the quarter.

季度內。

Okay.

好的。

Got it.

知道了。

That's helpful.

這很有幫助。

And then in terms of your guidance, a bump up on revenue, tightening the range on EBITDA.

然後就你的指導而言，收入的增加，收緊了 EBITDA 的範圍。

What is this trying to communicate to us in terms of the incremental profitability of these new adds?

就這些新增功能的增量盈利能力而言，這試圖向我們傳達什麼信息？

Yes, that's a great question.

是的，這是一個很好的問題。

So here's what I would say.

所以這就是我要說的。

First of all, just for context and a reminder, if you look at the midpoint of our EBITDA of the range that we have given, it's more than doubling the adjusted EBITDA from last year.

首先，僅出於上下文和提醒的目的，如果您查看我們給出的 EBITDA 範圍的中點，它是去年調整後 EBITDA 的兩倍多。

It's also -- in Q4, we are calling on a delivery for the fourth quarter that is roughly about equal to what we have delivered from an adjusted EBITDA through Q3.

這也是 - 在第四季度，我們要求第四季度的交付量大致等於我們從調整後的 EBITDA 到第三季度的交付量。

We feel very confident that we are able to -- that we see a clear line of sight to delivering that.

我們非常有信心，我們能夠——我們看到了實現這一目標的清晰視野。

And it is based on all of the same levers that we talked about in Q3, either revenue growth, the gross margin delivery that we expect in Q4.

它基於我們在第三季度討論的所有相同槓桿，無論是收入增長，還是我們預期第四季度的毛利率交付。

Now I will remind you the gross margin in Q4 is typically more muted from a seasonal perspective relative to the other quarters, and then the operating leverage that we hope to drive in Q4.

現在我要提醒您，從季節性的角度來看，與其他季度相比，第四季度的毛利率通常更為溫和，然後是我們希望在第四季度推動的運營槓桿。

So I would not say that we are trying to communicate anything different from what we have said before and from what our levers are to drive EBITDA -- adjusted EBITDA year-to-date.

因此，我不會說我們正在嘗試傳達與我們之前所說的內容以及我們推動 EBITDA 的槓桿 - 調整後的 EBITDA 年初至今的內容不同的任何內容。

Your next question comes from David Windley with Jefferies.

您的下一個問題來自 Jefferies 的 David Windley。

That's perfect.

那很完美。

Because I had a follow-up question to Sam's question.

因為我對 Sam 的問題有一個後續問題。

He doesn't seem like a Sam to me.

在我看來，他不像山姆。

The question -- Sean's question obviously -- the question that I have is around utilization.

這個問題——顯然是肖恩的問題——我的問題是關於利用率的。

And if the -- if you could share with us the range of utilization from your, obviously, very low for the most recently onboarded, I'm presuming, to what kind of levels are you achieving?

如果 - 如果您可以與我們分享您的利用率範圍，顯然，對於最近入職的人員來說非常低，我猜想，您達到了什麼樣的水平？

And what is characteristic of the highest achievement?

最高成就的特徵是什麼？

I think there was some mention in the prepared remarks about multiproduct clients, obviously, ones that have been on your platform for longer, but kind of interested in the profile of those.

我認為在準備好的關於多產品客戶的評論中提到了一些，顯然，那些已經在您的平台上存在更長時間的客戶，但對這些客戶的個人資料很感興趣。

And then as you've talked about advertising, what type of -- how important is it and what type of initiatives are you taking on to drive utilization towards those highest levels?

然後正如您談到的廣告，它是什麼類型的 - 它有多重要以及您正在採取哪些類型的舉措來推動利用率達到最高水平？

Sure.

當然。

Thanks, David.

謝謝，大衛。

We've talked about multiple times the fact that we have clients up in the 80% to 100% utilization range.

我們已經多次談到我們的客戶利用率在 80% 到 100% 範圍內的事實。

In fact, our own employee population is north of that.

事實上，我們自己的員工人數就在這個數字的北部。

Those tend to be employers where we have very close relationships and we can do direct communications, and we work hand-in-hand with the employer to promote the services.

那些往往是我們關係非常密切的雇主，我們可以進行直接溝通，我們與雇主攜手合作以推廣服務。

It also tends to be where we have a broad scope of our products and services in the population, those multiproduct implementations.

它也往往是我們在人群中擁有廣泛的產品和服務的地方，即多產品實施。

I can give you a couple of stats that sort of help to set the tone around why we feel confident about the continued growth of utilization.

我可以為您提供一些統計數據，這些數據有助於確定我們為何對利用率的持續增長充滿信心。

First, I would say, 50% of our -- of the growth in visits year-over-year are coming from new registrations.

首先，我想說，我們 50% 的訪問量同比增長來自新註冊。

So that's very, very strong for us because it keeps the flywheel moving, right?

所以這對我們來說非常非常強大，因為它使飛輪保持運動，對吧？

We continue to add more people into the mix.

