Teladoc Health Inc (TDOC) 2019 Q4 法說會逐字稿

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

歡迎來到 Teladoc 2019 年第四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 Patrick Feeley, Vice President of Investor Relations.

現在我很高興將發言權交給投資者關係副總裁 Patrick Feeley。

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 fourth quarter and full year 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 年第四季度和全年的財務業績。

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 also provide our first quarter and full year 2020 outlook, and our prepared remarks will be followed by a question-and-answer session.

在本次電話會議中，我們還將提供 2020 年第一季度和全年展望，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 will now turn the call over to Jason.

我現在將把電話轉給傑森。

Thanks, Patrick.

謝謝，帕特里克。

It's great to have you on board, and thank you to everyone for joining us this afternoon.

很高興有你加入，感謝大家今天下午加入我們。

2019 was an important year for Teladoc Health.

2019 年對 Teladoc Health 來說是重要的一年。

And today, we're reporting record performance as the robust growth trajectory we experienced in the first 3 quarters continued through the fourth quarter.

今天，我們報告了創紀錄的業績，因為我們在前三個季度經歷的強勁增長軌跡一直持續到第四季度。

The benefit of our diversified growth strategies across multiple channels continues to pay off, enabling us to meet or exceed our expectations across key metrics in 2019, and it gives us great confidence in our ability to deliver even stronger results in 2020.

我們跨多個渠道的多元化增長戰略的好處繼續得到回報，使我們能夠在 2019 年在關鍵指標上達到或超過我們的預期，這讓我們對我們在 2020 年實現更強勁業績的能力充滿信心。

You see that confidence reflected in the guidance that we issued this afternoon, which we'll discuss later in our remarks.

您會在我們今天下午發布的指導中看到這種信心，我們將在稍後的評論中討論。

We ended 2019 with 36.7 million U.S. paid members, adding another 1.8 million members in the fourth quarter.

到 2019 年底，我們擁有 3670 萬美國付費會員，第四季度又增加了 180 萬會員。

This brings our total to approximately 14 million new paid members in 2019, the largest number of new member adds in company history, representing a 61% growth rate over 2018.

這使我們在 2019 年新增付費會員總數約為 1400 萬，是公司歷史上新增會員數量最多的一次，比 2018 年增長 61%。

Visit fee only access increased to 19.3 million individuals at year-end, more than double the prior year.

到年底，僅訪問費的訪問量增加到 1930 萬人，比上一年增加了一倍多。

The pace of new client wins and expansions reflects how our competitive and comprehensive virtual offerings are resonating in the marketplace.

新客戶贏得和擴張的步伐反映了我們具有競爭力和全面的虛擬產品如何在市場上引起共鳴。

Visit growth was a highlight again in the fourth quarter, with total visits growing 44% over the prior year's fourth quarter, resulting in over 4.1 million visits for the full year 2019.

訪問量增長再次成為第四季度的一大亮點，總訪問量比去年第四季度增長 44%，2019 年全年訪問量超過 410 萬。

We continued to see accelerating adoption across specialties as our clients are increasingly embracing our engagement strategies.

隨著我們的客戶越來越多地接受我們的參與策略，我們繼續看到跨專業的加速採用。

This is particularly evident among our largest clients with multiple products, as our diversified product offering helped drive over 50% visit growth from our top 10 clients versus the prior year's fourth quarter.

這在我們擁有多種產品的最大客戶中尤為明顯，因為與去年第四季度相比，我們提供的多元化產品幫助我們的前 10 名客戶的訪問量增長了 50% 以上。

Visit volume is also impacted by the flu season, although the flu is not as meaningful to our overall operating results as it was in the past given the diversification of our business.

訪問量也受到流感季節的影響，儘管鑑於我們業務的多元化，流感對我們的整體經營業績的意義不如過去。

According to the Teladoc Health flu tracker, which gives us a look at flu trends in real time even before CDC data is available, this year's flu season has been more severe than the prior year.

根據 Teladoc Health 流感追踪器，即使在 CDC 數據可用之前，我們就可以實時查看流感趨勢，今年的流感季節比前一年更加嚴重。

We have experienced more than double the number of flu cases this season versus the prior year.

與上一年相比，本季的流感病例數量增加了一倍多。

And during the peak of the flu season in early February, approximately one out of 8 of our U.S. general medical visits was flu-related.

在 2 月初流感季節的高峰期，大約八分之一的美國普通醫療就診與流感有關。

We also see that once members use our services for the first time, they are much more likely to use us again.

我們還看到，一旦會員第一次使用我們的服務，他們就更有可能再次使用我們。

About half of our visits completed in the month of January came from users who had not previously utilized our services.

1 月份完成的訪問中約有一半來自以前未使用過我們服務的用戶。

We expect a strong flu season to continue to benefit us and help drive increased adoption of our products as new users look to Teladoc Health for more of their health care needs.

我們預計強勁的流感季節將繼續使我們受益，並有助於推動我們產品的更多采用，因為新用戶希望 Teladoc Health 滿足他們的更多醫療保健需求。

Mental health continues to be a strong driver as we see increased adoption and momentum in both the B2B and B2C channels.

隨著我們看到 B2B 和 B2C 渠道的採用率和勢頭有所增加，心理健康仍然是一個強大的驅動力。

On the B2B side, mental health has been a significant contributor to our multiproduct adoption.

在 B2B 方面，心理健康一直是我們採用多種產品的重要因素。

Bookings that include mental health more than doubled in 2019, reflecting accelerating client demand for our mental health solution.

包括心理健康在內的預訂量在 2019 年增加了一倍以上，反映出客戶對我們的心理健康解決方案的需求不斷增加。

In fact, the fourth quarter was one of the strongest we've experienced for new mental health product adds.

事實上，第四季度是我們在新的心理健康產品添加方面經歷的最強勁的季度之一。

On the D2C side, our BetterHelp product continues to outperform.

在 D2C 方面，我們的 BetterHelp 產品繼續表現出色。

Not only is BetterHelp significantly improving our members' lives, but it has consistently exceeded expectations, extending our leadership position in the direct-to-consumer channel.

BetterHelp 不僅顯著改善了我們會員的生活，而且一直超出預期，擴大了我們在直接面向消費者的渠道中的領導地位。

During the fourth quarter, we continued to expand our product offering with the launch of Teladoc Nutrition, offering personalized nutrition counseling combined with specialized care.

在第四季度，隨著 Teladoc Nutrition 的推出，我們繼續擴大我們的產品供應，提供個性化的營養諮詢和專業護理。

Members utilizing the service work directly with a registered dietitian to develop a personalized program based on the latest science-based guidelines consistent with the Academy of Nutrition and Dietetics.

利用該服務的會員直接與註冊營養師合作，根據與營養與飲食學會一致的最新科學指南開發個性化計劃。

This latest expansion of our comprehensive virtual offering will allow us to improve long-term health outcomes for our members and ultimately reduce overall medical costs, particularly for individuals with chronic conditions.

我們綜合虛擬產品的最新擴展將使我們能夠改善會員的長期健康結果，並最終降低總體醫療成本，特別是對於患有慢性病的個人而言。

Before I turn the call over to Mala to discuss 2019 results and 2020 guidance in more detail, I wanted to talk briefly about our outlook for 2020.

在我將電話轉給 Mala 以更詳細地討論 2019 年業績和 2020 年指導之前，我想簡要談談我們對 2020 年的展望。

Following a robust selling season and the significant momentum we saw exiting 2019, we feel confident in our outlook for 2020 revenue growth.

在經歷了強勁的銷售季節和我們看到 2019 年退出的顯著勢頭之後，我們對 2020 年的收入增長前景充滿信心。

For the full year 2020, we expect revenue to be in the range of $695 million to $710 million, representing 26% to 28% growth, toward the upper end of our long-term 20% to 30% target range.