我們繼續增加更多的人。

And having said that, about 60% of our total visits come from -- at least in the general medical population, come from existing users.

話雖如此，我們總訪問量的大約 60% 來自 - 至少在一般醫療人群中，來自現有用戶。

So we're adding more people in and we get repeat utilization.

所以我們增加了更多的人，我們得到了重複利用。

And so we're seeing increased visits per user.

因此，我們看到每位用戶的訪問量有所增加。

And then lastly, as you think about those new products and services that we bring to market, they frequently are stickier or create more visits per user.

最後，當您考慮我們推向市場的那些新產品和服務時，它們通常更具粘性或為每位用戶創造更多訪問量。

So in our mental health population, almost 80% of our mental health visits are from repeat users, meaning it's not their first visit, but rather it's a second or third or fourth or fifth visit in the cycle of their treatment.

因此，在我們的心理健康人群中，我們幾乎 80% 的心理健康訪問來自重複用戶，這意味著這不是他們的第一次訪問，而是他們治療週期中的第二次或第三次或第四次或第五次訪問。

And so you put all that together, we feel really good about the underlying model.

所以你把所有這些放在一起，我們對底層模型感覺非常好。

And then layering on top of it is our surround sound engagement model where we have a very, very strong data underpinning.

然後在它之上分層是我們的環繞聲參與模型，我們有非常非常強大的數據支持。

We apply data science against it to target where we're going to communicate in digital channels, in worksite channels in partnership with our clients in the home and increasingly, on a more generalized basis.

我們針對它應用數據科學來定位我們將在數字渠道、工作場所渠道與我們的客戶在家裡進行交流的目標，並且越來越多地在更普遍的基礎上進行交流。

Because now with over 50 million people who have access to the Teladoc platform, those more generalized lower-cost channels can be really effective for us.

因為現在有超過 5000 萬人可以訪問 Teladoc 平台，那些更通用的低成本渠道對我們來說真的很有效。

I appreciate that.

我很感激。

And my follow-up question is around trends in PMPM versus visit-fee-only.

我的後續問題是關於 PMPM 與僅訪問費的趨勢。

You mentioned in MA, in the answer on MA that you're seeing similar pursuit from the health plans with PMPM plus fee.

您在 MA 中提到，在 MA 的答案中，您從 PMPM 加費用的健康計劃中看到了類似的追求。

And the UNH was 1/3 PMPM of the total 15 million, I believe.

我相信，UNH 是 1500 萬總人口的 1/3 PMPM。

I guess I'm curious what your dialogue with health plans sounds like in terms of the interest in pursuing -- continuing to pursue PMPM models that I believe also helped to fund and contribute to your ability to grow that utilization.

我想我很好奇你與健康計劃的對話在追求的興趣方面聽起來是什麼樣的——繼續追求 PMPM 模型，我相信這也有助於資助和促進你提高利用率的能力。

Yes.

是的。

So that's exactly right.

所以這是完全正確的。

Your last phrase is exactly the right lever.

你的最後一句話是正確的槓桿。

We've proven our ability to drive higher utilization levels, and that is in the best interest of our clients.

我們已經證明了我們提高利用率水平的能力，這符合我們客戶的最大利益。

And they come to us, and we model out what we can drive for them and what we can save for them.

他們來找我們，我們模擬我們可以為他們駕駛什麼以及我們可以為他們節省什麼。

And they get a very, very strong ROI on a total spend, which includes both the visit fee and the subscription fee.

他們在總支出中獲得了非常非常高的投資回報率，其中包括訪問費和訂閱費。

We only have a handful of very, very large clients in that bucket of visit-fee-only.

我們只有少數非常非常大的客戶在那個只收參觀費的桶裡。

And so I would call those the exception, not the rule and really not a trend.

所以我會把這些稱為例外，而不是規則，也不是趨勢。

So it's interesting.

所以很有趣。

I was looking back at what our PMPM and membership was 4 years ago, the first quarter after we went public.

我回顧了 4 年前，即我們上市後的第一季度，我們的 PMPM 和會員資格。

And we had 12.6 million members and a $0.45 PMPM.

我們有 1260 萬會員和 0.45 美元的 PMPM。

So people have been asking whether the PMPM is sustainable and can continue to grow over time since we went public, and we've more than doubled it while we've gotten to the point of being now more than 50 million people who have access to the platform.

所以人們一直在問 PMPM 是否是可持續的，並且自我們上市以來能否隨著時間的推移繼續增長，而我們已經將它翻了一番多，而我們現在已經達到了超過 5000 萬人可以訪問的地步該平台。

So sorry, if I could turn that question around, and then I'll drop off.

很抱歉，如果我能把這個問題轉過來，然後我就下車了。

I promise.

我保證。

But to -- maybe to come at it the other way, what's the logic behind United not putting all 15 million members in PMPM?

但是——也許換個角度來看，美聯航不將所有 1500 萬會員都放在 PMPM 背後的邏輯是什麼？

Yes.

是的。

So I'm not going to comment on the specific negotiations and discussions with an individual client or put words in their mouth.

因此，我不會評論與個別客戶的具體談判和討論，也不會在他們嘴裡說什麼。

That would put me over my skis.

那會讓我超過我的滑雪板。

So with due respect, I'm probably going to pass on that.

因此，恕我直言，我可能會轉告這一點。

Your next question comes from Ryan Daniels with William Blair.

您的下一個問題來自 Ryan Daniels 和 William Blair。

This is Nick speaking out in for Ryan.

這是尼克為瑞恩說話。

I guess on this new product offering with the mental health combination, I was wondering why only limit that to the 100,000 members, I think it was?

我猜想在這個帶有心理健康組合的新產品上，我想知道為什麼只將其限制在 100,000 名成員之內，我認為是這樣嗎？

And then who exactly is receiving that benefit? .

那麼究竟是誰在獲得這種好處呢？ .

Yes.

是的。

So you're talking about Teladoc Medical Experts.

所以你說的是 Teladoc 醫學專家。

Thanks for the question.

謝謝你的問題。

Yes.

是的。

So we just sold it to our first 100,000 employee client -- or 2 clients with 100,000 employees.

所以我們只是把它賣給了我們的第一個 100,000 名員工的客戶——或 2 個擁有 100,000 名員工的客戶。

That was UPS and Nationwide Insurance.

那是 UPS 和 Nationwide Insurance。

This is really an enhanced combination of the expert medical services that were offered by Best Doctors, the expert medical services that were offered by Advanced Medical and the mental health Navigator that we stood up sort of at the -- roughly at the same time that we were doing the Best Doctors acquisition and putting them all together into a physician-led expert medical service that's really holistic and spans across medical and mental health and also spans across virtual care and physical -- the physical delivery system.

這實際上是 Best Doctors 提供的專家醫療服務、Advanced Medical 提供的專家醫療服務和我們在大約同時站起來的心理健康導航器的增強組合。正在進行 Best Doctors 的收購，並將它們全部整合到一個由醫生主導的專家醫療服務中，該服務非常全面，跨越醫療和心理健康，也跨越虛擬護理和物理——物理交付系統。

We're really excited about the prospects here.

我們對這裡的前景感到非常興奮。

We think this is not only going to be a very attractive product for clients but also make a big impact on the health of our members.

我們認為這不僅會成為對客戶非常有吸引力的產品，而且會對我們會員的健康產生重大影響。

And we see this as just the beginning of a big trend.

我們認為這只是一個大趨勢的開始。

And was this something that they came to you looking for?

這是他們來找你的東西嗎？

Or is that something that you offered to them, kind of like on your own side?

或者那是你提供給他們的東西，有點像你自己的東西？

It was a little bit of a combination of both.

這是兩者的結合。

Nationwide was an existing client, and we transitioned them on to this product and -- or we added it in really.

Nationwide 是一個現有的客戶，我們將他們轉移到這個產品上，並且 - 或者我們真的添加了它。

And UPS was going to market looking for a solution kind of like this, and we were able to meet their needs by pulling together all of our -- several of our assets into a single solution.

UPS 正在市場上尋找類似的解決方案，我們能夠通過將我們所有的 - 我們的幾個資產整合到一個解決方案中來滿足他們的需求。

We were already moving down this path anyway.

無論如何，我們已經在沿著這條道路前進。

So it was sort of a convergence of those.

所以這是一種融合。

Got you.

得到你。

And then kind of shifting gears a little bit, I've seen quite a bit of data regarding flu season and how it's supposed to be a pretty bad one here.

然後稍微換檔，我已經看到了很多關於流感季節的數據，以及這裡應該是一個非常糟糕的季節。

I was wondering if that's reflected at all in your guidance.

我想知道這是否反映在您的指導中。

And then if not, like, would that represent an upside, I guess, to where we're guiding it?

然後，如果不是，我想，這是否代表了我們正在引導的方向？

Yes.

是的。

So right now, the early indications that we are seeing, we are obviously monitoring it all the time.

所以現在，我們看到的早期跡象，顯然我們一直在監控它。

It's very, very early for us to take a call on how much worse or not it is relative to last year.

對我們來說，現在判斷它與去年相比是否更糟還為時過早。

So at this point in time, we have not made those specific assumptions of it being much worse than last year.

所以在這個時間點上，我們並沒有做出比去年更糟糕的具體假設。

It's too early to tell.

現在說還為時過早。

Your next question comes from Daniel Grosslight with SVB Leerink.

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

I just got a couple for you on the mental health side of the equation.

在等式的心理健康方面，我剛剛為您準備了一對。

So I think last quarter, you noted that you expect to see around 50% growth year-over-year on the mental health side, so about $90 million of mental health revenue for this year.