對於 2020 年全年，我們預計收入將在 6.95 億美元至 7.1 億美元之間，增長 26% 至 28%，接近我們長期 20% 至 30% 目標範圍的上限。

We expect visit revenue growth to accelerate as we activate the large populations we added in 2019.

隨著我們在 2019 年增加大量人口，我們預計訪問收入增長將加速。

And we're very pleased with the broad-based momentum we're seeing across the business, including continued strength in mental health and in the international marketplace.

我們對我們在整個業務中看到的廣泛勢頭感到非常滿意，包括在心理健康和國際市場上的持續強勢。

We also expect Medicare Advantage to begin to become a more meaningful contributor to our growth.

我們還預計 Medicare Advantage 將開始成為我們增長的更有意義的貢獻者。

As we've said previously, we expect that opportunity to play out over a multiyear period as MA plans begin to adopt virtual care strategies.

正如我們之前所說，隨著 MA 計劃開始採用虛擬護理策略，我們預計這一機會將在多年內發揮出來。

As of January 31, we have more than 15 Medicare Advantage clients with over 1 million lives and a robust pipeline of new opportunities that will benefit us in the future.

截至 1 月 31 日，我們擁有超過 15 名 Medicare Advantage 客戶，擁有超過 100 萬人的生命，並擁有強大的新機會管道，這些機會將在未來使我們受益。

I also would like to highlight a proposal from CMS released last month, which would ease network adequacy requirements for Medicare Advantage plans that contract with telehealth providers.

我還想強調 CMS 上個月發布的一項提案，該提案將放寬與遠程醫療提供商簽約的 Medicare Advantage 計劃的網絡充分性要求。

We view this as further evidence of CMS encouraging the adoption of virtual care in the Medicare population.

我們認為這是 CMS 鼓勵在醫療保險人群中採用虛擬護理的進一步證據。

And we continue to see a significant avenue for growth within the Medicare program.

我們繼續看到醫療保險計劃的重要增長途徑。

Finally, as previously announced, we expect to close the InTouch Health acquisition at the end of the second quarter.

最後，正如之前宣布的，我們預計將在第二季度末完成對 InTouch Health 的收購。

Only 6 weeks have passed since signing the deal, but our teams have hit the ground running, and we could not be more pleased with the progress being made on the combined commercial strategy and integration planning.

自簽署交易以來僅過去了 6 週，但我們的團隊已經開始運作，我們對聯合商業戰略和整合規劃所取得的進展感到非常滿意。

We have signed a commercial agreement with InTouch that allows us to jointly sell the combined InTouch Health and Teladoc Health offerings ahead of the transaction closing.

我們已經與 InTouch 簽署了一項商業協議，允許我們在交易完成前聯合銷售 InTouch Health 和 Teladoc Health 的組合產品。

And the feedback from our collective health system clients has been extremely positive.

我們集體衛生系統客戶的反饋非常積極。

In fact, we already have our first committed health system cross-sale in contract.

事實上，我們已經有了第一個承諾的衛生系統交叉銷售合同。

We see a tremendous opportunity for cross-selling, upselling and virtualizing care across our collective customer bases, and I'm extremely excited to welcome the InTouch team to the Teladoc Health family.

我們看到了在我們的集體客戶群中交叉銷售、追加銷售和虛擬化護理的巨大機會，我非常高興地歡迎 InTouch 團隊加入 Teladoc Health 大家庭。

With that, I'll turn the call over to Mala for a review of our fourth quarter and full year financials as well as detailed 2020 guidance.

有了這個，我將把電話轉給 Mala，以審查我們的第四季度和全年財務狀況以及詳細的 2020 年指導。

Thank you, Jason, and good afternoon, everyone.

謝謝你，傑森，大家下午好。

I would like to echo Jason's comments regarding the broad-based momentum that the business is experiencing, and we are very pleased with the 2019 performance.

我想回應 Jason 關於業務正在經歷的廣泛發展勢頭的評論，我們對 2019 年的表現非常滿意。

I will now review the fourth quarter and the full year at a more granular level.

我現在將更詳細地回顧第四季度和全年。

Total revenue increased 27% to $156.5 million in the fourth quarter.

第四季度總收入增長 27% 至 1.565 億美元。

That revenue growth was entirely organic, but for the small impact of the MedecinDirect acquisition.

這種收入增長完全是有機的，但收購 MedecinDirect 的影響很小。

For the full year of 2019, total revenue increased 32% to $553.3 million or 24% on an organic basis.

2019 年全年，總收入有機增長 32% 至 5.533 億美元或 24%。

We continue to see a stronger U.S. dollar versus the prior year, resulting in an FX-adjusted revenue growth approximately 96 basis points above our reported full year revenue growth.

與去年相比，我們繼續看到美元走強，導致外匯調整後的收入增長比我們報告的全年收入增長高出約 96 個基點。

Global subscription access fee revenue for the quarter of $127 million grew 24% versus the prior year and accounted for 81% of our consolidated revenue, with visit fee revenue comprising the remaining 19%.

本季度全球訂閱訪問費收入為 1.27 億美元，同比增長 24%，占我們綜合收入的 81%，訪問費收入佔其餘 19%。

U.S. subscription access fee revenue of $98.1 million grew 25% in the quarter versus last year, and international subscription revenue grew 19% to $28.9 million, demonstrating accelerating momentum as we exited the year.

本季度美國訂閱訪問費收入為 9810 萬美元，與去年同期相比增長 25%，國際訂閱收入增長 19% 至 2890 萬美元，顯示出今年結束時的增長勢頭。

Visit fee revenue for the quarter increased to $29.5 million, representing growth of 47% over the prior year; of which revenue from individuals with visit fee only access was $8 million in the quarter, representing 112% growth versus the prior year.

本季度參觀費收入增至 2950 萬美元，比上年增長 47%；其中，僅訪問費的個人在本季度的收入為 800 萬美元，比上年增長 112%。

Turning to membership and access.

轉向會員資格和訪問權限。

As Jason highlighted, U.S. paid membership increased this quarter to 36.7 million members, up 61% versus the prior year, reflecting the increased adoption of virtual care and demand for our comprehensive service offering.

正如 Jason 強調的那樣，本季度美國付費會員增加到 3670 萬會員，比去年同期增長 61%，這反映了虛擬護理的採用增加以及對我們綜合服務產品的需求。

As a reminder, the U.S. paid membership includes only members associated with a PMPM and does not include individuals with visit fee only access.

提醒一下，美國付費會員僅包括與 PMPM 關聯的會員，不包括僅訪問費訪問權的個人。

Individuals with visit fee only access increased to 19.3 million at the end of the fourth quarter, up approximately 9.9 million versus the prior year and 0.3 million sequentially.

第四季度末，僅訪問費的個人增加到 1930 萬，比上年增加約 990 萬，環比增加 30 萬。

Turning to visits.

轉向訪問。

Total visit volume was 1.239 million in the quarter, representing a 44% increase versus the prior year.

本季度總訪問量為 123.9 萬，同比增長 44%。

Visit volume from paid members in the U.S. grew 40% to 850,000, which represents an annualized utilization rate of 9.5%, a 125 basis point decrease over last year's fourth quarter.

美國付費會員訪問量增長 40% 至 850,000 次，年化使用率為 9.5%，比去年第四季度下降 125 個基點。

Excluding the impact of the large health plan onboarding during the third quarter, annualized utilization during the fourth quarter would have been 11.9%, up 110 basis points over the fourth quarter of 2018.

排除第三季度大型健康計劃加入的影響，第四季度的年化利用率為 11.9%，比 2018 年第四季度增長 110 個基點。

For the full year, we completed over 4.1 million visits, representing growth of 57% over the prior year.

全年，我們完成了超過 410 萬次訪問，比上一年增長 57%。

PMPM in the quarter was $0.91 compared to $1.16 in the prior year's quarter.