所以我認為上個季度，您指出您預計心理健康方面將同比增長約 50%，因此今年的心理健康收入約為 9000 萬美元。

Wondering how you're tracking to that $90 million guide.

想知道你是如何追踪那份價值 9000 萬美元的指南的。

And then you also noted that mental health RFPs were up around 200% year-over-year last quarter.

然後您還注意到，上個季度的心理健康 RFP 同比增長了約 200%。

Can you comment on the win rates you're seeing on those RFPs and what we can expect for growth rates in 2020?

您能否評論一下您在這些 RFP 上看到的勝率以及我們對 2020 年增長率的預期？

So let me address the first part, and then I'll turn it over to Jason.

所以讓我先談談第一部分，然後我會把它交給傑森。

We -- what we specifically said is that we expect the mental health business to grow over 50%, north of 50% this year.

我們——我們具體說的是，我們預計心理健康業務將增長 50% 以上，今年將超過 50%。

And so far, we feel pretty good about the momentum that we are seeing coming out of the business.

到目前為止，我們對我們看到的業務發展勢頭感到非常滿意。

I've talked about it, Jason talked about it, et cetera.

我談過，傑森談過，等等。

Jason?

傑森？

Yes.

是的。

On the RFP side, we don't generally release win rates within any part of our business.

在 RFP 方面，我們通常不會在我們業務的任何部分發布勝率。

Mental health falls into, in many cases, the multi-specialty or multiproduct RFPs.

在許多情況下，心理健康屬於多專業或多產品 RFP。

We're -- it's only -- it's rare that we're seeing just mental health RFP isolated.

我們 - 只是 - 我們很少看到孤立的心理健康 RFP。

More often, we're seeing a multiproduct RFP that includes mental health, and we tend to have a very good win rate in those RFPs because of the breadth of our product portfolio.

更常見的是，我們看到一個包含心理健康的多產品 RFP，由於我們產品組合的廣度，我們往往在這些 RFP 中獲得非常好的勝率。

Got it.

知道了。

And just in terms of growth rate, obviously, you're working off of a bigger base now.

就增長率而言，顯然，你現在正在一個更大的基礎上工作。

But how should we think about growth rate in that segment of the business, both DTC and the B2B side of it?

但是我們應該如何看待該業務領域的增長率，包括 DTC 和 B2B 方面？

So we won't comment on specific growth rates for parts of the business, specific parts of the business.

因此，我們不會評論部分業務、特定業務部分的具體增長率。

I think that is something based on the color we provided and the comments we've made.

我認為這是基於我們提供的顏色和我們所做的評論。

That is just something that you will have to sort of just factor in and reflect in your model.

這只是您必須考慮並反映在您的模型中的東西。

Next question comes from Matt Hewitt with Craig-Hallum Capital.

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

This is Lucas Baranowski on for Matt Hewitt.

這是馬特休伊特的盧卡斯巴拉諾夫斯基。

I guess my first one here, you've talked in the past about how your first go-live date in Canada was scheduled for Q3, and it sounds like that occurred.

我想我在這裡的第一個，你過去曾談到你在加拿大的第一個上線日期是如何安排在第三季度的，聽起來好像發生了。

So maybe you could just tell us what kind of traction you're seeing in Canada generally.

所以也許你可以告訴我們你在加拿大看到的一般情況是什麼樣的。

Yes.

是的。

Great receptivity in Canada to our new telemedicine offering there, which, of course, is in addition to our expert medical services, which were there already, and our mental health Navigator.

加拿大對我們在那裡的新遠程醫療產品的接受度很高，當然，這是我們已經存在的專業醫療服務以及我們的心理健康導航器的補充。

So that's another example of us continuing to expand the product portfolio.

這是我們繼續擴大產品組合的另一個例子。

Receptivity has been really good.

接受度真的很好。

We launched with a client, the Johnson Group, as our first client.

我們的第一個客戶是 Johnson Group。

And we're already seeing additional interest, and we're seeing good traction with that client.

而且我們已經看到了更多的興趣，並且我們看到了該客戶的良好牽引力。

Okay.

好的。

That's great to hear.

聽到這個消息我很高興。

And then, I guess, just with some of the noise around potential competition, I guess, we were just wondering what levers could you pull to maintain your margin profile if competition comes in and decides to compete on price?

然後，我想，只是圍繞潛在競爭的一些噪音，我想，我們只是想知道，如果競爭進入並決定在價格上競爭，你可以利用哪些槓桿來維持你的利潤狀況？

Well, I think there are a few things.

嗯，我認為有幾件事。

One is we have unmatched scale, right?

一是我們擁有無與倫比的規模，對吧？

And so scale gives us a competitive advantage with respect to cost and enables us to protect our margins.

因此，規模使我們在成本方面具有競爭優勢，並使我們能夠保護我們的利潤。

Two is the nature of our broad product portfolio enables us to not compete on a single product, but rather to compete as a full holistic virtual care solution.

二是我們廣泛的產品組合的性質使我們能夠不是在單一產品上競爭，而是作為一個完整的整體虛擬護理解決方案進行競爭。

And that is really a different offering.

這確實是一個不同的產品。

It's incredibly difficult to replicate the entire breadth of our product portfolio.

複製我們產品組合的整個廣度非常困難。

And as a result, we're in talking about an entirely different strategy than anyone else can in the market or a new entrant into the market.

因此，我們正在談論一種與市場上其他任何人或新進入市場的人完全不同的策略。

And the other thing I would also add is, we are really the only one who activates and drives membership engagement, and that really helps the returns for our clients.

我還要補充的另一件事是，我們確實是唯一激活和推動會員參與的人，這確實有助於為我們的客戶帶來回報。

And all of that allows us to not only drive to further scale, but also from a pricing perspective as we talk about extending relationships.

所有這一切使我們不僅能夠進一步擴大規模，而且在我們談論擴展關係時從定價的角度來看也是如此。

So it's all of the things that Jason talked about in his closing remarks on what are our strategic differentiators.

因此，傑森在結束語中談到了我們的戰略差異化因素。

Your next question comes from Charles Rhyee with Cowen.

您的下一個問題來自 Charles Rhyee 和 Cowen。

Just wanted to -- Jason, if I could just jump back to some of the earlier comments when we were talking about activating and engaging, obviously, the United population is coming on.

只是想--傑森，如果我能跳回到之前的一些評論，當我們談論激活和參與時，很明顯，曼聯的人口正在增加。

Are you guys able to bring all your engagement tools to bear when trying to reach out to this population?

在嘗試接觸這些人群時，你們是否能夠使用所有參與工具？

And is there any differences between how you can activate these members, whether they're between -- is there any difference if they're a visit-only member versus a U.S. paid member?

您如何激活這些會員之間是否有任何區別，無論它們是否介於兩者之間 - 如果他們是僅限訪問的會員與美國付費會員有什麼區別嗎？

So I won't get into the details of all of the tools that we're going to use, but what I will say is it's extraordinarily collaborative with the UHC team.

所以我不會詳細介紹我們將要使用的所有工具，但我要說的是它與 UHC 團隊非常協作。

Our marketing teams have been working together for months in launch planning, communication, collaboration using joint capabilities between the 2 organizations.

我們的營銷團隊幾個月來一直在利用兩個組織之間的聯合能力進行發布計劃、溝通和協作。

And so I feel really good about both the collaboration between the 2 organizations and the yield that we're going to get out of that -- those efforts.

因此，我對這兩個組織之間的合作以及我們從中獲得的收益感到非常好——這些努力。

Okay.

好的。

And maybe just on the visit-fee-only model, if we think about the modeling.

如果我們考慮建模，也許只是在僅訪問費模型上。

For visit-fee-only visits, when we think about the way we should model it, should we think about sort of the revenue per visit similar to more like the Aetna contract or at least the numbers that we were kind of told a few years back regarding that?

對於僅收取訪問費用的訪問，當我們考慮應該如何建模時，我們是否應該考慮類似於 Aetna 合同的每次訪問收入，或者至少是幾年前我們被告知的數字回來關於那個？

Or how should we think about that as we build out our models?

或者我們在構建模型時應該如何考慮這一點？

Yes.

是的。

So we have always said that our visit-fee-only population is not just Aetna.

所以我們一直說，我們只收參觀費的人群不只是安泰。

It is a mix of customers.

它是客戶的混合體。

And we obviously have been fairly public with the pricing we have with Aetna, but we have more than Aetna in our visit-fee-only population.

我們顯然已經相當公開了我們與 Aetna 的定價，但在我們只收取參觀費的人群中，我們擁有的不僅僅是 Aetna。

So what I would say to you is just think about that broader mix, look at our results from a visit revenue perspective and a visit count and growth that we have for VFO.

所以我要對你說的只是考慮更廣泛的組合，從訪問收入的角度來看我們的結果，以及我們對 VFO 的訪問次數和增長。

And you will be able to come to, from a modeling perspective, more of a weighted mix.

從建模的角度來看，您將能夠獲得更多的加權組合。

Okay.

好的。

Okay.

好的。

I think I understand what you're saying here.

我想我明白你在這裡說什麼。

If I could just squeeze one more in here about CVS.

如果我能在這裡再擠一點關於 CVS 的信息。

You talked about how that's ramping up, and we're now in 39 states.

你談到這是如何增加的，我們現在在 39 個州。

Can you talk about how this ramp-up works as well, since I would imagine you don't really reach this population directly?

你能談談這種增長是如何運作的嗎，因為我想你並沒有真正直接接觸到這個人群？

Is this really more incumbent on CVS to drive members that access their app or the website to the virtual service?