該季度的 PMPM 為 0.91 美元，而去年同期為 1.16 美元。

As we have previously discussed, we expect to see a dampening effect on average PMPM, when we onboard large new health plan member populations.

正如我們之前所討論的，當我們加入大量新的健康計劃成員時，我們預計會對平均 PMPM 產生抑製作用。

Excluding the impact of the large health plan population added during the third quarter, fourth quarter PMPM would be $1.19.

排除第三季度增加的大型健康計劃人口的影響，第四季度 PMPM 將為 1.19 美元。

Gross margin percentage for the quarter was in line with our expectations at 65% compared to 67% in the fourth quarter of last year.

本季度的毛利率百分比符合我們的預期，為 65%，而去年第四季度為 67%。

The year-over-year decline in percentage gross margin reflects the strong visit growth and visit fee revenue performance in the quarter, as visit fee revenue comprised 19% of total revenue in the fourth quarter compared to 16% in the fourth quarter of last year.

毛利率同比下降反映了該季度強勁的訪問增長和訪問費收入表現，因為訪問費收入佔第四季度總收入的 19%，而去年第四季度為 16% .

For the full year, gross margin percentage was 67% compared to 69% in the previous year.

全年毛利率為 67%，而上一年為 69%。

Dollar gross margin increased 28% for the full year to $369 million.

全年美元毛利率增長 28% 至 3.69 億美元。

Operating expense for the quarter totaled $116.7 million or 74.6% of revenue compared to 81.9% in the fourth quarter of last year.

本季度的運營費用總計 1.167 億美元，佔收入的 74.6%，而去年第四季度為 81.9%。

Excluding noncash charges, such as depreciation and amortization, stock compensation and onetime acquisition and integration-related expenses, quarterly adjusted operating expenses were $85.9 million or 55% of revenue compared to 63% in the fourth quarter of last year.

不包括折舊和攤銷、股票補償以及一次性收購和整合相關費用等非現金費用，季度調整後的運營費用為 8590 萬美元，佔收入的 55%，而去年第四季度為 63%。

Adjusted EBITDA increased to $15.2 million for the quarter compared to $5.8 million in last year's fourth quarter, reflecting our strong revenue growth and ability to drive operating leverage.

本季度調整後的 EBITDA 增加到 1520 萬美元，而去年第四季度為 580 萬美元，這反映了我們強勁的收入增長和推動運營槓桿的能力。

EBITDA, including stock compensation and onetime acquisition cost, was a loss of $5.7 million for the quarter compared to a $8.3 million loss in the same period last year.

包括股票薪酬和一次性收購成本在內的 EBITDA 本季度虧損 570 萬美元，而去年同期虧損 830 萬美元。

For the full year, adjusted EBITDA increased to $31.8 million, more than doubling versus the prior year as adjusted EBITDA margins expanded over 250 basis points.

全年，調整後的 EBITDA 增加到 3180 萬美元，比上一年增加了一倍以上，因為調整後的 EBITDA 利潤率擴大了 250 個基點以上。

Our net loss in the quarter was $19 million compared to a net loss of $25 million in the fourth quarter of 2018.

我們本季度的淨虧損為 1900 萬美元，而 2018 年第四季度的淨虧損為 2500 萬美元。

On a per-share basis, our net loss was $0.26 for the fourth quarter compared to $0.35 in the fourth quarter of last year.

按每股計算，我們第四季度的淨虧損為 0.26 美元，而去年第四季度為 0.35 美元。

For the full year, net loss per share was $1.38 in 2019 compared to $1.47 in the previous year.

全年，2019 年每股淨虧損為 1.38 美元，而上一年為 1.47 美元。

At the outset of the year, one of our key financial goals was to achieve positive cash flows from operations.

今年年初，我們的主要財務目標之一是從運營中實現正現金流。

And we have delivered on that, generating nearly $30 million of operating cash flow for the full year 2019.

我們已經實現了這一目標，在 2019 年全年產生了近 3000 萬美元的運營現金流。

As a result, we ended the quarter with $517 million in cash and short-term investments, an improvement of nearly $39 million versus the prior year and $26 million sequentially.

因此，我們在本季度結束時獲得了 5.17 億美元的現金和短期投資，與去年同期相比增加了近 3900 萬美元，環比增加了 2600 萬美元。

Our total debt outstanding as of December 31 was $562.5 million, which consists of our 2 convertible notes.

截至 12 月 31 日，我們的未償債務總額為 5.625 億美元，其中包括我們的 2 份可轉換票據。

Now turning to forward guidance.

現在轉向前向指導。

Please note that all forward guidance will exclude the impact of the recently announced InTouch Health acquisition until the transaction closes, which is expected at the end of the second quarter.

請注意，在交易完成之前，所有前瞻性指引都將排除最近宣布的 InTouch Health 收購的影響，交易預計在第二季度末完成。

As Jason noted, for the full year 2020, we expect revenue to be in the range of $695 million to $710 million, representing 26% to 28% growth versus the prior year, which again is substantially all organic.

正如 Jason 指出的那樣，對於 2020 年全年，我們預計收入將在 6.95 億美元至 7.1 億美元之間，與上一年相比增長 26% 至 28%，這基本上也是有機的。

We expect total U.S. paid membership of approximately 43 million to 45 million members, representing 17% to 23% growth in new membership as compared to 2019 and visit fee only access to be available to approximately 19 million to 20 million individuals.

我們預計美國付費會員總數約為 4,300 萬至 4,500 萬，與 2019 年相比，新會員增長 17% 至 23%，大約有 1,900 萬至 2,000 萬個人可以使用訪問費。

We expect total visits to be between 5.5 million and 5.9 million, representing total visit growth of 33% to 43% over the prior year.

我們預計總訪問量將在 550 萬至 590 萬之間，總訪問量比去年增長 33% 至 43%。

We expected an EBITDA loss in the range of $15 million to $5 million and adjusted EBITDA in the range of positive $60 million to $70 million, which is more than double 2019 adjusted EBITDA at the midpoint.

我們預計 EBITDA 虧損在 1500 萬美元至 500 萬美元之間，調整後 EBITDA 將在 6000 萬美元至 7000 萬美元之間，是 2019 年調整後 EBITDA 中點的兩倍多。

The expected EBITDA improvement reflects operating leverage as we grow top line in conjunction with our continued focus on operating efficiency, while still allowing us to continue to make significant investments against future growth opportunities.

預期的 EBITDA 改善反映了運營槓桿，因為我們在增長收入的同時繼續關注運營效率，同時仍使我們能夠繼續針對未來的增長機會進行重大投資。

Net loss per share is expected to range from a loss of $1.19 to $1.06 per share based on 73.7 million weighted shares outstanding.

根據已發行的 7370 萬股加權股票，每股淨虧損預計為每股虧損 1.19 美元至 1.06 美元。

We expect cash flow from operations to grow consistent with adjusted EBITDA growth.

我們預計運營現金流的增長將與調整後的 EBITDA 增長保持一致。

For the first quarter of 2020, we expect total revenue of $169 million to $172 million.

對於 2020 年第一季度，我們預計總收入為 1.69 億美元至 1.72 億美元。

We expect to end the quarter with U.S. paid membership of approximately 40 million to 41 million members and visit fee only access to be available to approximately 19.2 million individuals.

我們預計本季度末美國付費會員將達到約 4,000 萬至 4,100 萬，並且只有約 1,920 萬個人可以使用訪問費。

We expect total visits of between 1.4 million and 1.6 million in the quarter.

我們預計本季度的總訪問量在 140 萬至 160 萬之間。

We expect a first quarter EBITDA loss in the range of $9 million to $7 million, adjusted EBITDA of positive $9 million to $11 million, and net loss per share to be between $0.37 and $0.34 based on 73.1 million shares outstanding.