CVS 是否真的更有責任將訪問其應用程序或網站的成員推向虛擬服務？

And can you remind us how that's captured maybe in your visit numbers?

你能提醒我們這可能是如何在你的訪問數字中被捕捉到的嗎？

Or is it separate?

還是分開的？

So the answer to the first part of the question is yes, this is a private-labeled service where we power it with our technology.

所以問題第一部分的答案是肯定的，這是一項自有品牌的服務，我們用我們的技術為其提供動力。

We provide the clinical services.

我們提供臨床服務。

Although the agreement, as we've discussed before, does provide for the opportunity for their providers also to provide the clinical services, again using our technology.

儘管正如我們之前討論過的那樣，該協議確實為他們的供應商提供了同樣使用我們的技術提供臨床服務的機會。

But they are responsible for the marketing and engagement of their customers.

但他們負責客戶的營銷和參與。

And then with the second part of the question, we capture any visits that are on our platform in our visit volume.

然後對於問題的第二部分，我們在訪問量中捕獲我們平台上的任何訪問。

Would that be in the U.S. paid member volume?

那會在美國付費會員數量中嗎？

Or is that in visit-fee-only volume.

或者是只收參觀費的捲。

No.

不。

The -- by definition, there is not a membership and so it's in visit-fee-only.

- 根據定義，沒有會員資格，因此只收取訪問費。

It's in the visit-fee-only.

只收參觀費。

Your next question comes from Allen Lutz with Bank of America.

您的下一個問題來自美國銀行的 Allen Lutz。

The 4Q EBITDA range is pretty wide.

4Q EBITDA 範圍相當廣泛。

Can you talk about what gets you to both the top and bottom end of that range?

你能談談是什麼讓你達到了這個範圍的頂端和底端嗎？

So the way I would think about it is as follows.

所以我的想法如下。

You are -- look at the revenue growth rates, and I'd look at it both sequentially from Q3 and I would also look at it from a year-over-year perspective for Q4.

你是 - 看看收入增長率，我會從第三季度開始按順序查看，我也會從第四季度的同比角度來看。

So that's number one.

所以這是第一名。

The second thing I would say is we have definitely always in Q4, lower gross margins typically because of the greater mix of visits and visit revenue.

我要說的第二件事是，我們在第四季度肯定總是毛利率較低，這通常是因為訪問量和訪問收入的組合更大。

But again, like I said, we are very early in the flu season.

但是，就像我說的，我們正處於流感季節的早期。

At this point in time, I would stay with the midpoint.

在這個時間點上，我會留在中點。

But depending on that, that could change, whether you're at the bottom end or the top end, so that's the second thing.

但取決於這一點，這可能會改變，無論你是在底端還是頂端，所以這是第二件事。

And then the last thing I would say is we are definitely going to drive more leverage in the fourth quarter from an OpEx and a spending perspective.

然後我要說的最後一件事是，從運營支出和支出的角度來看，我們肯定會在第四季度提高槓桿率。

We will -- typically, as we have talked about marketing spend in Q3, we are pretty judicious about when we buy, how much we spend from a marketing perspective.

我們會——通常，正如我們在第三季度談到的營銷支出一樣，我們非常明智地決定何時購買，從營銷的角度來看我們花了多少錢。

So I do expect to drive leverage on that.

所以我確實希望在這方面發揮槓桿作用。

So I would say those are typically the factors that will drive us to either the bottom end or the top end of the range.

所以我想說，這些通常是驅使我們到達該範圍的底端或頂端的因素。

But I -- at this point in time, I wouldn't say there is any other extraneous set of factors other than those.

但是我 - 在這個時間點上，我不會說除了這些之外還有任何其他無關的因素。

That's helpful.

這很有幫助。

And then on BetterHelp, is revenue growing faster than advertising?

然後在 BetterHelp 上，收入增長是否比廣告更快？

Or are you viewing this as more of a land grab and you're willing to spend up to get an incremental member?

或者您是否將其視為更多的土地掠奪，並且您願意花費大量資金來獲得增量成員？

So we haven't broken out either the revenue or the advertising spend for BetterHelp or our DTC channel.

因此，我們還沒有列出 BetterHelp 或我們的 DTC 渠道的收入或廣告支出。

What we have said and what we continue to find is that our customer acquisition costs continue to come down, so we're getting leverage out of that.

我們所說的以及我們繼續發現的是，我們的客戶獲取成本繼續下降，因此我們正在從中獲得槓桿作用。

Our pricing continues to be strong.

我們的定價繼續保持強勁。

And our lifetime value of a member continues to increase.

我們的會員終身價值不斷增加。

So you can sort of derive the answer from those factors.

所以你可以從這些因素中得出答案。

And we feel good about the direction all of those are heading.

我們對所有這些前進的方向感覺良好。

And I would also say the data we track shows our membership churn is also improving.