我們預計第一季度 EBITDA 虧損在 900 萬美元至 700 萬美元之間，調整後的 EBITDA 為正 900 萬美元至 1100 萬美元，每股淨虧損將在 0.37 美元至 0.34 美元之間（基於已發行股票 7310 萬股）。

In conclusion, I am pleased with our financial results and excited about the momentum we see across the business as we enter 2020.

總之，我對我們的財務業績感到滿意，並對我們在進入 2020 年時看到的整個業務的發展勢頭感到興奮。

With that, I will turn the call back to Jason for closing remarks.

有了這個，我將把電話轉回傑森的閉幕詞。

Thanks, Mala.

謝謝，馬拉。

2019 was an important year for Teladoc Health as we delivered on our commitments and exceeded our expectations across our key metrics.

2019 年對 Teladoc Health 來說是重要的一年，因為我們兌現了承諾，並在關鍵指標上超出了我們的預期。

I'd like to thank the team around the world for their commitment to our mission and contributions to another successful year.

我要感謝世界各地的團隊對我們使命的承諾以及對又一個成功的一年的貢獻。

Our diverse range of product offerings and capabilities continues to expand and are resonating with our clients as they see the unique value that Teladoc Health provides to them and their constituents.

隨著客戶看到 Teladoc Health 為他們及其選民提供的獨特價值，我們多樣化的產品和功能範圍不斷擴大，並引起客戶的共鳴。

We see the pace of virtual care adoption accelerating, and we're well positioned to satisfy the increasing needs of the marketplace.

我們看到採用虛擬護理的步伐正在加快，我們已做好準備滿足市場日益增長的需求。

We look forward to 2020 and beyond and are confident in our ability to continue to positively impact the way health care is delivered.

我們期待 2020 年及以後，並相信我們有能力繼續對醫療保健的提供方式產生積極影響。

We also hope you'll have the opportunity to join us on March 5 in New York for our Investor Day, where you will be able to hear from more of our leadership team as well as see the InTouch Health product offering up close, which will help to demonstrate why we are so excited about this combined opportunity.

我們還希望您有機會參加 3 月 5 日在紐約舉行的投資者日活動，屆時您將能夠聽到我們領導團隊的更多信息，並近距離了解 InTouch Health 產品，這將有助於證明為什麼我們對這個合併的機會如此興奮。

Before I turn the call over for Q&A, I'd like to take a moment to welcome Cathy Jacobson to our Board of Directors.

在我轉交問答之前，我想花一點時間歡迎凱茜·雅各布森加入我們的董事會。

Cathy is currently President and CEO of Froedtert Health, a Milwaukee-based integrated delivery system.

Cathy 目前是 Froedtert Health 的總裁兼首席執行官，這是一家位於密爾沃基的綜合交付系統。

She brings deep insight into the strategic priorities of health systems at a time when virtual care is becoming a key area of focus for these organizations, and we're very pleased to have her join us.

在虛擬護理成為這些組織關注的關鍵領域之際，她對衛生系統的戰略重點有了深入的了解，我們很高興她能加入我們。

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。

Since we'll be seeing you all next week at Investor Day, we'd like to limit everyone to one question today, please.

由於我們將在下週的投資者日與大家見面，因此我們希望今天將每個人限制在一個問題上，拜託。

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 is from Lisa Gill with JPMorgan.

（操作員說明）我們的第一個問題來自摩根大通的 Lisa Gill。

Congratulations on a great year, Jason, and the outlook for 2020.

祝賀傑森，這是偉大的一年，也是對 2020 年的展望。

I'm surprised in your prepared comments, you didn't talk at all about coronavirus.

我對您準備好的評論感到驚訝，您根本沒有談論冠狀病毒。

I know that the CDC has made comments around the expectation for incremental use of telehealth-type services as people are potentially afraid of being contaminated with others in health care facilities.

我知道疾病預防控制中心已經就增加使用遠程醫療類型服務的期望發表了評論，因為人們可能害怕在醫療機構中被其他人污染。

So can you maybe just start there as to the impact that you would expect to see.

那麼您是否可以從那裡開始了解您期望看到的影響。

And then as you think about half of those new customers coming into the system being new to Teladoc -- I remember last year, it was kind of something similar as well.

然後，當您想到進入系統的新客戶中有一半是 Teladoc 的新客戶時——我記得去年，這也是類似的事情。

What's the pull-through that you continue to see?

您繼續看到的推動力是什麼？

Like, okay, you're new, but do they continue to come back again?

就像，好吧，你是新來的，但他們會繼續回來嗎？

Just how do we think about those 2 elements as we think about new people coming on to the platform?

當我們考慮新人進入平台時，我們如何考慮這兩個元素？

Thanks, Lisa.

謝謝，麗莎。

I'm not surprised in your first question.

我對你的第一個問題並不感到驚訝。

Clearly, we've been closely tracking the coronavirus outbreak from the beginning.

顯然，我們從一開始就密切關注冠狀病毒的爆發。

Our clinical teams, which are comprised of thousands of physicians around the world, have been actively working alongside of our commercial teams and our clients to ensure that our members have the most timely and relevant access to the latest information regarding this unfolding situation and the access to care if and when they need it.

我們的臨床團隊由全球數千名醫生組成，一直在與我們的商業團隊和客戶積極合作，以確保我們的成員能夠最及時、最相關地獲得有關這一發展情況的最新信息和訪問權限關心他們是否以及何時需要它。

Yesterday's comments from the U.S. health officials obviously signal a potentially significant milestone in the progression of the outbreak.

美國衛生官員昨天的評論顯然標誌著疫情發展過程中一個潛在的重要里程碑。

That having been said, there are still several potential scenarios.

話雖如此，仍有幾種潛在的情況。

And at this point, it's still too early to be able to quantify the impact that the outbreak could have on our business.

在這一點上，要量化疫情可能對我們的業務產生的影響還為時過早。

Our top priority right now is to take care of those people who are potentially affected, spanning both care providers and individuals around the world.

我們現在的首要任務是照顧那些可能受到影響的人，包括世界各地的護理提供者和個人。

As I said, I'm not surprised by your question.

正如我所說，我對你的問題並不感到驚訝。

And so Mala and I asked our Chief Medical Officer, Dr. Lew Levy to join us for the Q&A.

所以 Mala 和我請我們的首席醫療官 Lew Levy 博士加入我們的問答環節。

Maybe, Lew, you can provide just a little bit more perspective on the coronavirus and our role.

也許，Lew，你可以就冠狀病毒和我們的角色提供更多的觀點。

Thanks, Jason.

謝謝，傑森。

As you mentioned, our clinical teams are focused on meeting the health care needs of our members in a potential outbreak with the same accessible high-quality care they have come to expect from Teladoc Health.

正如您所提到的，我們的臨床團隊專注於滿足我們成員在潛在爆發中的醫療保健需求，並提供他們期望從 Teladoc Health 獲得的同樣可獲得的高質量護理。

As a result of our long-standing clinical-quality leadership, there are 3 key areas which I'd really like to highlight, where I believe we are uniquely positioned to make a meaningful contribution to already ongoing public health efforts.

由於我們長期在臨床質量方面處於領先地位，我非常想強調三個關鍵領域，我相信我們在這些領域處於獨特的地位，可以為已經在進行的公共衛生工作做出有意義的貢獻。

First, ensuring best practice for virtual care visits for patients who think they may have been exposed to the COVID-19.

首先，確保為認為自己可能接觸過 COVID-19 的患者提供虛擬護理訪問的最佳實踐。

All of our global medical directors have provided their teams with the most up-to-date information regarding the appropriate way to evaluate and treat patients at potential risk for this virus.

我們所有的全球醫療主管都向他們的團隊提供了有關評估和治療有潛在感染這種病毒風險的患者的適當方法的最新信息。

Secondly, we are enabling health systems to provide virtual care at greater scale through the technology and capabilities of both the Teladoc Health as well as the InTouch Health platform.

其次，我們通過 Teladoc Health 和 InTouch Health 平台的技術和能力，使衛生系統能夠提供更大規模的虛擬護理。

And thirdly, the last point I'd like to raise is that in the U.S. specifically, we have been actively partnering with the CDC for several weeks now.

第三，我想提出的最後一點是，特別是在美國，我們已經與 CDC 積極合作了幾個星期。

Led by our clinical quality leadership team, we are equipped to provide near real-time disease surveillance data as well as proliferate disease-specific clinical practice guidelines.

在我們的臨床質量領導團隊的帶領下，我們有能力提供近乎實時的疾病監測數據以及針對特定疾病的臨床實踐指南。

So Lisa, I think you'll see us continue to play an active role here depending on which one of those scenarios plays out.

所以麗莎，我想你會看到我們繼續在這裡發揮積極作用，這取決於其中一種情況的發生。

I expect that we'll talk more about this next week at our Investor Day.

我希望我們將在下週的投資者日上更多地討論這個問題。

And then just to answer the second half of your question, we do benefit when we have a severe flu season by bringing new people into becoming active users.

然後只是為了回答你問題的後半部分，當我們有一個嚴重的流感季節時，我們確實會受益於讓新人成為活躍用戶。

The activating new users feeds the flywheel that drives visit growth over time.

隨著時間的推移，激活的新用戶為推動訪問增長的飛輪提供了動力。

As we saw last year, each user used the Teladoc Health platform about 1.5x.

正如我們去年看到的，每個用戶使用 Teladoc Health 平台的次數約為 1.5 倍。

And Stephany will shed more on the effect that this flywheel has next week at our Investor Day.

斯蒂芬妮將在下週的投資者日上更多地闡述這個飛輪的影響。

Your next question is from Sean Wieland with Piper Sandler.

您的下一個問題來自 Sean Wieland 和 Piper Sandler。

So beyond the cross-sell opportunity with InTouch, can you speak a little bit about the integration of the assets and the capabilities?

那麼除了與 InTouch 的交叉銷售機會之外，您能否談談資產和能力的整合？

And if you had a Venn -- if we could draw a Venn diagram, what that would look like?

如果你有一個維恩圖——如果我們可以畫一個維恩圖，那會是什麼樣子？

In particular, the telestroke market and the behavioral, how does that fit in with your business?

特別是遠程擊球市場和行為，它如何適合您的業務？

And also, they've got a very strong network backbone, and I wanted to get an understanding of what your thinking is with that.

而且，他們有一個非常強大的網絡骨幹，我想了解您對此的想法。

Yes.

是的。

Thanks, Sean.

謝謝，肖恩。

There is very little overlap between the 2 companies' product portfolios and the services that we provide.

兩家公司的產品組合與我們提供的服務之間幾乎沒有重疊。

Essentially, they are providing a software, hardware and the technology network as well as in some cases, the clinical resources for high-acuity situations primarily in the hospital.

從本質上講，他們提供了軟件、硬件和技術網絡，在某些情況下，還為主要在醫院的高危重症情況提供臨床資源。

And as you know, Teladoc Health provides software and a platform that enables the hospitals to extend out into the community.

如您所知，Teladoc Health 提供軟件和平台，使醫院能夠擴展到社區。

And so there is very little overlap.

所以幾乎沒有重疊。

There's a little bit of overlap for scheduled visits that are done primarily on a provider-to-provider basis using the InTouch platform, but that is a tiny fraction of the overall use cases.

對於主要使用 InTouch 平台在提供者對提供者的基礎上完成的預定訪問有一點重疊，但這只是整個用例的一小部分。

And so I do see a significant opportunity for integration so that the providers, the physicians who are operating on the platform, have a single unified interface.

因此，我確實看到了一個重要的整合機會，以便提供者，即在平台上運行的醫生，擁有一個統一的界面。

And the consumers who are receiving care have a single unified interface, regardless of what the services that they're receiving.

接受護理的消費者有一個統一的界面，無論他們接受什麼服務。

And then, lastly, when you put the 2 companies together, you get this really tremendous network effect relative to the physician populations of our collective clients.

最後，當你把這兩家公司放在一起時，相對於我們集體客戶的醫生群體，你會得到這種非常巨大的網絡效應。

And by enabling that entire population on the InTouch Health technology network, that really allows for the extension of the provider capacity to the entire client base.

通過在 InTouch Health 技術網絡上啟用整個人口，這確實可以將提供者的能力擴展到整個客戶群。

So I think we're very, very excited.

所以我認為我們非常非常興奮。

And as I said in my prepared remarks, the teams are actively engaged with each other doing integration planning around all of those areas.

正如我在準備好的評論中所說，團隊正在積極參與，圍繞所有這些領域進行整合規劃。

Your next question is from Ryan Daniels with William Blair.

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

This is Nick Spiekhout in for Ryan.

這是 Ryan 的 Nick Spiekhout。

I guess to start off, it might be a little bit early to tell, but I was curious how kind of utilization trends and activation engagement are tracking for the new United lives so far.

我想開始，現在說可能有點早，但我很好奇到目前為止，新曼聯生活的使用趨勢和激活參與度如何。

Yes.

是的。

Thanks, Nick.

謝謝，尼克。

We're pleased with the progress we've made with United.

我們對與曼聯取得的進展感到高興。

Our marketing teams are working very well together.

我們的營銷團隊合作得很好。

We really kicked off the bulk of our activation efforts in the first quarter.

我們確實在第一季度啟動了大部分激活工作。

So it was a relatively slow ramp through the fourth quarter.

因此，第四季度的增長相對緩慢。

We saw a little bit of a benefit from the United business in the fourth quarter, but it rapidly accelerates as we head into 2020.

我們在第四季度看到了美聯航業務帶來的一點好處，但隨著我們進入 2020 年，它會迅速加速。

It's part of what gives us confidence around our 2020 guidance.

這是讓我們對 2020 年指導充滿信心的部分原因。

And we're seeing activation occur very strongly as the 2 marketing teams really work together.

我們看到激活非常強烈，因為 2 個營銷團隊真正合作。

And having said that, we're still at the early stages of that.

話雖如此，我們仍處於早期階段。

So I think that's only going to improve and gain velocity.

所以我認為這只會改善和提高速度。

Your next question is from Matthew Gillmor with Baird.

您的下一個問題來自 Matthew Gillmor 和 Baird。

I wanted to ask about BetterHelp.

我想問一下 BetterHelp。

I think Jason mentioned it's continuing to outperform, and hoping to get some details around that.

我認為 Jason 提到它繼續表現出色，並希望獲得一些細節。

Is that due to more new sign-ups?

是因為有更多的新註冊嗎？

Or are the members on BetterHelp just staying longer on the platform so that turn's lower?

還是 BetterHelp 上的成員只是在平台上停留的時間更長，從而降低了轉機？

Fortunately, Matt, the answer is both.

幸運的是，馬特，答案是兩者兼而有之。

We're seeing all 3 of the key metrics continue to improve, meaning customer acquisition cost continues to come down.

我們看到所有 3 個關鍵指標都在繼續改善，這意味著客戶獲取成本繼續下降。

Duration of a member or stickiness, so to speak, continues to extend, and therefore, a lifetime value of each member continues to improve.

可以說，成員的持續時間或粘性繼續延長，因此每個成員的終生價值不斷提高。

So we continue to see that business growing at an incredibly robust pace and don't see any end in sight for that.

因此，我們繼續看到該業務以令人難以置信的強勁速度增長，並且看不到任何終點。

Your next question is 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 I'll ask one on the member growth.

我想也許我會問一個關於成員增長的問題。

It seemed like you guys saw more adds there in the fourth quarter than you had originally expected.

看起來你們在第四季度看到的增加比你最初預期的要多。

Just any color on type of customer that was incrementally going live.

只是逐漸上線的客戶類型的任何顏色。

Is that the MA lives?

那是MA的生活嗎？

Or just anything on that front would be great.