我還要說，我們跟踪的數據顯示我們的會員流失也在改善。

So it's all of those different factors that essentially will allow us to get to a greater lifetime value and the ROI.

因此，所有這些不同的因素本質上將使我們獲得更大的生命週期價值和投資回報率。

(Operator Instructions) Your next question comes from George Hill with Deutsche Bank.

（操作員說明）您的下一個問題來自德意志銀行的 George Hill。

Jason, I have a question, I guess, it's a little bit about the competitive environment and how you talked about this holistic virtual care solution.

傑森，我想我有一個問題，它有點關於競爭環境以及你如何談論這個整體虛擬護理解決方案。

We're seeing a lot of plan sponsors, particularly on the employer side, start to bring in what I would call like these niche -- they're not perfect telemedicine comps, but niche companies that do like an integrated tech stack and services around things like back pain, musculoskeletal, obesity, diabetes.

我們看到很多計劃贊助商，特別是在雇主方面，開始引入我所說的這些利基——它們不是完美的遠程醫療組合，而是喜歡集成技術堆棧和服務的利基公司背痛、肌肉骨骼、肥胖、糖尿病等疾病。

And I guess, just how do you think about whether those things, I guess, compete for wallet share with Teladoc or whether they're complementary opportunities for Teladoc.

而且我想，你如何看待這些東西，我猜，是否與 Teladoc 競爭錢包份額，或者它們是否是 Teladoc 的補充機會。

Or is that like share of wallet that you guys try to take in the future?

或者那是你們將來嘗試拿走的錢包份額？

And I'm just kind of -- I guess how you're seeing that edge of the market evolve?

我只是有點——我猜你是如何看待市場邊緣的發展的？

Yes.

是的。

It's interesting.

這真有趣。

We're seeing, quite frankly, quite a bit of vendor fatigue among especially employer clients who have one of each of the things that you just described and they're uncoordinated.

坦率地說，我們在特別是雇主客戶中看到了相當多的供應商疲勞，他們擁有您剛才描述的每一種東西並且他們不協調。

And they have to deal with each one of those vendors, and so they prefer to come to us for a holistic solution.

他們必須與這些供應商中的每一個打交道，因此他們更願意來找我們尋求整體解決方案。

So you talked about musculoskeletal, we have a partnership with Telespine, which gets delivered through our interface in a seamless experience.

所以你談到了肌肉骨骼，我們與 Telespine 建立了合作夥伴關係，它通過我們的界面以無縫體驗交付。

We also bring the expert medical services around musculoskeletal so that we can do treatment decision support before someone has back surgery or something like that.

我們還提供肌肉骨骼方面的專家醫療服務，以便我們可以在有人進行背部手術或類似手術之前提供治療決策支持。

Our partnership with Vida, where we're going to bring a seamless program to market through our interface, is really resonating with our clients and prospects because it has the promise of being a virtual multi-specialty practice, combined with a virtual Center of Excellence, all wrapped into one and kind of obviates the need for all of those individual point solutions.

我們與 Vida 的合作夥伴關係將通過我們的界面將無縫程序推向市場，這確實引起了我們的客戶和潛在客戶的共鳴，因為它有望成為一個虛擬的多專業實踐，並結合一個虛擬的卓越中心，所有這些都包含在一種中，從而消除了對所有這些單獨的點解決方案的需求。

So we're going to continue to focus on that holistic solution.

因此，我們將繼續專注於整體解決方案。

And we've been pretty methodical about building out all the various components of that or partnering or acquiring for them where we see that it's appropriate.

我們一直非常有條不紊地構建所有不同的組件，或者在我們認為合適的地方為他們合作或收購。

Your next question comes from Glen Santangelo from Guggenheim.

您的下一個問題來自古根海姆的 Glen Santangelo。

Jason, I just want to follow up on some of the comments you made earlier with respect to PMPM pricing.

Jason，我只想跟進您之前就 PMPM 定價所做的一些評論。

I appreciate the fact that the company has done a great job over the last 4 years sort of growing that number, but I just kind of want to tie that back to some comments you've made more recently that the company's goal remains to be to sort of grow that PMPM pricing by $0.05 to $0.10 a year.

我很欣賞該公司在過去 4 年中做得很好並且這個數字不斷增長的事實，但我只是想將其與您最近發表的一些評論聯繫起來，即公司的目標仍然是PMPM 定價每年增加 0.05 美元到 0.10 美元。

And I'm trying to reconcile that with some of the comments you made with respect to having a strong health plan pipeline.

我正試圖將這一點與您就擁有強大的健康計劃管道所做的一些評論相協調。

And I appreciate the dilutive impact of bringing on those big populations.

我很欣賞這些龐大人口帶來的稀釋影響。

And so given the comments you made about your pipeline, like how should we think about that number on a go-forward basis, at least in the near term?