或者只是這方面的任何事情都會很棒。

Yes.

是的。

It's -- thanks, Jamie.

這是 - 謝謝，傑米。

It's primarily health plan members but across multiple lines of business, both the government programs as well as commercial lives.

它主要是健康計劃成員，但涉及多個業務領域，包括政府計劃和商業生活。

We did see some sort of early adds, if you will, from employers who came on in the fourth quarter rather than waiting for January 1, but the predominant population was health plan lives.

如果你願意的話，我們確實看到了一些來自雇主的早期補充，他們在第四季度加入而不是等待 1 月 1 日，但主要人群是健康計劃的生命。

Your next question is from Sean Dodge with RBC Capital Markets.

您的下一個問題來自加拿大皇家銀行資本市場的 Sean Dodge。

This is Thomas Kelliher on for Sean.

這是肖恩的托馬斯·凱利赫。

Just a question on Virtual First.

只是關於 Virtual First 的一個問題。

You all had to help launch kind of the first iteration of this a little over a year ago with the self-insured payer.

一年多前，你們所有人都必須幫助自保付款人啟動第一次迭代。

Can you share any data or any sort of anecdotes on how that's sort of progressed over 2019?

您能否分享有關 2019 年進展情況的任何數據或任何軼事？

And then as we continue to have these conversations with other payers, can you give us a sense of the kind of traction around that concept?

然後，當我們繼續與其他付款人進行這些對話時，您能否讓我們了解圍繞該概念的那種牽引力？

Yes.

是的。

So I would call Virtual First kind of a capability or a planned design.

因此，我將虛擬優先稱為一種功能或計劃設計。

And what we've seen is that, that is rapidly evolving into a virtual primary care sort of full capability.

我們所看到的是，它正在迅速演變成一種虛擬初級保健的完整功能。

So you're now seeing -- and I'm sure you've seen some of the big payers roll out planned designs that encourage virtual care as the first stop for the member.

所以你現在看到了——我相信你已經看到一些大支付者推出了鼓勵虛擬護理作為會員第一站的計劃設計。

I think when we look at the broader set of capabilities and the bigger trends in the market, and we'll talk about this next week, we really see virtual primary care as stepping forward as a consumer-facing capability that looks to truly reimagine how consumers access primary care and think about consuming health care overall.

我認為，當我們看到更廣泛的功能和更大的市場趨勢時，我們將在下週討論這個問題，我們真的認為虛擬初級保健作為一種面向消費者的能力正在向前邁進，它旨在真正重新構想如何消費者獲得初級保健並考慮整體醫療保健。

And given the broad set of our capabilities and the consumer-friendly interface and access, we think that we're uniquely positioned for that.

鑑於我們廣泛的能力和對消費者友好的界面和訪問，我們認為我們在這方面處於獨特的地位。

So I think you'll see a Virtual First plan design, combined with a virtual primary care capability, coming from us that both where we deliver that as well as enable providers in the market to deliver it as well really transforming how consumers get care.

因此，我認為您會看到一個 Virtual First 計劃設計，結合虛擬初級保健功能，來自我們，無論是我們提供的地方，還是使市場上的提供者能夠提供它，以及真正改變消費者獲得護理的方式。

Your next question is from Charles Rhyee with Cowen.

您的下一個問題來自 Charles Rhyee 和 Cowen。

I wanted to ask about sort of what you're kind of seeing so far with -- in Medicare Advantage, I guess, in particular, how saturated -- maybe that's not the right word.

我想問一下你到目前為止所看到的那種——我想在 Medicare Advantage 中，特別是飽和度——也許這不是正確的詞。

What percent of plans do you get a sense in the market are starting to offer these additional telehealth benefits for their members?

您認為市場上有多少計劃開始為其會員提供這些額外的遠程醫療福利？

And then, I guess, particularly to your sort of the 15 MA clients that you have, can you kind of speak to sort of the marketing push that they are using to encourage their members to turn to telehealth for full services?

然後，我想，特別是對於您擁有的 15 位 MA 客戶，您能談談他們用來鼓勵其成員轉向遠程醫療以獲得全面服務的營銷推動嗎？

And -- or do you see that really driving more from the provider side?

而且 - 或者您是否認為這真的從供應商方面推動了更多？

Yes.

是的。

So Charles, I appreciate the question.

所以查爾斯，我很欣賞這個問題。

I think what we said in the prepared remarks was more than 15 clients and more than 1 million members.

我認為我們在準備好的評論中所說的是超過 15 個客戶和超過 100 萬會員。

And what we've always said is this is going to be a multiyear phase-in.

我們一直說的是，這將是一個多年的階段。

Our best guess going into this year was a 3-year rollout.

我們對今年的最佳猜測是推出 3 年。

I still feel pretty good about that.

對此我感覺還是不錯的。

We may not get to 100% of MA by the end of 3 years, but I think we'll get pretty close, certainly north of 80%.

到 3 年末，我們可能無法達到 100% 的 MA，但我認為我們會非常接近，肯定會超過 80%。

And this is, thus far, not really a provider-driven initiative.

到目前為止，這並不是一個真正由提供商驅動的計劃。

The reimbursement becomes tricky for a provider because they don't generally differentiate what they deliver to a consumer based on the payment mechanism.

對於供應商來說，報銷變得很棘手，因為他們通常不會根據支付機制來區分他們向消費者提供的產品。

So they don't deliver different services to an MA member than they would to a Medicare fee-for-service member and Medicare fee-for-service still doesn't pay.

因此，他們向 MA 成員提供的服務與向 Medicare 按服務收費成員提供的服務不同，而且 Medicare 按服務收費仍然不支付。

So it is really a plan-driven initiative, and we're working with our MA plans almost identically to how we work with our commercial plans but for the nuances of how we reach the consumer, what the messaging is to the consumer, and of course, the sort of overall integration with the plan from a regulatory perspective.

所以這真的是一個計劃驅動的計劃，我們使用 MA 計劃的方式幾乎與我們使用商業計劃的方式相同，但對於我們如何接觸消費者、向消費者傳達的信息以及當然，從監管的角度來看，與計劃的整體整合。

So I would call it, from a marketing perspective, this is much more sort of the plan, taking advantage of our activation capabilities.

所以我稱之為，從營銷的角度來看，這更像是一種計劃，利用我們的激活能力。

Your next question is from Donald Hooker with KeyBanc.

您的下一個問題來自 KeyBanc 的 Donald Hooker。

I wanted to ask a question on the InTouch acquisition.

我想問一個關於收購 InTouch 的問題。

I know you're not willing to provide forward-looking guidance on that, but just wanted maybe a little bit of clarity.

我知道您不願意為此提供前瞻性指導，但只是想稍微清楚一點。

Kind of looking back, you mentioned that, I think, InTouch had about $80 million of revenues in 2019, so just to confirm that.

回顧一下，你提到過，我認為 InTouch 在 2019 年的收入約為 8000 萬美元，所以只是為了證實這一點。

And that revenue growth was up, I think, north of 30% year-over-year.

我認為，收入增長同比增長了 30% 以上。

Now that revenue growth up 30%, I would believe includes some acquisitions and maybe some large onetime deals or does it?

現在收入增長了 30%，我相信包括一些收購，也許還有一些大型一次性交易，或者是這樣嗎？

I mean can you maybe help us understand that sort of looking back growth that you -- at InTouch Health, how much of that is like normalized or organic?

我的意思是，您能否幫助我們了解您在 InTouch Health 的那種回顧性增長，其中有多少是正常化或有機的？

So we will give more detailed guidance upon close.

因此，我們將在關閉時提供更詳細的指導。

What I would say is we are pleased with the momentum of the business.

我想說的是，我們對業務的發展勢頭感到滿意。

As Jason mentioned in his prepared remarks, we are working pretty closely with them as we go through the integration planning phase, et cetera.

正如 Jason 在他準備好的講話中提到的那樣，我們正在與他們密切合作，因為我們正在經歷整合計劃階段等等。

What's important is that on both sides of the house, be it InTouch Health or Teladoc Health, we are laser-focused on each of our own businesses through this integration period so that we keep up the momentum we have.

重要的是，在公司的兩邊，無論是 InTouch Health 還是 Teladoc Health，在這個整合期間，我們都專注於我們自己的每一項業務，以便我們保持現有的勢頭。

That's all we'll say for now and we'll give you much more detailed guidance at the end of Q2.

這就是我們現在要說的全部內容，我們將在第二季度末為您提供更詳細的指導。

Your next question is from George Hill with Deutsche Bank.

您的下一個問題來自德意志銀行的 George Hill。

Jason, I was hoping to revisit the Medicare Advantage topic a little bit more.

傑森，我希望再重新審視一下 Medicare Advantage 話題。

You mentioned more than 15 clients in the more than 1 million-plus members.

您提到超過 100 萬會員中有超過 15 個客戶。

I guess can you talk about kind of the broader selling environment?

我想你能談談更廣泛的銷售環境嗎？

Can you maybe -- win rate or how many RFPs you've seen in MA?

你能不能——勝率或你在 MA 看到過多少 RFP？

I know it's a little early to talk about utilization in the book, and I imagine this is going to be one of the targets for a chronic care delivery model as you guys think about the engagement strategy.

我知道現在談論本書中的利用率還為時過早，我想這將成為你們考慮參與策略時慢性護理提供模式的目標之一。

I know we touched on it a bit, but just kind of thinking of those topics.

我知道我們談到了一點，但只是想這些話題。

Would love any more color you could put around the MA opportunity.

希望您可以在 MA 機會周圍提供更多顏色。

Yes.

是的。

Thanks, George.

謝謝，喬治。

I understand your interest there.

我理解你對那裡的興趣。

We haven't and generally don't break down win rates or RFP volume by sort of subsector of the market.

我們沒有也通常不會按市場子行業細分贏率或 RFP 數量。

I think we'll continue that.

我想我們會繼續這樣做。

I will say that we have a very robust continuing pipeline in that area.

我會說我們在該領域擁有非常強大的持續管道。

And as I think I said, last quarter, we expect the MA plans to roll out over the course of the year.

正如我想我在上個季度所說的那樣，我們預計 MA 計劃將在今年推出。

Many filed for it and have sort of place marker for it in their bids to CMS and haven't yet rolled it out into the market.

許多人申請了它，並在他們對 CMS 的競標中為其提供了某種位置標記，但尚未將其推向市場。

So I think you're going to see that, that continues to roll out and expand over the course of the year.

所以我認為你會看到這一點，它會在一年中繼續推出和擴展。

This was not a one-and-done sort of big bang January 1 season for that.

這不是 1 月 1 日一季的大爆炸。

Your next question is from Matt Hewitt with Craig-Hallum Capital.

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

Just a follow-up on coronavirus.

只是對冠狀病毒的跟進。

I'm curious if you have factored any tailwind from that into your guidance.

我很好奇您是否將任何順風因素納入您的指導。

And I guess kind of tangentially, you mentioned that you've been in close contact with the U.S. regulators, the CDC.

我猜有點切題，你提到你一直與美國監管機構疾病預防控制中心保持密切聯繫。

Have you also had contacts with international agencies?

您是否也與國際機構有過接觸？

So let me take the first part, then turn it to Jason.

所以讓我先講第一部分，然後交給傑森。

We have not included the impact of that in our forward-looking guidance, as Jason mentioned and Lew did as well.

正如 Jason 和 Lew 提到的那樣，我們沒有將其影響納入我們的前瞻性指導。

It's too early for us to know which scenarios will transpire.

我們現在知道會發生哪些情況還為時過早。

And so for now, we have not included it in our forward-looking guidance.

因此，目前，我們尚未將其包含在我們的前瞻性指導中。

And we have been in touch with a number of the international agencies.

我們已經與許多國際機構保持聯繫。

Specifically, we've been in touch with the WHO.

具體來說，我們一直與世界衛生組織保持聯繫。

And as Lew mentioned, we have a global network of medical directors who have been actively involved locally in their markets.

正如 Lew 所提到的，我們擁有一個全球醫療主管網絡，他們一直積極參與當地市場。

So this is a situation where our global presence really enables us to work collaboratively amongst ourselves.

因此，在這種情況下，我們的全球業務確實使我們能夠相互協作。

And so as our U.S. team interacts, for example, with the CDC, we're able to proliferate that information around the world and similarly, gather the information from the WHO or from local health authorities in market.

因此，例如，當我們的美國團隊與 CDC 互動時，我們能夠在世界範圍內傳播這些信息，並且類似地，從 WHO 或市場上的當地衛生當局那裡收集信息。

As you know, we have a presence in China and have for some time.

如您所知，我們在中國已經有一段時間了。

And so that gives us the ability to have information flow to and from that market and to the rest of our clinical network.

因此，這使我們能夠讓信息流進出該市場以及我們的臨床網絡的其他部分。

Your next question is from Kevin Caliendo with UBS.

您的下一個問題來自瑞銀的 Kevin Caliendo。

This is Adam Noble in for Kevin.

這是凱文的亞當諾布爾。

I just wanted to ask around the PMPM rate.

我只是想問一下 PMPM 費率。

Obviously, the 4Q number heavily impacted by the United implementation.

顯然，第四季度的數字受到聯合實施的嚴重影響。

Just any thoughts on how PMPM should look next year.

只是對 PMPM 明年應該如何看待的任何想法。

Should there be a more typical seasonal ramp throughout the year?

全年是否應該有一個更典型的季節性斜坡？

Or does the UNH implementation to some of your other contracts, could that dampen it somewhat?

或者 UNH 對您的其他一些合同的實施是否會有所抑制？

Yes.

是的。

Thanks for the question.

謝謝你的問題。

Absent the impact of the large population onboarding, we will -- we expect to see PMPM continue to grow in 2020.

如果沒有大量人口入職的影響，我們將——我們預計 PMPM 將在 2020 年繼續增長。

And what I would say is we have, typically, again, talked about PMPM growing in the -- expanding in the $0.05 to $0.10 range.

我想說的是，我們通常會再次談到 PMPM 的增長——在 0.05 美元到 0.10 美元的範圍內增長。

And I would continue to expect PMPM to grow in that range, again normalized for the impact of the large onboarding of populations.

我將繼續預計 PMPM 將在該範圍內增長，再次針對大量人口入職的影響進行標準化。

Your next question is from Allen Lutz with Bank of America Merrill Lynch.

您的下一個問題來自美銀美林的 Allen Lutz。

On behavioral health, can you talk about the demand on the B2B side?

關於行為健康，您能談談 B2B 方面的需求嗎？

And then how much is that contributing to multiproduct bookings?

那麼這對多產品預訂有多大貢獻？

Yes.

是的。

So it's our strongest driver of multiproduct bookings.

所以它是我們多產品預訂的最強大驅動力。

There's significant demand.

需求量很大。

We saw both demand from a B2B client perspective as well as behavioral health visits coming through that channel increase substantially in 2019, and we would expect to continue to see that into 2020.

我們從 B2B 客戶的角度看到需求以及通過該渠道進行的行為健康訪問在 2019 年大幅增加，我們預計到 2020 年將繼續看到這種情況。

And multiproduct bookings has been a significant driver of our revenue growth.

多產品預訂一直是我們收入增長的重要推動力。

50% of our 2019 bookings were multiproduct bookings.

我們 2019 年的預訂中有 50% 是多產品預訂。

And multiproduct sales were, on average, 50% larger than single product sales.

平均而言，多產品銷售額比單產品銷售額高 50%。

So -- and again, behavioral health is the single biggest driver of that.

所以——再一次，行為健康是最大的驅動力。

Your next question is from Jonathan Yong with Barclays.