因此，鑑於您對管道的評論，例如我們應該如何看待這個數字，至少在短期內？

And then Mala, I'm not sure kind of what's implied in the 4Q number and how we should maybe think about 2020 in that regard.

然後是 Mala，我不確定 4Q 數字中暗示了什麼，以及在這方面我們應該如何看待 2020 年。

Yes.

是的。

So what I would guide you to is we have always said that when we onboard large populations, there will be a temporary dampening impact on the PMPM.

所以我要指導你的是，我們一直說，當我們登上大量人口時，將對 PMPM 產生暫時的抑制影響。

What I would expect is -- you should actually remember that we launched United only in the last month of the quarter.

我所期望的是——你應該記住我們只是在本季度的最後一個月才推出了曼聯。

So if you think about the PMPM in Q4, you will continue to see a depression in the -- a dampening in the PMPM for Q4.

因此，如果您考慮第四季度的 PMPM，您將繼續看到第四季度的 PMPM 下降。

But what you should also see is, over time, you will see the PMPM reassert and grow.

但您還應該看到的是，隨著時間的推移，您會看到 PMPM 重新確立並發展壯大。

And the thing I would say, why?

我要說的是，為什麼？

Because, again, we are, today, a diverse set of businesses and channels, right, all the way from the health plans that you've talked about, where, yes, the PMPM is one thing for a health plan.

因為，今天，我們是多元化的業務和渠道，從您談到的健康計劃一路走來，是的，PMPM 對於健康計劃來說是一回事。

But when we sell through the broker channel, for example, the PMPM that we have there is multiples of what you see in the health plan.

但是，例如，當我們通過經紀人渠道銷售時，我們擁有的 PMPM 是您在健康計劃中看到的數倍。

That's a channel for us.

這對我們來說是一個渠道。

So I would say, think of us as a diverse portfolio of channels with different PMPMs.

所以我想說，將我們視為具有不同 PMPM 的多樣化渠道組合。

And what you are seeing us deliver and demonstrate because of that diversity of channels is a growth in PMPM, absent the temporary impact of the -- when we onboard large populations.

由於渠道的多樣性，您所看到的我們交付和展示的是 PMPM 的增長，沒有臨時影響——當我們加入大量人口時。

The one other thing I will tell you is if we were to, again, normalize for our -- the expansion that we had in the quarter, our PMPM would really be at about 107.

我要告訴你的另一件事是，如果我們再次正常化我們在本季度的擴張，我們的 PMPM 將真正達到 107 左右。

So you will see -- so that's the point I'm making about the dampening, and then you should see it growing back.

所以你會看到——這就是我要說的關於阻尼的觀點，然後你應該看到它重新長出來。

Okay.

好的。

That's helpful.

這很有幫助。

Maybe if I could just follow up one question on the selling season.

也許如果我能就銷售季節跟進一個問題。

I think you touched on this a little bit, but it sounds like with the RFP volume up 25%, Jason, are you seeing any increased interest in one of the revenue models, whether it be PMPM or shared services or visit-fee-only?

我想你稍微提到了這一點，但聽起來 RFP 量增加了 25%，Jason，你是否看到對其中一種收入模式的興趣增加了，無論是 PMPM 或共享服務還是僅訪問費?

Are you seeing more interest in one way or another?

您是否以一種或另一種方式看到了更多的興趣？

And does the company have a strong preference one way or another?

公司是否有一種強烈的偏好？

Can you -- do you prefer PMPM because you can increase the membership engagement?

您能否——您是否更喜歡 PMPM，因為您可以增加會員參與度？

What's the company's preference?

公司的偏好是什麼？

And what are you seeing from the customers at this point in time.

你在這個時間點從客戶那裡看到了什麼。

Yes.

是的。

The RFP volume or content is pretty consistent with what we've seen historically.

RFP 的數量或內容與我們在歷史上看到的非常一致。

We're not seeing any major shifts in that.

我們沒有看到任何重大變化。

And what we've always said is that we have enough data, enough experience and the sort of underlying analytics to be successful regardless of what the economic model is.

我們一直說的是，無論經濟模型是什麼，我們都有足夠的數據、足夠的經驗和基礎分析來取得成功。

And we know how to price the business according to the expenditure and the costs that we're going to lay out in order to deliver it.

而且我們知道如何根據支出和我們為交付它而準備的成本來為業務定價。

So we have target gross margins that we work to and we're able to dial in, regardless of what the economic model is.

所以我們有我們努力的目標毛利率，我們能夠撥入，不管經濟模式是什麼。

There are no further questions at this time.

目前沒有其他問題。

I'll turn the call back to the presenters for any closing remarks.

如果有任何結束語，我會將電話轉回給演示者。

Thanks very much.

非常感謝。

Appreciate it.

欣賞它。

We're excited about what was another great quarter, and thank you for joining us.

我們對又一個偉大的季度感到興奮，感謝您加入我們。

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。