您的下一個問題來自巴克萊銀行的 Jonathan Yong。

Just on the member guidance.

就在會員指導上。

I'm curious sort of new members that you're adding, are they single products, largely multiproduct?

我很好奇您要添加的新成員，它們是單一產品還是多產品？

Do you have full marketing capability to these members?

你對這些成員有完整的營銷能力嗎？

Just any color there would be helpful.

任何顏色都會有幫助。

Yes.

是的。

So about 50% of our bookings were multiproducts for 2019.

因此，我們約 50% 的預訂是 2019 年的多產品。

And we're -- a long time ago, many years ago, when we were sort of scraping for any business that we could get, we would say yes to a deal where we weren't able to actively market or collaborate for the marketing with our clients.

而且我們 - 很久以前，很多年前，當我們在某種程度上爭取我們可以獲得的任何業務時，我們會同意我們無法積極營銷或合作進行營銷的交易與我們的客戶。

We generally walk away from those now, just there's not -- it's not worth it for us to go through the implementation in the event that there's not a real activation strategy.

我們現在通常會放棄這些，只是沒有——如果沒有真正的激活策略，我們不值得進行實施。

And to be honest, most of our clients engage with us and are willing to pay a higher price because of our engagement capabilities because it drives more value and return on investment for them.

老實說，我們的大多數客戶與我們合作並願意支付更高的價格，因為我們的合作能力為他們帶來了更多的價值和投資回報。

Your next question is from David Windley with Jefferies.

您的下一個問題來自 Jefferies 的 David Windley。

Kind of a related question, your member add guidance is quite attractive on the paid U.S. side.

一個相關的問題，您的會員添加指南在付費美國方面非常有吸引力。

Your visit fee only lies relatively flat.

您的參觀費只是相對平穩。

Is that now a reflection that your pipeline, your potential customers are kind of fully bought in on the PMPM model?

現在這是否反映了您的管道和潛在客戶已經完全接受了 PMPM 模型？

And those are the kind of exclusively the discussions you're having these days?

這些是你最近進行的專門討論嗎？

Or is it perhaps idiosyncratic to the particular pipeline at this point in time?

或者在這個時間點對特定的管道可能是特殊的？

Yes.

是的。

It's a good insight.

這是一個很好的洞察力。

I would flip it around a little bit and say the visit fee only clients are anomalous.

我會稍微翻轉一下，並說只有客戶的訪問費是異常的。

So they're just -- each one of the handful of them is a unique, very large client, and therefore, not representative of the overall trends.

所以他們只是——他們中的每一個都是一個獨特的、非常大的客戶，因此不能代表整體趨勢。

Conversely, your statement is exactly right, which is our clients understand the value that we provide and what the PMPM goes to pay for and the results that it yields.

相反，您的說法是完全正確的，即我們的客戶了解我們提供的價值以及 PMPM 所支付的費用以及它產生的結果。

And so we continue to see strong demand for that revenue model and pricing model.

因此，我們繼續看到對該收入模式和定價模式的強勁需求。

And if I look -- I can't ever say anything with absolute 100%, but I can't think of a single case in our pipeline that's a visit fee only case.

如果我看 - 我不能說任何絕對 100% 的事情，但我想不出我們管道中的單個案例是僅訪問費的案例。

Your next question is from Jailendra Singh with Crédit Suisse.

您的下一個問題來自瑞士信貸的 Jailendra Singh。

So you guys talked about some -- making some significant investments in 2020.

所以你們談到了一些——在 2020 年進行一些重大投資。

Can you elaborate more on that?

你能詳細說明一下嗎？

Are there any particular areas you are primarily focused on in 2020?

您在 2020 年主要關注哪些特定領域？

And how should we think about the impacting -- impact on your long-term EBITDA margin target of getting 20%?

我們應該如何考慮對您獲得 20% 的長期 EBITDA 利潤率目標的影響？

Any color on that?

上面有什麼顏色嗎？

Yes.

是的。

So we've given you EBITDA guidance for the full year of 2020.

因此，我們為您提供了 2020 年全年的 EBITDA 指導。

We've given you revenue guidance.

我們為您提供了收入指導。

As you can see, Jailendra, based on the guidance we have given, we are expecting a continuing expansion of adjusted EBITDA margins in 2020.

如您所見，Jailendra 根據我們提供的指導，我們預計 2020 年調整後的 EBITDA 利潤率將繼續擴大。

We had that in 2019 as well for the full year of 250 basis points.

我們在 2019 年也有這一點，全年也有 250 個基點。

We're expecting 350 basis points in 2020.

我們預計 2020 年將達到 350 個基點。

It's on the back of revenue growth as well as nice operating leverage that we expect.

這是基於我們預期的收入增長以及良好的運營槓桿。

But we will continue to invest in our business, as we said.

但正如我們所說，我們將繼續投資於我們的業務。

The investments, we will talk more about in our Investor Day next week.

投資，我們將在下週的投資者日更多地討論。

But if I were to give you just a few quick highlights of how to think about it, from an A&M and a marketing spend standpoint, you should continue to see that keep pace with revenue growth.

但是，如果我只是從 A&M 和營銷支出的角度為您提供一些快速思考的要點，您應該繼續看到它與收入增長保持同步。

And it will be invested in the kinds of things that we do today in customer acquisition in our membership marketing engine that we have.

它將投資於我們今天在我們擁有的會員營銷引擎中在客戶獲取方面所做的各種事情。

We will expect to get efficient as we spend it.

我們將期望在我們花費它時變得高效。

We are getting smarter in terms of how we manage our channel mix, et cetera.

我們在如何管理我們的渠道組合等方面變得越來越聰明。

So you should continue to see that.

所以你應該繼續看到這一點。

We will continue to make judiciously the technology investments that we need to make.

我們將繼續明智地進行我們需要進行的技術投資。

And we -- and so we will talk a little bit more about that.

我們——所以我們會多談一點。

In terms of our longer term, again, we'll speak more to that as we come on to Investor Day.

再次，就我們的長期而言，我們將在投資者日到來時更多地談論這一點。

So stay tuned.

所以請繼續關注。

And our last question comes from Brian Hoffman with Canaccord Genuity.

我們的最後一個問題來自 Canaccord Genuity 的 Brian Hoffman。

This is Brian on for Richard Close.

這是理查德·克洛斯的布萊恩。

Can you give us an update on your relationship with CVS?

您能否向我們介紹一下您與 CVS 的關係？

How many states are you in now?

你現在在幾個州？

How has the uptake in visit volume been in those states?

這些州的訪問量如何？

And any other commentary you may have on how that rollout is progressing would be great.

您可能對部署的進展情況發表任何其他評論都會很棒。

Sure, Brian.

當然，布賴恩。

The relationship with CVS on both sides of the house is excellent.

房子兩邊和CVS的關係很好。

Well, I personally spent quite a bit of time with them, and we're working on some really exciting strategic opportunities.

嗯，我個人花了很多時間和他們在一起，我們正在尋找一些非常令人興奮的戰略機會。

The growth has continued every month in terms of visit volume and the trajectory is very strong, although still on the small side.

就訪問量而言，每個月都在持續增長，而且軌跡非常強勁，儘管仍然很小。

So I don't want to get over my skis in terms of impact and expectations.

所以我不想在影響和期望方面超越我的滑雪板。

But we're very pleased with the trajectory that that's on.

但我們對目前的發展軌跡感到非常滿意。

We're currently in 39 states plus D.C. with them, and we look forward to the continued rollout to all 50 states.

我們目前在 39 個州和華盛頓特區與他們一起工作，我們期待繼續向所有 50 個州推出。

Ladies and gentlemen, this does conclude the Q&A and today's conference call.

女士們先生們，問答環節和今天的電話會議到此結束。

We do thank you for your participation.

我們非常感謝您的參與。

And at this time, you may now disconnect.

此時，您現在可以斷開連接。